$459.01
21040 describes enucleation and curettage of a benign jaw lesion. Choose 21047 when the mandibular operation requires intraoral osteotomy, tooth extraction, or both.
On this page
CMS RVU26D · Effective 2026-10-01
21047 Jaw cyst excision Medicare reimbursement rates in New Mexico
Removal and repair of a benign mandibular cyst or tumor when intraoral osteotomy, tooth extraction, or both are required. Compare 21047 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 21047 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
No supported rate
Facility setting
$1066.17
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 surgery
About 21047: Mandibular cyst excision with intraoral osteotomy
Removal and repair of a benign mandibular cyst or tumor when intraoral osteotomy, tooth extraction, or both are required.
This service removes a benign cyst or tumor arising in the mandible when removal requires an osteotomy performed through the mouth, extraction of a tooth, or both. The surgeon also repairs the operative site. Oral and maxillofacial surgeons commonly perform the procedure in an ambulatory surgery center or hospital; selected cases may be performed in an office setting. The operative report should identify the mandibular lesion and document the intraoral approach, bone work, any tooth extraction, and repair.
Report this code when the required intraoral osteotomy or tooth extraction distinguishes the operation from simpler enucleation and curettage. The repair associated with the excision is part of the service. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in its 90-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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 service.
CMS billing rules for 21047
- 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 RVU19.57 · 61%
- Practice expense (office) RVU10.05 · 31%
- Malpractice RVU2.61 · 8%
342
Medicare services in 2024 · #3878 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.
21047 compared with similar codes
Office rates for New Mexico, from the same CMS release.
No office rate
21046 involves an extraoral approach and partial mandibulectomy for a benign mandibular lesion; 21047 describes the intraoral operation.
No office rate
21048 applies to a benign cyst or tumor of the maxilla. This code is for a lesion of the mandible.
No office rate
21049 is the related upper-jaw cyst procedure with repair. Use this code for the corresponding lower-jaw service.
Compare 21047 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
Unavailable
Facility
$1066.17
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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 21047 in New Mexico.
PPRRVU2026_Oct_nonQPP.csv
1,854
- Code
- 21047
- Physician work
- 19.57
- Practice expense
- 10.05
- Malpractice
- 2.61
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.57 | × 1.000 | 19.5700 |
| Practice expense | 10.05 | × 0.917 | 9.2159 |
| Malpractice | 2.61 | × 1.201 | 3.1346 |
| Total RVUs | 31.9205 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$1066.17
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.57 | 1 |
| Practice expense | 10.05 | 0.917 |
| Malpractice | 2.61 | 1.201 |
(19.57 × 1 + 10.05 × 0.917 + 2.61 × 1.201) × $33.4009 = $1066.17
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.
21047 billing questions
When should this code be selected instead of 21040?
Use this code when removal of a mandibular cyst or benign tumor requires intraoral osteotomy, tooth extraction, or both. Code 21040 describes removal by enucleation and curettage.
How does this differ from 21046?
Both concern a benign mandibular lesion, but 21046 is for cases requiring an extraoral osteotomy and partial mandibulectomy. This code describes the intraoral approach with osteotomy, tooth extraction, or both.
Is repair separately reported?
The repair associated with removing the lesion is included in this service. Document the repair in the operative report.
What documentation supports reporting this code?
Document the mandibular lesion, the intraoral approach, the osteotomy and/or tooth extraction required for removal, and the repair performed.
How does the Medicare global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
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.
1,85121044,,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
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
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