Billing code 21046: Mandibular lesion excisionMedicare rate & RVUs in Florida
Reports removal of a benign mandibular cyst or tumor when intraoral osteotomy is required to access and excise the lesion.
CMS doesn’t publish an office rate for 21046 in Florida.
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 21046 covers
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.
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 21046 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.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $951.90 |
| Miami | Unavailable | $1,004.87 |
| Rest Of Florida | Unavailable | $912.42 |
How the 21046 rate is calculated
Each of 21046’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 · 21046
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.85Practice expense 11.32Malpractice 1.76
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21046
21046 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21046
Mandibular lesion 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 21046
Mandibular lesion 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
21046 without 51 · national facility
$899.49
Mandibular lesion excision
21046-51 · Second procedure: 50%
$449.75
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%).
21046 compared with similar codes
Compare codes
21046 vs 21040 vs 21047 vs 21048: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21040Mandibular lesion excision
- Use 21040 for mandibular benign cyst or tumor removal by enucleation and curettage. Choose 21046 when the documented procedure requires intraoral osteotomy.
- 21047Jaw cyst excision
- 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.
- 21048Maxillary excision
- 21048 concerns a benign cyst or tumor in the maxilla requiring intraoral osteotomy; 21046 is for the mandible.
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 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
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