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Billing code 21045: Mandible tumor resectionMedicare rate & RVUs

Report this service for extensive surgical removal of a malignant mandibular tumor when the operative work requires a broad resection of jaw bone.

CMS RVU26DEffective Oct 1, 2026109 payment localities458 Medicare services in 2024

Medicare pays $1,061.15 for 21045 nationally in a facility.

Medicare rate · 21045

Mandible tumor resection

Swap in your local Medicare rate.

Work RVUs
17.91
Total RVUs
31.77
Global days
090

National rate · 2026

$1,061.15

Facility setting, before claim adjustments.

See every locality for 21045 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 21045 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21045 covers

An oral and maxillofacial surgeon or head and neck surgeon performs this operation to remove a malignant tumor of the mandible when the required bone resection is extensive. It is typically performed in an operating room as part of cancer treatment. The operative report should identify the tumor site, the extent of mandibular bone removed, and the surgical approach; pathology findings support the malignant diagnosis.

Choose this code based on the documented extent of resection, not simply the tumor’s size or the fact that it is malignant. The less extensive malignant mandible resection code is a closer fit when the operative work does not reach this level. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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.

Where 21045 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

21045 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$975.31
Alaska*Unavailable$1,343.82
ArizonaUnavailable$1,036.57
ArkansasUnavailable$964.73
AtlantaUnavailable$1,087.09
AustinUnavailable$1,073.62
BakersfieldUnavailable$1,072.87
Baltimore/Surr. CntysUnavailable$1,119.36
BeaumontUnavailable$1,021.20
BrazoriaUnavailable$1,042.67

21045 rates by state

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

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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
21045 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

How the 21045 rate is calculated

Each of 21045’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 · 21045

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.91Practice expense 11.15Malpractice 2.71

31.7700 adjusted RVUs×$33.4009 conversion factor=$1,061.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 21045

21045 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21045

Mandible tumor resection

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)2Paid.
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 · 21045

Mandible tumor resection

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

21045 without 51 · national facility

$1,061.15

Mandible tumor resection

21045-51 · Second procedure: 50%

$530.58

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

21045 compared with similar codes

Compare codes

21045 vs 21044 vs 21040 vs 21025 vs 21034: national Medicare rates

Swap in your local Medicare rate.

  • 21045
    Mandible tumor resection · 17.91 wRVU
    —
  • 21044
    Jaw tumor excision · 12.48 wRVU
    —
  • 21040
    Mandibular lesion excision · 4.79 wRVU
    $479.97
  • 21025
    Bone excision · 9.78 wRVU
    $840.03
  • 21034
    Tumor excision · 16.95 wRVU
    $1,305.64

How to choose

21044Jaw tumor excision
Both address malignant tumors of the mandible. Choose 21045 when the documented bone removal is extensive; 21044 represents the less extensive resection.
21040Mandibular lesion excision
This code is for a benign mandibular tumor or cyst. A malignant mandibular tumor requiring extensive resection points to 21045.
21025Bone excision
21025 describes excision of mandibular bone, while 21045 is specific to extensive resection for a malignant mandibular tumor.
21034Tumor excision
21034 applies to malignant tumors of the maxilla or zygoma. Use 21045 for the corresponding extensive malignant tumor resection in the mandible.

Codes related to 21045

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

Codes related to 21045
CodeHow it relatesNational office range
Same family
21044Jaw tumor excisionMalignant mandible tumor excision for a less extensive resection.No office rate
Used instead
21040Mandibular lesion excisionFor a benign mandibular tumor or cyst rather than a malignant tumor.$428.07–$621.15
21025Bone excisionFor mandibular bone excision when the malignant-tumor resection service is not appropriate.$752.60–$1,063.23
21034Tumor excisionMalignant tumor excision involving the maxilla or zygoma rather than the mandible.$1,172.65–$1,619.12

21045 billing questions

How is this different from 21044?

Use 21045 when the operative report supports the more extensive mandibular resection. Use 21044 for the less extensive malignant mandible tumor excision.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code based on its descriptor or anatomy.

What postoperative care is included?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

What documentation supports choosing this code?

Document the malignant diagnosis, mandibular site, and the extent of bone removed. The operative details should substantiate why the resection was extensive rather than the less extensive service.

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 21045PPRRVU2026_Oct_nonQPP.csv, line 1,852 (RVU26D)

Open CMS sourceHow we calculate rates

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