No office rate
Use 21040 for intraoral removal of a benign mandibular lesion without the osteotomy specified for 21046. The operative report should establish whether osteotomy was required.
On this page
CMS RVU26D · Effective 2026-10-01
21040 Mandibular lesion excision Medicare reimbursement rates in Nevada
Reports intraoral removal of a benign lesion of the mandible when the procedure requires more than routine dental extraction or simple cyst care. Compare 21040 office and facility rates across CMS payment localities in Nevada.
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 21040 in Nevada?
Nevada 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
$476.98
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
Facility setting
$334.55
1 of 1 localities have a supported rate.
Payment area: Nevada**
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 21040: Intraoral excision of benign mandibular lesion
Reports intraoral removal of a benign lesion of the mandible when the procedure requires more than routine dental extraction or simple cyst care.
CPT 21040 describes removal of a benign tumor or cyst from the mandible through an intraoral approach. Oral and maxillofacial surgeons and other surgeons with appropriate training may perform it in an office, ambulatory surgery center, or hospital operating room. The operative work may involve incising oral mucosa, exposing the mandibular lesion, removing it, and closing the site. The code is for a benign lesion, not a malignant jaw tumor or an exostosis.
Select the code based on the documented lesion, mandibular site, and intraoral route; distinguish it from procedures that require osteotomy, address a different jaw, or remove bone for another indication. The operative report should describe the lesion and approach, the removal performed, and any relevant pathology. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur 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; co-surgeons and team surgery are not permitted.
CMS billing rules for 21040
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.79 · 33%
- Practice expense (office) RVU8.99 · 63%
- Malpractice RVU0.59 · 4%
1.3K
Medicare services in 2024 · #2756 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.
21040 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
21047 describes benign mandibular lesion removal requiring an extraoral osteotomy. 21040 describes an intraoral approach.
No office rate
21040 is for a benign mandibular lesion; 21044 is used for the applicable malignant mandibular tumor procedure.
$472.97
Both address benign jaw lesions, but 21030 is for the maxilla and 21040 is for the mandible.
Compare 21040 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
Nevada** →
Office / nonfacility
$476.98
Facility
$334.55
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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 21040 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
1,850
- Code
- 21040
- Physician work
- 4.79
- Practice expense
- 8.99
- Malpractice
- 0.59
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.79 | × 1.000 | 4.7900 |
| Practice expense | 8.99 | × 1.001 | 8.9990 |
| Malpractice | 0.59 | × 0.833 | 0.4915 |
| Total RVUs | 14.2805 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nevada**$476.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.79 | 1 |
| Practice expense | 8.99 | 1.001 |
| Malpractice | 0.59 | 0.833 |
(4.79 × 1 + 8.99 × 1.001 + 0.59 × 0.833) × $33.4009 = $476.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.79 | 1 |
| Practice expense | 4.73 | 1.001 |
| Malpractice | 0.59 | 0.833 |
(4.79 × 1 + 4.73 × 1.001 + 0.59 × 0.833) × $33.4009 = $334.55
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.
21040 billing questions
How is 21040 different from 21046?
21040 is for intraoral removal of a benign mandibular lesion without the osteotomy described for 21046. Report 21046 when the documented procedure requires that intraoral osteotomy.
Can 21040 be reported for a malignant mandibular lesion?
No. This code is for a benign lesion; a malignant mandibular tumor requires the code that describes the applicable malignant-tumor procedure.
What documentation supports 21040?
Document the mandibular location, benign lesion or cyst diagnosis, intraoral approach, and the removal performed. Include pathology findings when available.
Should modifier 50 be used for lesions on both sides?
No. The CMS bilateral adjustment is not appropriate for this code, so do not report it with modifier 50.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the surgical global package.
Can an assistant or co-surgeon be paid for this procedure?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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.
1,84721031,,Remove exostosis mandible,A,,3.22,8.01,,3.93,,0.43,11.66,7.58,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097