No office rate
This code represents the extraoral approach. Use 21049 when the complex maxillary lesion operation is performed through an intraoral approach.
On this page
CMS RVU26D · Effective 2026-10-01
21048 Maxillary excision Medicare reimbursement rates in Hawaii
Reports removal of a complex benign cyst or tumor from the maxilla when an extraoral approach, osteotomy, and partial maxillectomy are performed. Compare 21048 office and facility rates across CMS payment localities in Hawaii.
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 21048 in Hawaii?
Hawaii 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
$932.65
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 21048: Complex maxillary cyst or tumor excision
Reports removal of a complex benign cyst or tumor from the maxilla when an extraoral approach, osteotomy, and partial maxillectomy are performed.
This service removes a complex benign cyst or tumor from the upper jaw through an external approach, with bone division and partial removal of the maxilla. Oral and maxillofacial surgeons commonly perform it for extensive maxillary lesions, including an odontogenic cyst when its extent requires this operation. The operative report should identify the lesion and site and describe the external approach, osteotomy, and partial maxillectomy performed.
Choose this code based on the documented approach and extent of bone removal, not simply the presence of a cyst or tumor. A less extensive lesion treated by enucleation and curettage may fit 21040; an intraoral operation of this extent is represented by 21049. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is not appropriate for this service. Assistant-at-surgery payment requires documented medical necessity, co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21048
- 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 RVU14.34 · 53%
- Practice expense (office) RVU11.05 · 41%
- Malpractice RVU1.76 · 6%
789
Medicare services in 2024 · #3161 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.
21048 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$512.81
21040 describes enucleation and curettage of a benign maxillary or zygomatic lesion. Use 21048 when the documented operation includes an extraoral approach, osteotomy, and partial maxillectomy.
No office rate
21046 is the corresponding complex benign lesion operation on the mandible. This code is for the maxilla.
$508.25
21030 describes excision of a benign maxillary or zygomatic tumor without the specific complex extraoral osteotomy and partial maxillectomy represented by 21048.
Compare 21048 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$932.65
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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 21048 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,855
- Code
- 21048
- Physician work
- 14.34
- Practice expense
- 11.05
- Malpractice
- 1.76
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.34 | × 1.000 | 14.3400 |
| Practice expense | 11.05 | × 1.137 | 12.5639 |
| Malpractice | 1.76 | × 0.579 | 1.0190 |
| Total RVUs | 27.9229 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$932.65
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.34 | 1 |
| Practice expense | 11.05 | 1.137 |
| Malpractice | 1.76 | 0.579 |
(14.34 × 1 + 11.05 × 1.137 + 1.76 × 0.579) × $33.4009 = $932.65
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.
21048 billing questions
How is 21048 distinguished from 21049?
Both represent complex maxillary lesion removal with osteotomy and partial maxillectomy. Choose 21048 for the extraoral approach and 21049 for the intraoral approach.
When would 21040 be more appropriate?
Use 21040 for a maxillary or zygomatic benign lesion treated by enucleation and curettage, rather than the more extensive osteotomy and partial maxillectomy represented by 21048.
What operative details support 21048?
Document the maxillary lesion and its location, the extraoral approach, the osteotomy, and the partial maxillectomy performed. The report should make the extent of the operation clear.
Are related postoperative visits included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other same-session procedures handled?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity, while co-surgeon payment requires supporting documentation. 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.
1,85221045,,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
1,85721050,,Removal of jaw joint,A,,11.47,10.70,NA,10.70,,1.66,23.83,23.83,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,85821060,,Remove jaw joint cartilage,A,,10.79,9.13,NA,9.13,,1.56,21.48,21.48,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014