CPT code 21047: Jaw cyst excision, lower jaw, intraoral approach2026 Medicare rate & RVUs

Medicare pays $1,076.51 for 21047 nationally in a facility.

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

What 21047 covers

This service removes a benign cyst or tumor arising in the mandible when removal requires an osteotomy performed through the mouth, extraction of a tooth, or both. The surgeon also repairs the operative site. Oral and maxillofacial surgeons commonly perform the procedure in an ambulatory surgery center or hospital; selected cases may be performed in an office setting. The operative report should identify the mandibular lesion and document the intraoral approach, bone work, any tooth extraction, and repair.

Report this code when the required intraoral osteotomy or tooth extraction distinguishes the operation from simpler enucleation and curettage. The repair associated with the excision is part of the service. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in its 90-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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 service.

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.

Where 21047 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21047 rates by state

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

How the 21047 rate is calculated

Each of 21047’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 21047

21047 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

21047 compared with similar codes

How to choose

21040Mandibular lesion excisionIntraoral approach

21040 describes enucleation and curettage of a benign jaw lesion. Choose 21047 when the mandibular operation requires intraoral osteotomy, tooth extraction, or both.

21046Mandibular lesion excisionIntraoral osteotomy required

21046 involves an extraoral approach and partial mandibulectomy for a benign mandibular lesion; 21047 describes the intraoral operation.

21048Maxillary excisionExtraoral approach, partial maxillectomy

21048 applies to a benign cyst or tumor of the maxilla. This code is for a lesion of the mandible.

21049Maxillary cyst excisionWith extraoral approach and repair

21049 is the related upper-jaw cyst procedure with repair. Use this code for the corresponding lower-jaw service.

Codes related to 21047

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

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