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CPT 21048: Maxillary Benign Tumor Excision via Intraoral Osteotomy
CPT code 21048 denotes the open surgical excision of a benign tumor of the maxilla performed via an intraoral osteotomy. This code captures a specialized maxillofacial surgical procedure used to remove fast-growing or locally destructive noncancerous lesions of the upper jaw bone. Clinically, it is relevant to oral and maxillofacial surgeons, otolaryngologists, and surgical oncologists working in head and neck specialties.
Nationally, accurate reporting of this procedure code matters for clinical documentation, facility and professional reimbursement, and outcome tracking for maxillary tumor management. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. These payers typically influence coverage policies, prior authorization requirements, and coding guidelines for surgical head and neck procedures.
Readers will find a concise overview of the clinical context for 21048, common sites of service, and the typical service type. The publication outlines benchmarking and payer coverage considerations, highlights relevant policy and coding interpretations where available, and summarizes clinical factors that affect service setting and billing. Data not available in the input is noted where applicable, and the focus remains on national-level clinical and billing context rather than state-specific rules.
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Billing Code Overview
CPT code 21048 describes the open surgical removal of a benign tumor of the maxilla (upper jaw bone) via an intraoral osteotomy. The procedure involves making an incision inside the mouth and cutting into the maxillary bone to excise a fast-growing or locally destructive noncancerous lesion.
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Service type: Open surgical tumor excision involving intraoral osteotomy of the maxilla
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Typical site of service: Operating room or ambulatory surgical center with intraoral access; typical setting is inpatient or outpatient surgical care depending on case complexity and perioperative needs