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CPT code 21034: Tumor excision, malignant, maxilla or zygoma2026 Medicare rate & RVUs in North Carolina

Report this service when a surgeon excises a malignant tumor arising in the maxilla or zygoma, rather than a benign lesion or a tumor at another jaw site.

CMS RVU26DEffective Oct 1, 2026One payment locality163 Medicare services in 2024

In North Carolina, Medicare pays $1,231.55 for 21034 in the office and $935.18 when it’s performed in a hospital or facility.

$1,231.55Office (non-facility)
$935.18Hospital or facility
−5.7%vs the national office rate ($1,305.64)

Check a contract rate as a % of Medicare · 21034 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21034 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 21034 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 21034 covers

This service covers surgical excision of a malignant tumor involving the maxilla, or upper jaw, or the zygoma, the cheekbone. It is typically performed in an operating room by an oral and maxillofacial surgeon, head and neck surgeon, or another surgeon treating facial bone malignancy. The operative approach and tissue removed depend on the tumor’s location and extent; the code is specific to the malignant tumor site, not simply any procedure on facial bone.

Choose this code when the operative report supports a malignant tumor of the maxilla or zygoma and documents the excision performed. A benign tumor at those sites points to 21030; a malignant mandibular tumor belongs to a different code family. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this descriptor and anatomy.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How North Carolina compares for 21034

Across 109 of 109 payment localities, the office rate for 21034 runs from $1,172.65 in Arkansas to $1,619.12 in San Benito County, CA. North Carolina pays $1,231.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

21034 in North Carolina vs other payment areas
  1. North Carolina · this page$1,231.55
  2. Los Angeles, CA · California$1,420.84+$189.29
  3. Washington, DC area · District of Columbia$1,462.42+$230.87
  4. Miami, FL · Florida$1,460.21+$228.66
  5. Chicago, IL · Illinois$1,421.02+$189.47
  6. Manhattan, NY · New York$1,497.08+$265.53
  7. Alaska · Alaska$1,593.86+$362.31

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

21034 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,187.40$909.46
ArkansasArkansas$1,172.65$899.79
ArizonaArizona$1,273.28$965.49
Bakersfield, CACalifornia$1,346.72$998.59
Chico, CACalifornia$1,339.50$991.36
El Centro, CACalifornia$1,339.91$991.78
Fresno, CACalifornia$1,339.50$991.36
Hanford, CACalifornia$1,339.50$991.36

21034 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$1,172.65

$1,593.86

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
21034 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,593.861
AL$1,187.401
AR$1,172.651
AZ$1,273.281
CA$1,339.50–$1,619.1229
CO$1,336.131
CT$1,385.011
DC$1,462.421
DE$1,292.171
FL$1,318.78–$1,460.213
GA$1,250.83–$1,334.622
GU$1,360.361
HI$1,360.361
IA$1,199.531
ID$1,209.161
IL$1,295.58–$1,421.024
IN$1,214.831
KS$1,201.251
KY$1,225.731
LA$1,226.69–$1,278.292
MA$1,332.52–$1,446.932
MD$1,312.33–$1,462.423
ME$1,221.60–$1,268.922
MI$1,259.34–$1,339.962
MN$1,265.881
MO$1,212.94–$1,274.323
MS$1,192.661
MT$1,305.471
NC$1,231.551
ND$1,256.041
NE$1,203.191
NH$1,322.101
NJ$1,396.74–$1,451.952
NM$1,267.981
NV$1,292.351
NY$1,248.04–$1,537.425
OH$1,249.241
OK$1,216.831
OR$1,278.22–$1,366.142
PA$1,247.26–$1,358.842
PR$1,311.601
RI$1,329.031
SC$1,243.261
SD$1,250.201
TN$1,207.281
TX$1,240.67–$1,336.988
UT$1,257.761
VA$1,269.94–$1,462.422
VI$1,311.601
VT$1,257.831
WA$1,327.81–$1,467.582
WI$1,220.311
WV$1,255.701
WY$1,283.931

See 21034 in every payment locality

How the 21034 rate is calculated

Each of 21034’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 21034

RVUs × geographic indexes × conversion factor

Office or facility?

Work16.95

16.95 RVUs× 1.000 GPCI

Practice expense19.64

19.64 RVUs× 1.000 GPCI

Malpractice2.50

2.50 RVUs× 1.000 GPCI

Adjusted RVUs

39.0900

Conversion factor

$33.4009

Medicare rate

$1,305.64

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,849

Code
21034
Physician work
16.95
Practice expense
19.64
Malpractice
2.50

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 21034 in North Carolina
ComponentRVULocality factorAdjusted
Physician work16.95× 1.00016.9500
Practice expense19.64× 0.93318.3241
Malpractice2.50× 0.6391.5975
Total RVUs36.8716
Conversion factor× 33.4009

Office rate, North Carolina$1231.55

Office: (16.95 × 1 + 19.64 × 0.933 + 2.5 × 0.639) × $33.4009 = $1231.55

Facility: (16.95 × 1 + 10.13 × 0.933 + 2.5 × 0.639) × $33.4009 = $935.18

Open 21034 in the RVU calculator

Payment rules and modifiers for 21034

21034 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21034

Tumor excision, malignant, maxilla or zygoma

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21034

Tumor excision, malignant, maxilla or zygoma

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21034 without 51 · national office

$1,305.64

Tumor excision, malignant, maxilla or zygoma

21034-51 · Second procedure: 50%

$652.82

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 21034

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21034
CodeHow it relatesOffice range, North Carolina
Same family
21030Bone lesion excision, maxilla or zygoma, benignCovers benign tumor or cyst excision at the maxilla or zygoma.$449.00
Used instead
21044Jaw tumor excision, mandible, intraoral approachUsed for malignant tumor excision at the mandible rather than the maxilla or zygoma.No office rate
21026Facial bone excision, one or more facial bonesDescribes excision of facial bone when the specific malignant maxillary or zygomatic tumor service is not represented.$542.64

How 21034 has changed in North Carolina

21034 · Office / nonfacility

$1231.55

Effective 2026-10-01

The base rate is $41.40 higher than on 2025-10-01, moving from $1190.15 to $1231.55 (3.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $1190.15changed to$1231.55

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 17.38 changed to 16.95
    • Practice expense RVU 19.22 changed to 19.64
    • Malpractice RVU 2.43 changed to 2.50
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1223.93changed to$1190.15

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 19.20 changed to 19.22
    • Malpractice RVU 2.42 changed to 2.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1203.96changed to$1223.93

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1249.93changed to$1203.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 19.12 changed to 19.20
    • Malpractice RVU 2.40 changed to 2.42
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $1272.34changed to$1249.93

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 18.79 changed to 19.12
    • Malpractice RVU 2.38 changed to 2.40
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1275.23changed to$1272.34

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 18.58 changed to 18.79
    • Malpractice RVU 2.35 changed to 2.38

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1278.80changed to$1275.23

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 17.50 changed to 18.58
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1278.38changed to$1278.80

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 17.41 changed to 17.50
    • Malpractice RVU 2.71 changed to 2.35
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1271.80changed to$1278.38

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 17.30 changed to 17.41
    • Malpractice RVU 2.65 changed to 2.71

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1289.27changed to$1271.80

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 17.78 changed to 17.30
    • Malpractice RVU 2.72 changed to 2.65
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1292.61changed to$1289.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 17.91 changed to 17.78
    • Malpractice RVU 2.69 changed to 2.72
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1300.61changed to$1292.61

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 17.96 changed to 17.91
    • Malpractice RVU 2.75 changed to 2.69

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1294.13changed to$1300.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1284.39changed to$1294.13

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 18.05 changed to 17.96
    • Malpractice RVU 2.33 changed to 2.75
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1275.39changed to$1284.39

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 19.86 changed to 18.05
    • Malpractice RVU 2.44 changed to 2.33
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1275.39

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,231.55$935.18RVU26D
2026-07-01$1,231.55$935.18RVU26C
2026-04-01$1,231.55$935.18RVU26B
2026-01-01$1,231.55$935.18RVU26A
2025-10-01$1,190.15$1,036.79RVU25D
2025-07-01$1,190.15$1,036.79RVU25C
2025-04-01$1,190.15$1,036.79RVU25B
2025-01-01$1,190.15$1,036.79RVU25A
2024-10-01$1,223.93$1,063.34RVU24D
2024-07-01$1,223.93$1,063.34RVU24C
2024-04-01$1,223.93$1,063.34RVU24B
2024-03-09$1,223.93$1,063.34RVU24AR
2024-01-01$1,203.96$1,045.98RVU24A
2023-10-01$1,249.93$1,085.95RVU23D
2023-07-01$1,249.93$1,085.95RVU23C
2023-04-01$1,249.93$1,085.95RVU23B
2023-01-01$1,249.93$1,085.95RVU23A
2022-10-01$1,272.34$1,105.03RVU22D
2022-07-01$1,272.34$1,105.03RVU22C
2022-04-01$1,272.34$1,105.03RVU22B
2022-01-01$1,272.34$1,105.03RVU22A
2021-10-01$1,275.23$1,106.85RVU21D
2021-07-01$1,275.23$1,106.85RVU21C
2021-04-01$1,275.23$1,106.85RVU21B
2021-01-01$1,275.23$1,106.85RVU21A
2020-10-01$1,278.80$1,124.07RVU20D
2020-07-01$1,278.80$1,124.07RVU20C
2020-04-01$1,278.80$1,124.07RVU20B
2020-01-01$1,278.80$1,124.07RVU20A
2019-10-01$1,278.38$1,127.73RVU19D
2019-07-01$1,278.38$1,127.73RVU19C
2019-04-01$1,278.38$1,127.73RVU19B
2019-01-01$1,278.38$1,127.73RVU19A
2018-10-01$1,271.80$1,125.33RVU18D
2018-07-01$1,271.80$1,125.33RVU18C
2018-04-01$1,271.80$1,125.33RVU18B
2018-01-01$1,271.80$1,125.33RVU18AR1
2017-10-01$1,289.27$1,141.92RVU17D
2017-07-01$1,289.27$1,141.92RVU17C
2017-04-01$1,289.27$1,141.92RVU17B
2017-01-01$1,289.27$1,141.92RVU17A
2016-10-01$1,292.61$1,144.77RVU16D
2016-07-01$1,292.61$1,144.77RVU16C
2016-04-01$1,292.61$1,144.77RVU16B
2016-01-01$1,292.61$1,144.77RVU16A
2015-10-01$1,300.61$1,150.56RVU15D
2015-07-01$1,300.61$1,150.56RVU15C
2015-04-01$1,294.13$1,144.83RVU15B
2015-01-01$1,294.13$1,144.83RVU15A
2014-10-01$1,284.39$1,137.63RVU14D
2014-07-01$1,284.39$1,137.63RVU14C
2014-04-01$1,284.39$1,137.63RVU14B
2014-01-01$1,284.39$1,137.63RVU14A
2013-10-01$1,275.39$1,119.90RVU13D
2013-07-01$1,275.39$1,119.90RVU13C
2013-04-01$1,275.39$1,119.90RVU13B
2013-01-01$1,275.39$1,119.90RVU13AR

Price 21034 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

21034 billing questions

How does this differ from 21030?

Both codes concern the maxilla or zygoma, but 21034 is for a malignant tumor. Code 21030 describes excision of a benign tumor or cyst at those sites.

Can I use 21034 for a malignant mandibular tumor?

No. This code is limited to the maxilla or zygoma; a malignant tumor of the mandible is represented by a different code, such as 21044.

What documentation supports reporting 21034?

The operative report should identify the maxilla or zygoma as the tumor site and describe the excision. The record should also support that the tumor is malignant.

Is modifier 50 appropriate for bilateral work?

No. CMS identifies modifier 50 as inappropriate for this descriptor and anatomy.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 21034PPRRVU2026_Oct_nonQPP.csv, line 1,849 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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