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See a sample rate comparisonCPT 21048 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.
Remove Maxilla Cyst Complex, Excision Of Benign Tumor Or Cyst Of Maxilla; Requiring Intra-Oral Osteotomy (Eg Locally Aggressive Or Destructive Lesion[S])
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21048 |
| Medicaid Fee Schedule | View Medicaid rates for 21048 |
National average reimbursement for CPT 21048 by major payers:
$1,461.97
$1,449.77
$1,454.19
$1,719.01
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CPT 21048
5 of 25 sample ratesHigher to lower in this preview
Castle Hills Surgicare, LLC
Castle Hills Surgicare LLC
$8,238.00Published rateSurgcenter Of Plano LLC
Surgcenter Of Plano, LLC
$4,234.00Published rateCandescent Eye Health Surgicenter, LLC
$2,852.00Published ratePrime Surgery Center
$2,528.00Published rateConnecticut Gi Endoscopy Center LLC
$971.00Published rate
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See a sample payer proposalCPT 21048 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21048 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 21048 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 |
|---|---|---|
| 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]) |
| 21048-CPT | High | Remove Maxilla Cyst Complex, Excision Of Benign Tumor Or Cyst Of Maxilla; Requiring Intra-Oral Osteotomy (Eg Locally Aggressive Or Destructive Lesion[S]) |
| 21049-CPT | High | Excis Uppr Jaw Cyst W/Repair, Excision Of Benign Tumor Or Cyst Of Maxilla; Requiring Extra-Oral Osteotomy And Partial Maxillectomy (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 21048. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21048 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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