CPT code 21046: Mandibular lesion excision, intraoral osteotomy required2026 Medicare rate & RVUs in Barrington, Illinois

CPT 21046: $958.32–$980.74 facility across 2 localities in Barrington, IL in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20262 payment localities

CMS doesn’t publish an office rate for 21046 in Barrington, Illinois.

—Office (non-facility)

$958.32–$980.74Hospital or facility

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

On this page 6 sections

Rate in Barrington, Illinois
By payment locality
City and payment areas
How it’s calculated
Payment rules
Sources

Where 21046 pays more and less in Barrington, Illinois

Barrington, Illinois maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

21046 office and facility rates by payment locality
Payment locality	Office	Facility
Chicago, IL	Unavailable	$980.74
Suburban Chicago, IL	Unavailable	$958.32

How payment areas work in Barrington

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

Chicago · Cook County
Suburban Chicago · Lake County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 21046 rate is calculated

Each of 21046’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 · 21046

RVUs × geographic indexes × conversion factor

Office or facility?

Your ZIP

Work13.85

13.85 RVUs× 1.000 GPCI

Practice expense11.32

11.32 RVUs× 1.000 GPCI

Malpractice1.76

1.76 RVUs× 1.000 GPCI

Adjusted RVUs

26.9300

Conversion factor

$33.4009

Medicare rate

$899.49

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

Payment rules and modifiers for 21046

21046 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21046

Mandibular lesion excision, intraoral osteotomy required

Rule	CMS value	What it means
Global period	090	Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures	2	Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)	0	The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)	0	Not paid without supporting documentation.
Co-surgeons (62)	1	Permitted with supporting documentation.
Team surgery (66)	0	Not permitted.
Professional/technical	0	Physician service: no professional/technical split.
Split (54/55/56)	0.10/0.69/0.21	Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21046

Mandibular lesion excision, intraoral osteotomy required

Date of surgery

Date of a later visit

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

21046 without 51 · national facility

$899.49

Mandibular lesion excision, intraoral osteotomy required

21046-51 · Second procedure: 50%

$449.75

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

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 21046PPRRVU2026_Oct_nonQPP.csv, line 1,853 (RVU26D)

1,85021040,,[CPT descriptor omitted],A,,4.79,8.99,,4.73,,0.59,14.37,10.11,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,85121044,,[CPT descriptor omitted],A,,12.48,8.57,NA,8.57,,1.85,22.90,22.90,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,85221045,,[CPT descriptor omitted],A,,17.91,11.15,NA,11.15,,2.71,31.77,31.77,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,85321046,,[CPT descriptor omitted],A,,13.85,11.32,NA,11.32,,1.76,26.93,26.93,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,85421047,,[CPT descriptor omitted],A,,19.57,10.05,NA,10.05,,2.61,32.23,32.23,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,85521048,,[CPT descriptor omitted],A,,14.34,11.05,NA,11.05,,1.76,27.15,27.15,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,85621049,,[CPT descriptor omitted],A,,18.84,9.27,NA,9.27,,2.46,30.57,30.57,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Open CMS source How we calculate rates

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Where 21046 pays more and less in Barrington, Illinois

How payment areas work in Barrington

How the 21046 rate is calculated

Payment rules and modifiers for 21046

What modifiers do to the payment

Where these rates come from

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