No office rate
Both describe removal of a malignant mandibular tumor; choose 21044 for an intraoral route and 21045 for an extraoral route.
On this page
CMS RVU26D · Effective 2026-10-01
21044 Jaw tumor excision Medicare reimbursement rates in Colorado
Removal of a malignant tumor of the mandible through an intraoral approach, typically performed by an oral and maxillofacial or head and neck surgeon. Compare 21044 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 21044 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$774.67
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Oral and maxillofacial surgery
About 21044: Intraoral excision of malignant mandibular tumor
Removal of a malignant tumor of the mandible through an intraoral approach, typically performed by an oral and maxillofacial or head and neck surgeon.
This service covers surgical removal of a malignant tumor arising in the mandible through an incision inside the mouth. Oral and maxillofacial surgeons and head and neck surgeons may perform it in an operating room. The operative report should identify the mandibular site, describe the tumor removal, and document the intraoral route; pathology findings can support the diagnosis. The code distinguishes this procedure from removal of a benign mandibular lesion and from malignant tumor surgery performed through an external approach.
Report the service for the malignant mandibular tumor excision itself, selecting the code based on the documented diagnosis, bone site, and surgical approach. CMS assigns a 90-day global period, including 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. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 21044
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.48 · 54%
- Practice expense (office) RVU8.57 · 37%
- Malpractice RVU1.85 · 8%
366
Medicare services in 2024 · #3809 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.
21044 compared with similar codes
Office rates for Colorado, from the same CMS release.
$496.79
21040 applies to a benign mandibular tumor or cyst. Code 21044 applies when the mandibular tumor is malignant.
$1,336.13
21034 addresses malignant tumor excision of the maxilla or zygoma. Code 21044 is for a malignant tumor of the mandible.
Compare 21044 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$774.67
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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 21044 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
1,851
- Code
- 21044
- Physician work
- 12.48
- Practice expense
- 8.57
- Malpractice
- 1.85
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.48 | × 1.012 | 12.6298 |
| Practice expense | 8.57 | × 1.064 | 9.1185 |
| Malpractice | 1.85 | × 0.781 | 1.4449 |
| Total RVUs | 23.1931 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$774.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.48 | 1.012 |
| Practice expense | 8.57 | 1.064 |
| Malpractice | 1.85 | 0.781 |
(12.48 × 1.012 + 8.57 × 1.064 + 1.85 × 0.781) × $33.4009 = $774.67
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.
21044 billing questions
When should 21044 be chosen instead of 21045?
Use 21044 when the malignant mandibular tumor is removed through an intraoral approach. Code 21045 describes the corresponding procedure using an extraoral approach.
How does 21044 differ from 21040?
21044 is for removal of a malignant mandibular tumor. Code 21040 concerns a benign tumor or cyst of the mandible.
Is modifier 50 appropriate for bilateral mandibular tumors?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the performed service according to the applicable coding instructions rather than appending modifier 50.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; 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.
1,84821032,,Remove exostosis maxilla,A,,3.26,7.80,,3.62,,0.43,11.49,7.31,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84921034,,Excise max/zygoma mal tumor,A,,16.95,19.64,,10.13,,2.50,39.09,29.58,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,85021040,,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
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
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