Billing code 21026: Facial bone excisionMedicare rate & RVUs in Florida
Reports surgical removal of one or more facial bones when the documented procedure is bone excision rather than contouring or a site-specific tumor operation.
Medicare pays $572.69–$629.45 for 21026 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 21026 covers
billing code 21026 describes surgical removal of facial bone, involving one or more bones of the face. An oral and maxillofacial surgeon, plastic surgeon, or otolaryngologist may perform the procedure in an operating room when the treatment plan calls for excision of facial bone. The operative report should identify the bone or bones treated and describe the extent of removal.
Select this code for facial bone excision, distinguishing it from lower-jaw bone excision and from codes describing contouring or a specified tumor operation. Documentation should support the anatomic site and the work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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 21026 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$572.69 to $629.45
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $601.16 | $436.38 |
| Miami | $629.45 | $460.12 |
| Rest Of Florida | $572.69 | $417.18 |
How the 21026 rate is calculated
Each of 21026’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 · 21026
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.56Practice expense 10.94Malpractice 0.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21026
21026 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21026
Facial bone excision
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 21026
Facial bone excision
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
21026 without 51 · national office
$576.17
Facial bone excision
21026-51 · Second procedure: 50%
$288.09
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%).
21026 compared with similar codes
Compare codes
21026 vs 21025 vs 21029 vs 21030 vs 21034: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21025Bone excision
- 21025 is specific to excision of lower-jaw bone. 21026 applies to facial bone excision outside that jaw-specific service.
- 21029Bone contouring
- 21029 describes contouring facial bone; 21026 describes excision. The operative report should show which type of bone work was performed.
- 21030Bone lesion excision
- 21030 is for a benign tumor or cyst of the maxilla or zygoma. 21026 describes facial bone excision without that specified tumor procedure.
- 21034Tumor excision
- 21034 describes excision of a malignant maxillary or zygomatic tumor. 21026 is the facial bone excision code when that tumor-specific service is not documented.
21026 billing questions
How does 21026 differ from 21025?
21026 describes facial bone excision; 21025 is the jaw-specific code for excision of lower-jaw bone. Choose based on the bone and procedure documented.
When would 21029 be a better fit?
21029 describes contouring facial bone, such as reshaping a bony prominence or lesion. Use 21026 when the documented work is excision rather than contouring.
Should modifier 50 be reported for both sides?
No. CMS identifies bilateral adjustment as inappropriate for 21026, so modifier 50 should not be used.
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 paid?
Medicare does not pay an assistant at surgery for 21026. Co-surgeons and team surgery are not permitted.
How does the multiple-procedure reduction work?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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
Fee sheets
Put 21026 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →