CPT code 21047: Jaw cyst excision, lower jaw, intraoral approach2026 Medicare rate & RVUs in Illinois
Removal and repair of a benign mandibular cyst or tumor when intraoral osteotomy, tooth extraction, or both are required.
CMS doesn’t publish an office rate for 21047 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $1,195.66 |
| East St. Louis, IL | Unavailable | $1,138.05 |
| Rest of Illinois | Unavailable | $1,096.39 |
| Suburban Chicago, IL | Unavailable | $1,157.45 |
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.
How the rate is built · 21047
RVUs × geographic indexes × conversion factor
Work19.57
19.57 RVUs× 1.000 GPCI
Practice expense10.05
10.05 RVUs× 1.000 GPCI
Malpractice2.61
2.61 RVUs× 1.000 GPCI
Adjusted RVUs
32.2300
Conversion factor
$33.4009
Medicare rate
$1,076.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21047
21047 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21047
Jaw cyst excision, lower jaw, intraoral approach
| 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) | 2 | Paid. |
| 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 · 21047
Jaw cyst excision, lower jaw, intraoral approach
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21047 without 51 · national facility
$1,076.51
Jaw cyst excision, lower jaw, intraoral approach
21047-51 · Second procedure: 50%
$538.26
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%).
21047 compared with similar codes
Compare codes · National
5 codes, side by side
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.
21047 billing questions
When should this code be selected instead of 21040?
Use this code when removal of a mandibular cyst or benign tumor requires intraoral osteotomy, tooth extraction, or both. Code 21040 describes removal by enucleation and curettage.
How does this differ from 21046?
Both concern a benign mandibular lesion, but 21046 is for cases requiring an extraoral osteotomy and partial mandibulectomy. This code describes the intraoral approach with osteotomy, tooth extraction, or both.
Is repair separately reported?
The repair associated with removing the lesion is included in this service. Document the repair in the operative report.
What documentation supports reporting this code?
Document the mandibular lesion, the intraoral approach, the osteotomy and/or tooth extraction required for removal, and the repair performed.
How does the Medicare global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
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
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