CPT code 21048: Maxillary excision, extraoral approach, partial maxillectomy2026 Medicare rate & RVUs in South Dakota

Reports removal of a complex benign cyst or tumor from the maxilla when an extraoral approach, osteotomy, and partial maxillectomy are performed.

CMS RVU26DEffective Oct 1, 2026One payment locality789 Medicare services in 2024

In South Dakota, Medicare pays $867.80 for 21048 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$867.80Hospital or facility

Check a contract rate as a % of Medicare · 21048 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 21048 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 21048 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 21048 covers

This service removes a complex benign cyst or tumor from the upper jaw through an external approach, with bone division and partial removal of the maxilla. Oral and maxillofacial surgeons commonly perform it for extensive maxillary lesions, including an odontogenic cyst when its extent requires this operation. The operative report should identify the lesion and site and describe the external approach, osteotomy, and partial maxillectomy performed.

Choose this code based on the documented approach and extent of bone removal, not simply the presence of a cyst or tumor. A less extensive lesion treated by enucleation and curettage may fit 21040; an intraoral operation of this extent is represented by 21049. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is not appropriate for this service. Assistant-at-surgery payment requires documented medical necessity, co-surgeon payment requires supporting documentation, and team surgery is 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 South Dakota compares for 21048

Across 109 of 109 payment localities, the facility rate for 21048 runs from $826.28 in Arkansas to $1,143.91 in Alaska. South Dakota pays $867.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

21048 in South Dakota vs other payment areas
  1. South Dakota · this page$867.80
  2. Los Angeles, CA · California$974.26+$106.46
  3. Washington, DC area · District of Columbia$1,005.04+$137.24
  4. Miami, FL · Florida$1,011.85+$144.05
  5. Chicago, IL · Illinois$988.16+$120.36
  6. Manhattan, NY · New York$1,031.73+$163.93
  7. Alaska · Alaska$1,143.91+$276.11

Other areas in South Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

21048 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$835.19
ArkansasArkansas—$826.28
ArizonaArizona—$886.93
Bakersfield, CACalifornia—$928.38
Chico, CACalifornia—$923.13
El Centro, CACalifornia—$923.43
Fresno, CACalifornia—$923.13
Hanford, CACalifornia—$923.13

21048 rates by state

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

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.

View every state and territory as a table
21048 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 21048 in every payment locality

How the 21048 rate is calculated

Each of 21048’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 · 21048

RVUs × geographic indexes × conversion factor

Office or facility?

Work14.34

14.34 RVUs× 1.000 GPCI

Practice expense11.05

11.05 RVUs× 1.000 GPCI

Malpractice1.76

1.76 RVUs× 1.000 GPCI

Adjusted RVUs

27.1500

Conversion factor

$33.4009

Medicare rate

$906.83

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

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,855

Code
21048
Physician work
14.34
Practice expense
11.05
Malpractice
1.76

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Facility calculation for 21048 in South Dakota
ComponentRVULocality factorAdjusted
Physician work14.34× 1.00014.3400
Practice expense11.05× 1.00011.0500
Malpractice1.76× 0.3360.5914
Total RVUs25.9814
Conversion factor× 33.4009

Facility rate, South Dakota$867.80

Facility: (14.34 × 1 + 11.05 × 1 + 1.76 × 0.336) × $33.4009 = $867.80

Open 21048 in the RVU calculator

Payment rules and modifiers for 21048

21048 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21048

Maxillary excision, extraoral approach, partial maxillectomy

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)0Not paid without supporting documentation.
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 · 21048

Maxillary excision, extraoral approach, partial maxillectomy

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

21048 without 51 · national facility

$906.83

Maxillary excision, extraoral approach, partial maxillectomy

21048-51 · Second procedure: 50%

$453.42

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

How 21048 has changed in South Dakota

21048 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$867.80RVU26D
2026-07-01Not available in this setting$867.80RVU26C
2026-04-01Not available in this setting$867.80RVU26B
2026-01-01Not available in this setting$867.80RVU26A
2025-10-01Not available in this setting$945.91RVU25D
2025-07-01Not available in this setting$945.91RVU25C
2025-04-01Not available in this setting$945.91RVU25B
2025-01-01Not available in this setting$945.91RVU25A
2024-10-01Not available in this setting$961.70RVU24D
2024-07-01Not available in this setting$961.70RVU24C
2024-04-01Not available in this setting$961.70RVU24B
2024-03-09Not available in this setting$961.70RVU24AR
2024-01-01Not available in this setting$946.00RVU24A
2023-10-01Not available in this setting$975.23RVU23D
2023-07-01Not available in this setting$975.23RVU23C
2023-04-01Not available in this setting$975.23RVU23B
2023-01-01Not available in this setting$975.23RVU23A
2022-10-01Not available in this setting$1,001.13RVU22D
2022-07-01Not available in this setting$1,001.13RVU22C
2022-04-01Not available in this setting$1,001.13RVU22B
2022-01-01Not available in this setting$1,001.13RVU22A
2021-10-01Not available in this setting$1,021.86RVU21D
2021-07-01Not available in this setting$1,021.86RVU21C
2021-04-01Not available in this setting$1,021.86RVU21B
2021-01-01Not available in this setting$1,021.86RVU21A
2020-10-01Not available in this setting$1,069.48RVU20D
2020-07-01Not available in this setting$1,069.48RVU20C
2020-04-01Not available in this setting$1,069.48RVU20B
2020-01-01Not available in this setting$1,069.48RVU20A
2019-10-01Not available in this setting$1,101.38RVU19D
2019-07-01Not available in this setting$1,101.38RVU19C
2019-04-01Not available in this setting$1,101.38RVU19B
2019-01-01Not available in this setting$1,101.38RVU19A
2018-10-01Not available in this setting$1,123.16RVU18D
2018-07-01Not available in this setting$1,123.16RVU18C
2018-04-01Not available in this setting$1,123.16RVU18B
2018-01-01Not available in this setting$1,123.16RVU18AR1
2017-10-01Not available in this setting$1,138.09RVU17D
2017-07-01Not available in this setting$1,138.09RVU17C
2017-04-01Not available in this setting$1,138.09RVU17B
2017-01-01Not available in this setting$1,138.09RVU17A
2016-10-01Not available in this setting$1,140.08RVU16D
2016-07-01Not available in this setting$1,140.08RVU16C
2016-04-01Not available in this setting$1,140.08RVU16B
2016-01-01Not available in this setting$1,140.08RVU16A
2015-10-01Not available in this setting$1,144.34RVU15D
2015-07-01Not available in this setting$1,144.34RVU15C
2015-04-01Not available in this setting$1,138.64RVU15B
2015-01-01Not available in this setting$1,138.64RVU15A
2014-10-01Not available in this setting$1,136.05RVU14D
2014-07-01Not available in this setting$1,136.05RVU14C
2014-04-01Not available in this setting$1,136.05RVU14B
2014-01-01Not available in this setting$1,136.05RVU14A
2013-10-01Not available in this setting$1,118.56RVU13D
2013-07-01Not available in this setting$1,118.56RVU13C
2013-04-01Not available in this setting$1,118.56RVU13B
2013-01-01Not available in this setting$1,118.56RVU13AR

Price 21048 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

21048 billing questions

How is 21048 distinguished from 21049?

Both represent complex maxillary lesion removal with osteotomy and partial maxillectomy. Choose 21048 for the extraoral approach and 21049 for the intraoral approach.

When would 21040 be more appropriate?

Use 21040 for a maxillary or zygomatic benign lesion treated by enucleation and curettage, rather than the more extensive osteotomy and partial maxillectomy represented by 21048.

What operative details support 21048?

Document the maxillary lesion and its location, the extraoral approach, the osteotomy, and the partial maxillectomy performed. The report should make the extent of the operation clear.

Are related postoperative visits included?

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

How are other same-session procedures handled?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity, while 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 21048PPRRVU2026_Oct_nonQPP.csv, line 1,855 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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