CPT code 21040: Mandibular lesion excision, intraoral approach2026 Medicare rate & RVUs in Iowa

In Iowa, Medicare pays $442.56 for 21040 in the office and $312.37 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 21040 nationwide

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

What 21040 covers

CPT 21040 describes removal of a benign tumor or cyst from the mandible through an intraoral approach. Oral and maxillofacial surgeons and other surgeons with appropriate training may perform it in an office, ambulatory surgery center, or hospital operating room. The operative work may involve incising oral mucosa, exposing the mandibular lesion, removing it, and closing the site. The code is for a benign lesion, not a malignant jaw tumor or an exostosis.

Select the code based on the documented lesion, mandibular site, and intraoral route; distinguish it from procedures that require osteotomy, address a different jaw, or remove bone for another indication. The operative report should describe the lesion and approach, the removal performed, and any relevant pathology. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

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 Iowa compares for 21040

Across 109 of 109 payment localities, the office rate for 21040 runs from $428.07 in Arkansas to $621.15 in San Benito County, CA. Iowa pays $442.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

21040 rates by state

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

See 21040 in every payment locality

How the 21040 rate is calculated

Each of 21040’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.

Payment rules and modifiers for 21040

21040 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 21040

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

How 21040 has changed in Iowa

Price 21040 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

• Ackley
• Ackworth
• Adair
• Adel
• Afton
• Agency
• Ainsworth
• Akron

Browse all communities in Iowa

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

Open CMS sourceHow we calculate rates