$361.62–$399.19
Use 21031 for a mandibular exostosis and 21032 for a maxillary torus; the jaw site distinguishes the services.
On this page
CMS RVU26D · Effective 2026-10-01
21031 Exostosis removal Medicare reimbursement rates in Pennsylvania
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. Compare 21031 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 21031 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
$366.73–$405.13
2 of 2 localities have a supported rate.
Facility setting
$241.63–$263.27
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 surgery
About 21031: Mandibular exostosis removal
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.
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.
CMS billing rules for 21031
- 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 RVU3.22 · 28%
- Practice expense (office) RVU8.01 · 69%
- Malpractice RVU0.43 · 4%
222
Medicare services in 2024 · #4225 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.
21031 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$799.12–$873.61
21031 addresses a mandibular exostosis. 21025 is for excision of lower-jaw bone, not specifically removal of an exostosis.
$454.26–$498.97
Choose 21040 for excision of a mandibular lesion. Choose 21031 when the documented target is an exostosis or torus.
Compare 21031 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
$405.13
Facility
$263.27
Rest Of Pennsylvania →
Office / nonfacility
$366.73
Facility
$241.63
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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 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.
1,84421026,,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
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