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See a sample rate comparisonCPT 21045 Fee Schedule
Medicare rates as of October 2026
CPT 21045 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Exc Malig Tumor Mandible Rad Resect
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 51Multiple procedures GCService performed by resident under supervision |
| Hospital Outpatient Group (APC) | APC 5165 - Level 5 ENT Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,061.15 national non-facility rate (2026)View Medicare rates for 21045 |
| Medicaid Fee Schedule | $855.44 median of the 8 states in the free previewView Medicaid rates for 21045 |
National average reimbursement for CPT 21045 by major payers:
$1,567.48
BCBS / Anthem
$1,625.71
UnitedHealthcare
$1,733.35
Aetna
$1,976.18
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21045.
CPT 21045
5 of 25 sample ratesHigher to lower in this preview
Inova Loudoun Ambulatory Surgery
$8,387.00Published rateBaylor Surgicare At North Dallas, LLC, Baylor Scott & White Surgicare-North Dallas
$4,234.00Published rateFresenius Vascular Care Cincinnati Asc LLC, Azura Surgery Center Cincinnati
Fresenius Vascular Care Cincinnati Asc LLC
$2,500.00Published rateLake Mary Surgery Center LLC
Lake Mary Surgery Center
$1,696.00Published rateNorth Pinellas Surgery Center LLC
North Pinellas Surgery Center, LLC
$680.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21045 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21045. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 21044-CPT | Exc Malign Tumor Mandible |
| 21045-CPT | Exc Malig Tumor Mandible Rad Resect |
| 21046-CPT | Remove Mandible Cyst Complex, Excision Of Benign Tumor Or Cyst Of Mandible; Requiring Intra-Oral Osteotomy (Eg Locally Aggressive Or Destructive Lesion[S]) |
| 21047-CPT | Excise Lwr Jaw Cyst W/Repair, Excision Of Benign Tumor Or Cyst Of Mandible; Requiring Extra-Oral Osteotomy And Partial Mandibulectomy (Eg Locally Aggressive Or Destructive Lesion[S]) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21045. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21045 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is CPT 21045 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21045 to APC 5165 (Level 5 ENT Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 21045 in an ambulatory surgery center?
CMS lists CPT 21045 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21045?
Hospital price transparency files list CPT 21045 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.