$455.33
Use 21034 for a malignant maxillary or zygomatic tumor. Code 21030 is for a benign tumor or cyst at those sites.
On this page
CMS RVU26D · Effective 2026-10-01
21034 Tumor excision Medicare reimbursement rates in New Mexico
Report this service when a surgeon excises a malignant tumor arising in the maxilla or zygoma, rather than a benign lesion or a tumor at another jaw site. Compare 21034 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 21034 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
$1267.98
1 of 1 localities have a supported rate.
Payment area: New Mexico
One mapped payment locality.
Facility setting
$976.70
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 21034: Malignant maxillary or zygomatic tumor excision
Report this service when a surgeon excises a malignant tumor arising in the maxilla or zygoma, rather than a benign lesion or a tumor at another jaw site.
This service covers surgical excision of a malignant tumor involving the maxilla, or upper jaw, or the zygoma, the cheekbone. It is typically performed in an operating room by an oral and maxillofacial surgeon, head and neck surgeon, or another surgeon treating facial bone malignancy. The operative approach and tissue removed depend on the tumor’s location and extent; the code is specific to the malignant tumor site, not simply any procedure on facial bone.
Choose this code when the operative report supports a malignant tumor of the maxilla or zygoma and documents the excision performed. A benign tumor at those sites points to 21030; a malignant mandibular tumor belongs to a different code family. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this descriptor and anatomy.
CMS billing rules for 21034
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.95 · 43%
- Practice expense (office) RVU19.64 · 50%
- Malpractice RVU2.50 · 6%
163
Medicare services in 2024 · #4496 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.
21034 compared with similar codes
Office rates for New Mexico, from the same CMS release.
No office rate
Both address malignant tumor excision, but 21044 is for the mandible; 21034 is for the maxilla or zygoma.
$550.87
Code 21026 describes excision of facial bone more generally. Use 21034 when the documented service is excision of a malignant tumor specifically involving the maxilla or zygoma.
Compare 21034 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
$1267.98
Facility
$976.70
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 21034 in New Mexico.
PPRRVU2026_Oct_nonQPP.csv
1,849
- Code
- 21034
- Physician work
- 16.95
- Practice expense
- 19.64
- Malpractice
- 2.50
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.95 | × 1.000 | 16.9500 |
| Practice expense | 19.64 | × 0.917 | 18.0099 |
| Malpractice | 2.50 | × 1.201 | 3.0025 |
| Total RVUs | 37.9624 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, New Mexico$1267.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.95 | 1 |
| Practice expense | 19.64 | 0.917 |
| Malpractice | 2.5 | 1.201 |
(16.95 × 1 + 19.64 × 0.917 + 2.5 × 1.201) × $33.4009 = $1267.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.95 | 1 |
| Practice expense | 10.13 | 0.917 |
| Malpractice | 2.5 | 1.201 |
(16.95 × 1 + 10.13 × 0.917 + 2.5 × 1.201) × $33.4009 = $976.70
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.
21034 billing questions
How does this differ from 21030?
Both codes concern the maxilla or zygoma, but 21034 is for a malignant tumor. Code 21030 describes excision of a benign tumor or cyst at those sites.
Can I use 21034 for a malignant mandibular tumor?
No. This code is limited to the maxilla or zygoma; a malignant tumor of the mandible is represented by a different code, such as 21044.
What documentation supports reporting 21034?
The operative report should identify the maxilla or zygoma as the tumor site and describe the excision. The record should also support that the tumor is malignant.
Is modifier 50 appropriate for bilateral work?
No. CMS identifies modifier 50 as inappropriate for this descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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.
1,84621030,,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
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
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