$1,267.98
Both concern the maxilla or zygoma, but 21030 describes enucleation and curettage of a benign lesion; 21034 is for a malignant tumor.
On this page
CMS RVU26D · Effective 2026-10-01
21030 Bone lesion excision Medicare reimbursement rates in New Mexico
Reports enucleation and curettage of a benign tumor or cyst involving the maxilla or zygoma, typically performed by an oral and maxillofacial surgeon. Compare 21030 office and facility rates across CMS payment localities in New Mexico.
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 21030 in New Mexico?
New Mexico 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
$455.33
1 of 1 localities have a supported rate.
Payment area: New Mexico
One mapped payment locality.
Facility setting
$327.61
1 of 1 localities have a supported rate.
Payment area: New Mexico
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 21030: Benign maxillary or zygomatic lesion excision
Reports enucleation and curettage of a benign tumor or cyst involving the maxilla or zygoma, typically performed by an oral and maxillofacial surgeon.
This service removes a benign tumor or cyst arising in the maxilla or zygoma by enucleating the lesion and curetting its bony site. Oral and maxillofacial surgeons commonly perform it for an intraosseous lesion identified on dental or facial imaging, with the specimen sent for pathologic examination. The approach and setting depend on the lesion and the patient; the defining work is enucleation and curettage, rather than resection of a malignant tumor or removal of a superficial facial mass.
Report the code when the operative record identifies a benign maxillary or zygomatic tumor or cyst and documents enucleation with curettage. A 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 21030
- 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 procedure with modifier 50 is paid at 150%.
- 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 · 34%
- Practice expense (office) RVU8.87 · 62%
- Malpractice RVU0.59 · 4%
1.1K
Medicare services in 2024 · #2898 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.
21030 compared with similar codes
Office rates for New Mexico, from the same CMS release.
$550.87
Use 21030 for enucleation and curettage of a benign tumor or cyst in the maxilla or zygoma. Code 21026 describes excision of facial bone or bones.
No office rate
Code 21048 concerns a maxillary benign tumor or cyst requiring intraoral osteotomy. Code 21030 describes enucleation and curettage.
$459.01
Code 21040 describes enucleation and curettage of a benign tumor or cyst in the mandible; 21030 is for the maxilla or zygoma.
Compare 21030 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
New Mexico →
Office / nonfacility
$455.33
Facility
$327.61
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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 21030 in New Mexico.
PPRRVU2026_Oct_nonQPP.csv
1,846
- Code
- 21030
- Physician work
- 4.79
- Practice expense
- 8.87
- Malpractice
- 0.59
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.79 | × 1.000 | 4.7900 |
| Practice expense | 8.87 | × 0.917 | 8.1338 |
| Malpractice | 0.59 | × 1.201 | 0.7086 |
| Total RVUs | 13.6324 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, New Mexico$455.33
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.79 | 1 |
| Practice expense | 8.87 | 0.917 |
| Malpractice | 0.59 | 1.201 |
(4.79 × 1 + 8.87 × 0.917 + 0.59 × 1.201) × $33.4009 = $455.33
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.79 | 1 |
| Practice expense | 4.7 | 0.917 |
| Malpractice | 0.59 | 1.201 |
(4.79 × 1 + 4.7 × 0.917 + 0.59 × 1.201) × $33.4009 = $327.61
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.
21030 billing questions
How does this differ from code 21034?
Code 21030 is for enucleation and curettage of a benign maxillary or zygomatic tumor or cyst. Code 21034 is for excision of a malignant tumor in those bones.
When would code 21026 be a better fit?
Code 21026 describes excision of facial bone or bones. Use 21030 when the documented service is enucleation and curettage of a benign tumor or cyst specifically involving the maxilla or zygoma.
Is the related postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant surgeon or co-surgeon be billed?
CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
What should the operative documentation establish?
Document the maxillary or zygomatic site, the benign tumor or cyst, and the enucleation and curettage performed. The record should distinguish this work from malignant tumor excision or a different bone-removal procedure.
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.
1,84321025,,Excision of bone lower jaw,A,,9.78,14.06,,7.28,,1.31,25.15,18.37,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84421026,,Excision of facial bone(s),A,,5.56,10.94,,6.07,,0.75,17.25,12.38,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84521029,,Contour of face bone lesion,A,,8.18,14.83,,7.57,,1.35,24.36,17.10,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84621030,,Excise max/zygoma b9 tumor,A,,4.79,8.87,,4.70,,0.59,14.25,10.08,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84721031,,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
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
7704212,NM,05,NEW MEXICO,1.000,0.917,1.201
7813202,NY,01,MANHATTAN,1.064,1.162,1.586
7913202,NY,02,NYC SUBURBS/LONG ISLAND,1.064,1.189,1.857
8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210