$475.18
Use 21040 for mandibular benign cyst or tumor removal by enucleation and curettage. Choose 21046 when the documented procedure requires intraoral osteotomy.
On this page
CMS RVU26D · Effective 2026-10-01
21046 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$891.32
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Oral and maxillofacial surgery
About 21046: Mandibular cyst or tumor excision with osteotomy
Reports removal of a benign mandibular cyst or tumor when intraoral osteotomy is required to access and excise the lesion.
This code describes operative removal of a benign cyst or tumor in the mandible when the surgeon must perform an osteotomy through an intraoral approach to reach or remove it. Oral and maxillofacial surgeons commonly perform the procedure for jaw lesions that cannot be managed by simple enucleation and curettage. The operative report should establish the lesion’s mandibular location and explain the osteotomy and excision performed.
Choose this code based on the documented surgical work and approach, not lesion size alone. A simpler enucleation-and-curettage procedure may fit 21040, while an extraoral osteotomy or resection may point to 21047. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple 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 for this code. Assistant-at-surgery and co-surgeon payment require supporting documentation; team surgery is not permitted.
CMS billing rules for 21046
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.85 · 51%
- Practice expense (office) RVU11.32 · 42%
- Malpractice RVU1.76 · 7%
850
Medicare services in 2024 · #3095 by national volume
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.
21046 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Both concern benign mandibular cysts or tumors, but 21047 describes work requiring an extraoral osteotomy and/or resection rather than the intraoral approach in 21046.
No office rate
21048 concerns a benign cyst or tumor in the maxilla requiring intraoral osteotomy; 21046 is for the mandible.
The same code, a different location
How does Delaware compare?
21046 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 21046
Office
Unavailable
Facility
$826.71
No comparable office rate is available.
Arkansas
Arkansas · 21046
Office
Unavailable
Facility
$817.66
No comparable office rate is available.
Arizona
Arizona · 21046
Office
Unavailable
Facility
$879.30
No comparable office rate is available.
Bakersfield
California · 21046
Office
Unavailable
Facility
$921.59
No comparable office rate is available.
Chico
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
El Centro
California · 21046
Office
Unavailable
Facility
$916.67
No comparable office rate is available.
Fresno
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Hanford-Corcoran
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Madera
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Merced
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Modesto
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Napa
California · 21046
Office
Unavailable
Facility
$1019.94
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 21046
Office
Unavailable
Facility
$959.09
No comparable office rate is available.
Redding
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Rest Of California
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 21046
Office
Unavailable
Facility
$935.47
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 21046
Office
Unavailable
Facility
$950.49
No comparable office rate is available.
Salinas
California · 21046
Office
Unavailable
Facility
$946.67
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 21046
Office
Unavailable
Facility
$960.55
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21046
Office
Unavailable
Facility
$1066.65
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21046
Office
Unavailable
Facility
$1064.65
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21046
Office
Unavailable
Facility
$1090.22
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21046
Office
Unavailable
Facility
$1082.04
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 21046
Office
Unavailable
Facility
$932.63
No comparable office rate is available.
Santa Cruz-Watsonville
California · 21046
Office
Unavailable
Facility
$963.22
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 21046
Office
Unavailable
Facility
$947.93
No comparable office rate is available.
Santa Rosa-Petaluma
California · 21046
Office
Unavailable
Facility
$972.29
No comparable office rate is available.
Stockton
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Vallejo
California · 21046
Office
Unavailable
Facility
$1017.06
No comparable office rate is available.
Visalia
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Yuba City
California · 21046
Office
Unavailable
Facility
$916.37
No comparable office rate is available.
Colorado
Colorado · 21046
Office
Unavailable
Facility
$916.36
No comparable office rate is available.
Connecticut
Connecticut · 21046
Office
Unavailable
Facility
$950.20
No comparable office rate is available.
Fort Lauderdale
Florida · 21046
Office
Unavailable
Facility
$951.90
No comparable office rate is available.
Rest Of Florida
Florida · 21046
Office
Unavailable
Facility
$912.42
No comparable office rate is available.
Atlanta
Georgia · 21046
Office
Unavailable
Facility
$918.74
No comparable office rate is available.
Rest Of Georgia
Georgia · 21046
Office
Unavailable
Facility
$869.94
No comparable office rate is available.
Hawaii, Guam
Hawaii · 21046
Office
Unavailable
Facility
$926.54
No comparable office rate is available.
Iowa
Iowa · 21046
Office
Unavailable
Facility
$831.90
No comparable office rate is available.
Idaho
Idaho · 21046
Office
Unavailable
Facility
$838.26
No comparable office rate is available.
East St. Louis
Illinois · 21046
Office
Unavailable
Facility
$928.85
No comparable office rate is available.
Rest Of Illinois
Illinois · 21046
Office
Unavailable
Facility
$899.69
No comparable office rate is available.
Suburban Chicago
Illinois · 21046
Office
Unavailable
Facility
$958.32
No comparable office rate is available.
Indiana
Indiana · 21046
Office
Unavailable
Facility
$841.67
No comparable office rate is available.
Kansas
Kansas · 21046
Office
Unavailable
Facility
$834.03
No comparable office rate is available.
Kentucky
Kentucky · 21046
Office
Unavailable
Facility
$852.52
No comparable office rate is available.
New Orleans
Louisiana · 21046
Office
Unavailable
Facility
$885.17
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 21046
Office
Unavailable
Facility
$853.54
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 21046
Office
Unavailable
Facility
$985.34
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 21046
Office
Unavailable
Facility
$914.99
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 21046
Office
Unavailable
Facility
$948.42
No comparable office rate is available.
Rest Of Maryland
Maryland · 21046
Office
Unavailable
Facility
$903.83
No comparable office rate is available.
Rest Of Maine
Maine · 21046
Office
Unavailable
Facility
$847.02
No comparable office rate is available.
Southern Maine
Maine · 21046
Office
Unavailable
Facility
$874.39
No comparable office rate is available.
Detroit
Michigan · 21046
Office
Unavailable
Facility
$926.58
No comparable office rate is available.
Rest Of Michigan
Michigan · 21046
Office
Unavailable
Facility
$874.18
No comparable office rate is available.
Minnesota
Minnesota · 21046
Office
Unavailable
Facility
$869.07
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 21046
Office
Unavailable
Facility
$875.07
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 21046
Office
Unavailable
Facility
$881.46
No comparable office rate is available.
Rest Of Missouri
Missouri · 21046
Office
Unavailable
Facility
$845.78
No comparable office rate is available.
Mississippi
Mississippi · 21046
Office
Unavailable
Facility
$831.59
No comparable office rate is available.
Montana**
Montana · 21046
Office
Unavailable
Facility
$899.37
No comparable office rate is available.
North Carolina
North Carolina · 21046
Office
Unavailable
Facility
$852.93
No comparable office rate is available.
North Dakota**
North Dakota · 21046
Office
Unavailable
Facility
$864.57
No comparable office rate is available.
Nebraska
Nebraska · 21046
Office
Unavailable
Facility
$833.81
No comparable office rate is available.
New Hampshire
New Hampshire · 21046
Office
Unavailable
Facility
$907.64
No comparable office rate is available.
Northern Nj
New Jersey · 21046
Office
Unavailable
Facility
$993.12
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 21046
Office
Unavailable
Facility
$958.48
No comparable office rate is available.
New Mexico
New Mexico · 21046
Office
Unavailable
Facility
$879.92
No comparable office rate is available.
Nevada**
Nevada · 21046
Office
Unavailable
Facility
$890.05
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 21046
Office
Unavailable
Facility
$1050.93
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 21046
Office
Unavailable
Facility
$968.57
No comparable office rate is available.
Queens
New York · 21046
Office
Unavailable
Facility
$1023.89
No comparable office rate is available.
Rest Of New York
New York · 21046
Office
Unavailable
Facility
$863.12
No comparable office rate is available.
Ohio
Ohio · 21046
Office
Unavailable
Facility
$867.06
No comparable office rate is available.
Oklahoma
Oklahoma · 21046
Office
Unavailable
Facility
$845.92
No comparable office rate is available.
Portland
Oregon · 21046
Office
Unavailable
Facility
$933.81
No comparable office rate is available.
Rest Of Oregon
Oregon · 21046
Office
Unavailable
Facility
$880.51
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 21046
Office
Unavailable
Facility
$934.66
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 21046
Office
Unavailable
Facility
$865.25
No comparable office rate is available.
Puerto Rico
Puerto Rico · 21046
Office
Unavailable
Facility
$902.76
No comparable office rate is available.
Rhode Island
Rhode Island · 21046
Office
Unavailable
Facility
$914.40
No comparable office rate is available.
South Carolina
South Carolina · 21046
Office
Unavailable
Facility
$861.93
No comparable office rate is available.
South Dakota**
South Dakota · 21046
Office
Unavailable
Facility
$860.45
No comparable office rate is available.
Tennessee
Tennessee · 21046
Office
Unavailable
Facility
$837.86
No comparable office rate is available.
Austin
Texas · 21046
Office
Unavailable
Facility
$915.64
No comparable office rate is available.
Beaumont
Texas · 21046
Office
Unavailable
Facility
$861.28
No comparable office rate is available.
Brazoria
Texas · 21046
Office
Unavailable
Facility
$886.85
No comparable office rate is available.
Dallas
Texas · 21046
Office
Unavailable
Facility
$893.79
No comparable office rate is available.
Fort Worth
Texas · 21046
Office
Unavailable
Facility
$890.77
No comparable office rate is available.
Galveston
Texas · 21046
Office
Unavailable
Facility
$890.43
No comparable office rate is available.
Houston
Texas · 21046
Office
Unavailable
Facility
$922.64
No comparable office rate is available.
Rest Of Texas
Texas · 21046
Office
Unavailable
Facility
$874.50
No comparable office rate is available.
Utah
Utah · 21046
Office
Unavailable
Facility
$870.80
No comparable office rate is available.
Virginia
Virginia · 21046
Office
Unavailable
Facility
$875.78
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 21046
Office
Unavailable
Facility
$902.76
No comparable office rate is available.
Vermont
Vermont · 21046
Office
Unavailable
Facility
$866.67
No comparable office rate is available.
Rest Of Washington
Washington · 21046
Office
Unavailable
Facility
$911.49
No comparable office rate is available.
Seattle (King Cnty)
Washington · 21046
Office
Unavailable
Facility
$997.69
No comparable office rate is available.
Wisconsin
Wisconsin · 21046
Office
Unavailable
Facility
$842.93
No comparable office rate is available.
West Virginia
West Virginia · 21046
Office
Unavailable
Facility
$875.29
No comparable office rate is available.
Wyoming**
Wyoming · 21046
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
See how rates vary across the country
21046 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21046 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$980.45
$891.32 × 110% = $980.45
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21046 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,853
- Code
- 21046
- Physician work
- 13.85
- Practice expense
- 11.32
- Malpractice
- 1.76
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.85 | × 1.005 | 13.9192 |
| Practice expense | 11.32 | × 0.988 | 11.1842 |
| Malpractice | 1.76 | × 0.899 | 1.5822 |
| Total RVUs | 26.6856 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$891.32
Open 21046 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.85 | 1.005 |
| Practice expense | 11.32 | 0.988 |
| Malpractice | 1.76 | 0.899 |
(13.85 × 1.005 + 11.32 × 0.988 + 1.76 × 0.899) × $33.4009 = $891.32
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
21046 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $891.32 | RVU26D |
| 2026-07-01 | Not available in this setting | $891.32 | RVU26C |
| 2026-04-01 | Not available in this setting | $891.32 | RVU26B |
| 2026-01-01 | Not available in this setting | $891.32 | RVU26A |
| 2025-10-01 | Not available in this setting | $961.34 | RVU25D |
| 2025-07-01 | Not available in this setting | $961.34 | RVU25C |
| 2025-04-01 | Not available in this setting | $961.34 | RVU25B |
| 2025-01-01 | Not available in this setting | $961.34 | RVU25A |
21046 billing questions
When should 21046 be selected instead of 21040?
Use 21046 when the operative work requires intraoral osteotomy to access or remove the mandibular lesion. 21040 describes removal by enucleation and curettage without that level of approach.
How does 21046 differ from 21047?
21046 describes the intraoral osteotomy approach. 21047 is the neighboring mandibular code for a lesion requiring extraoral osteotomy and/or resection.
What documentation supports 21046?
Document the benign cyst or tumor’s mandibular location, the intraoral approach, the osteotomy performed, and the excision. The operative note should make clear why simple enucleation and curettage was insufficient.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this code; report the service based on the mandibular lesion and work performed.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Separately reportable care must be outside those included services.
When may an assistant or co-surgeon be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,85021040,,Excise mandible lesion,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,,Removal of jaw bone lesion,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,,Extensive jaw surgery,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,,Remove mandible cyst complex,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,,Excise lwr jaw cyst w/repair,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,,Remove maxilla cyst complex,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,,Excis uppr jaw cyst w/repair,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
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503