Billing code 21031: Exostosis removalMedicare rate & RVUs in Ohio
Removal of a bony exostosis of the mandible, such as a mandibular torus, when excision is performed by an oral surgeon or other qualified clinician.
Medicare pays $366.29 for 21031 in the office in Ohio (Ohio). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 21031 covers
This service removes a localized bony prominence from the mandible, commonly a mandibular torus that interferes with denture placement, oral hygiene, or function. An oral and maxillofacial surgeon or dentist typically performs the intraoral procedure in an office or surgical facility. Documentation should identify the mandibular site, the exostosis, and the clinical reason for removal.
Report this code for removal of a mandibular exostosis, not for excision of a different jaw lesion or removal of a maxillary torus. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral work, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
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.
21031 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $366.29 | $241.87 |
How the 21031 rate is calculated
Each of 21031’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 21031
RVUs × geographic indexes × conversion factor
Work3.22
3.22 RVUs× 1.000 GPCI
Practice expense8.01
8.01 RVUs× 1.000 GPCI
Malpractice0.43
0.43 RVUs× 1.000 GPCI
Adjusted RVUs
11.6600
Conversion factor
$33.4009
Medicare rate
$389.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21031
21031 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21031
Exostosis removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21031
Exostosis removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
21031 without 50 · national office
$389.45
Exostosis removal
21031-50 · Bilateral: 150%
$584.18
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
21031 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21032Maxillary exostosis
- Use 21031 for a mandibular exostosis and 21032 for a maxillary torus; the jaw site distinguishes the services.
- 21025Bone excision
- 21031 addresses a mandibular exostosis. 21025 is for excision of lower-jaw bone, not specifically removal of an exostosis.
- 21040Mandibular lesion excision
- Choose 21040 for excision of a mandibular lesion. Choose 21031 when the documented target is an exostosis or torus.
21031 billing questions
How is this code different from removal of a maxillary torus?
This code is for an exostosis of the mandible. Use 21032 for removal of a maxillary torus.
When would a mandibular bone-lesion code be more appropriate?
Use a lesion-excision code when the target is a mandibular lesion rather than a bony exostosis or torus. Document the nature and location of the condition being removed.
Does the code include related postoperative care?
Yes. Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral removal handled?
CMS identifies the procedure as bilateral; modifier 50 is paid at 150%. Document the exostoses on both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services are not paid for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 21031 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →