No office rate
Use 21050 for removal of the mandibular condyle; 21060 concerns removal of TMJ cartilage or disc.
On this page
CMS RVU26D · Effective 2026-10-01
21050 Condylectomy Medicare reimbursement rates in Vermont
Reports surgical removal of a mandibular condyle at the temporomandibular joint for selected condylar disorders, rather than excision of the joint disc or other jaw bone. Compare 21050 office and facility rates across CMS payment localities in Vermont.
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 21050 in Vermont?
Vermont 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
$764.98
1 of 1 localities have a supported rate.
Payment area: Vermont
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 21050: Temporomandibular joint condylectomy
Reports surgical removal of a mandibular condyle at the temporomandibular joint for selected condylar disorders, rather than excision of the joint disc or other jaw bone.
This code represents surgical removal of the mandibular condyle where it meets the temporal bone at the temporomandibular joint. Oral and maxillofacial surgeons and other surgeons treating TMJ disorders may perform it, commonly in a hospital or ambulatory surgical setting. The operative report should identify the side and document the condylar abnormality and the extent of bone removed. Condylectomy is distinct from removing the joint disc or excising a lesion elsewhere in the mandible.
Report the code when the performed service is condylar removal, not merely joint manipulation or disc excision. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 21050
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.47 · 48%
- Practice expense (office) RVU10.70 · 45%
- Malpractice RVU1.66 · 7%
18
Medicare services in 2024 · #5961 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.
21050 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
21050 describes condylar removal. Code 21240 describes TMJ arthroplasty, including reconstruction work rather than condylectomy alone.
No office rate
21070 removes the coronoid process, a separate mandibular structure. It is not the code for removal of the condyle at the TMJ.
$813.72
21025 is for excision of mandibular bone; 21050 specifically identifies removal of the mandibular condyle at the TMJ.
Compare 21050 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
Vermont →
Office / nonfacility
Unavailable
Facility
$764.98
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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 21050 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
1,857
- Code
- 21050
- Physician work
- 11.47
- Practice expense
- 10.70
- Malpractice
- 1.66
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.47 | × 1.000 | 11.4700 |
| Practice expense | 10.70 | × 0.990 | 10.5930 |
| Malpractice | 1.66 | × 0.506 | 0.8400 |
| Total RVUs | 22.9030 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$764.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.47 | 1 |
| Practice expense | 10.7 | 0.99 |
| Malpractice | 1.66 | 0.506 |
(11.47 × 1 + 10.7 × 0.99 + 1.66 × 0.506) × $33.4009 = $764.98
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.
21050 billing questions
How is this different from 21060?
Code 21050 represents removal of the mandibular condyle. Code 21060 addresses removal of TMJ cartilage or disc, a different structure.
Does this code cover removal of the TMJ disc?
No. The code describes condylar bone removal; disc or cartilage removal is associated with 21060.
What documentation supports reporting 21050?
Document the affected side, the condylar condition, and the operative work showing removal of the mandibular condyle.
How is bilateral condylectomy reported?
Use modifier 50 for bilateral surgery; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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.
1,85421047,,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
1,85821060,,Remove jaw joint cartilage,A,,10.79,9.13,NA,9.13,,1.56,21.48,21.48,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,85921070,,Remove coronoid process,A,,8.40,6.54,NA,6.54,,1.23,16.17,16.17,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86021073,,Mnpj of tmj w/anesth,A,,3.36,9.03,,2.85,,0.48,12.87,6.69,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817