$799.12–$873.61
21025 is specific to excision of lower-jaw bone. 21026 applies to facial bone excision outside that jaw-specific service.
On this page
CMS RVU26D · Effective 2026-10-01
21026 Facial bone excision Medicare reimbursement rates in Pennsylvania
Reports surgical removal of one or more facial bones when the documented procedure is bone excision rather than contouring or a site-specific tumor operation. Compare 21026 office and facility rates across CMS payment localities in Pennsylvania.
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 21026 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$544.82–$599.32
2 of 2 localities have a supported rate.
Facility setting
$395.50–$429.99
2 of 2 localities have a supported rate.
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 21026: Excision of facial bone
Reports surgical removal of one or more facial bones when the documented procedure is bone excision rather than contouring or a site-specific tumor operation.
CPT 21026 describes surgical removal of facial bone, involving one or more bones of the face. An oral and maxillofacial surgeon, plastic surgeon, or otolaryngologist may perform the procedure in an operating room when the treatment plan calls for excision of facial bone. The operative report should identify the bone or bones treated and describe the extent of removal.
Select this code for facial bone excision, distinguishing it from lower-jaw bone excision and from codes describing contouring or a specified tumor operation. Documentation should support the anatomic site and the work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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 for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 21026
- 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 RVU5.56 · 32%
- Practice expense (office) RVU10.94 · 63%
- Malpractice RVU0.75 · 4%
835
Medicare services in 2024 · #3111 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.
21026 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$770.55–$847.58
21029 describes contouring facial bone; 21026 describes excision. The operative report should show which type of bone work was performed.
$450.59–$494.79
21030 is for a benign tumor or cyst of the maxilla or zygoma. 21026 describes facial bone excision without that specified tumor procedure.
$1,247.26–$1,358.84
21034 describes excision of a malignant maxillary or zygomatic tumor. 21026 is the facial bone excision code when that tumor-specific service is not documented.
Compare 21026 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$599.32
Facility
$429.99
Rest Of Pennsylvania →
Office / nonfacility
$544.82
Facility
$395.50
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21026 billing questions
How does 21026 differ from 21025?
21026 describes facial bone excision; 21025 is the jaw-specific code for excision of lower-jaw bone. Choose based on the bone and procedure documented.
When would 21029 be a better fit?
21029 describes contouring facial bone, such as reshaping a bony prominence or lesion. Use 21026 when the documented work is excision rather than contouring.
Should modifier 50 be reported for both sides?
No. CMS identifies bilateral adjustment as inappropriate for 21026, so modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for 21026. Co-surgeons and team surgery are not permitted.
How does the multiple-procedure reduction work?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid 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 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.
1,84121015,,Resect face/scalp tum < 2 cm,A,,9.64,7.82,NA,7.82,,1.69,19.15,19.15,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84221016,,Resect face/scalp tum 2 cm/>,A,,14.88,9.36,NA,9.36,,2.75,26.99,26.99,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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