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See a sample rate comparisonCPT 21047 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
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])
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21047 |
| Medicaid Fee Schedule | View Medicaid rates for 21047 |
National average reimbursement for CPT 21047 by major payers:
$1,709.22
$1,730.67
$1,771.87
$2,057.47
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CPT 21047
5 of 25 sample ratesHigher to lower in this preview
Johnson County Surgery Center, L.P.
Johnson County Surgery Center Lp
$7,121.00Published rateVivere Health Austin, LLC, Vivere Austin Surgery Center
Vivere Health Austin LLC
$4,312.00Published rateEdison Surgery Center LLC
$2,790.00Published rateSingle Day Surgery Center LLC
$2,012.00Published rateBergen Gastroenterology PC
Bergen Gastroenterology, P.C.
$840.00Published rate
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See a sample payer proposalCPT 21047 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21047 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 21047 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 21044-CPT | High | Exc Malign Tumor Mandible |
| 21045-CPT | High | Exc Malig Tumor Mandible Rad Resect |
| 21046-CPT | High | 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 | High | 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 21047. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21047 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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