FeeBase
Log inGet started
Menu

CPT code 21011: Facial tumor excision, subcutaneous, under 2 cm2026 Medicare rate & RVUs in Puerto Rico

Removal of a subcutaneous soft-tissue tumor under 2 cm from the face or scalp, reported when the surgical work is limited to that tissue plane.

CMS RVU26DEffective Oct 1, 2026One payment locality1.9K Medicare services in 2024

In Puerto Rico, Medicare pays $397.95 for 21011 in the office and $251.39 when it’s performed in a hospital or facility.

$397.95Office (non-facility)
$251.39Hospital or facility
+0.7%vs the national office rate ($395.13)

Check a contract rate as a % of Medicare · 21011 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21011 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 21011 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 21011 covers

This service removes a small soft-tissue tumor located beneath the skin of the face or scalp, such as a subcutaneous lipoma. The surgeon works in the superficial tissue plane rather than beneath the deep fascia. Plastic surgeons, otolaryngologists, and oral and maxillofacial surgeons may perform it in an office or outpatient surgical setting when the mass can be excised without a deeper or radical resection.

Select this code when the tumor is subcutaneous and measures less than 2 cm; use the documented site, tissue depth, and tumor size to distinguish it from larger or deeper masses. The operative report should identify the face or scalp location, depth, size, and extent of removal. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.

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.

How Puerto Rico compares for 21011

Across 109 of 109 payment localities, the office rate for 21011 runs from $347.08 in Arkansas to $521.36 in San Benito County, CA. Puerto Rico pays $397.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

21011 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$397.95
  2. Los Angeles, CA · California$444.40+$46.45
  3. Washington, DC area · District of Columbia$452.22+$54.27
  4. Miami, FL · Florida$433.68+$35.73
  5. Chicago, IL · Illinois$420.14+$22.19
  6. Manhattan, NY · New York$457.09+$59.14
  7. Alaska · Alaska$454.14+$56.19

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

21011 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$352.46$225.62
ArkansasArkansas$347.08$222.56
ArizonaArizona$383.91$243.44
Bakersfield, CACalifornia$416.93$258.06
Chico, CACalifornia$415.45$256.57
El Centro, CACalifornia$415.54$256.66
Fresno, CACalifornia$415.45$256.57
Hanford, CACalifornia$415.45$256.57

21011 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$347.08

$468.41

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
21011 office rate range by state
State / territoryOffice rate rangeLocalities
AK$454.141
AL$352.461
AR$347.081
AZ$383.911
CA$415.45–$521.3629
CO$410.341
CT$422.351
DC$452.221
DE$390.471
FL$391.72–$433.683
GA$368.30–$403.462
GU$426.031
HI$426.031
IA$360.671
ID$363.411
IL$380.75–$420.144
IN$365.601
KS$359.481
KY$362.561
LA$362.20–$381.032
MA$407.93–$451.482
MD$398.02–$452.223
ME$366.05–$386.082
MI$373.07–$397.482
MN$390.791
MO$356.05–$381.733
MS$351.611
MT$395.101
NC$369.991
ND$384.621
NE$362.571
NH$404.401
NJ$426.50–$447.262
NM$375.461
NV$392.461
NY$375.88–$469.455
OH$370.921
OK$361.241
OR$388.76–$423.232
PA$371.21–$411.782
PR$397.951
RI$404.311
SC$371.201
SD$383.381
TN$361.471
TX$368.68–$409.548
UT$376.531
VA$385.17–$452.222
VI$397.951
VT$383.591
WA$407.00–$460.312
WI$371.131
WV$366.101
WY$390.531

See 21011 in every payment locality

How the 21011 rate is calculated

Each of 21011’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 21011

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.92

2.92 RVUs× 1.000 GPCI

Practice expense8.38

8.38 RVUs× 1.000 GPCI

Malpractice0.53

0.53 RVUs× 1.000 GPCI

Adjusted RVUs

11.8300

Conversion factor

$33.4009

Medicare rate

$395.13

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,837

Code
21011
Physician work
2.92
Practice expense
8.38
Malpractice
0.53

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 21011 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.92× 1.0002.9200
Practice expense8.38× 1.0118.4722
Malpractice0.53× 0.9850.5221
Total RVUs11.9142
Conversion factor× 33.4009

Office rate, Puerto Rico$397.95

Office: (2.92 × 1 + 8.38 × 1.011 + 0.53 × 0.985) × $33.4009 = $397.95

Facility: (2.92 × 1 + 4.04 × 1.011 + 0.53 × 0.985) × $33.4009 = $251.39

Open 21011 in the RVU calculator

Payment rules and modifiers for 21011

21011 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21011

Facial tumor excision, subcutaneous, under 2 cm

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21011

Facial tumor excision, subcutaneous, under 2 cm

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21011 without 51 · national office

$395.13

Facial tumor excision, subcutaneous, under 2 cm

21011-51 · Second procedure: 50%

$197.57

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 21011

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21011
CodeHow it relatesOffice range, Puerto Rico
Same family
21012Soft-tissue excision, subcutaneous, 2 cm or largerSubcutaneous face or scalp tumor excision for a tumor measuring 2 cm or larger.No office rate
21013Tumor excision, deep, under 2 cmFace or scalp soft-tissue tumor excision beneath the deep fascia, under 2 cm.$568.91
21014Tumor excision, deep, 2 cm or largerFace or scalp soft-tissue tumor excision beneath the deep fascia, 2 cm or larger.No office rate
Used instead
21015Tumor resection, subfascial, under 2 cmRadical resection of a face or scalp soft-tissue tumor under 2 cm.No office rate
11440Lesion excision, face, 0.5 cm or lessExcision of a small benign skin lesion on the face when the work is limited to skin.$143.05

How 21011 has changed in Puerto Rico

21011 · Office / nonfacility

$397.95

Effective 2026-10-01

The base rate is $30.98 higher than on 2025-10-01, moving from $366.97 to $397.95 (8.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $366.97changed to$397.95

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.99 changed to 2.92
    • Practice expense RVU 7.78 changed to 8.38
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $377.66changed to$366.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.80 changed to 7.78
    • Malpractice RVU 0.51 changed to 0.53

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $371.50changed to$377.66

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $383.06changed to$371.50

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.75 changed to 7.80
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $381.23changed to$383.06

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $388.75changed to$381.23

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.65 changed to 7.75
    • Malpractice RVU 0.54 changed to 0.51
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $384.97changed to$388.75

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.48 changed to 7.65
    • Malpractice RVU 0.51 changed to 0.54

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $375.28changed to$384.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.85 changed to 7.48
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $366.19changed to$375.28

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.60 changed to 6.85
    • Malpractice RVU 0.53 changed to 0.51
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $358.17changed to$366.19

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.38 changed to 6.60
    • Malpractice RVU 0.54 changed to 0.53

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $316.28changed to$358.17

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.39 changed to 6.38
    • Malpractice RVU 0.55 changed to 0.54
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $274.37changed to$316.28

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.40 changed to 6.39
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $275.41changed to$274.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.41 changed to 6.40
    • Malpractice RVU 0.53 changed to 0.55

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $274.04changed to$275.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $267.95changed to$274.04

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.32 changed to 6.41
    • Malpractice RVU 0.43 changed to 0.53
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $268.86changed to$267.95

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.08 changed to 6.32
    • Malpractice RVU 0.45 changed to 0.43
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $268.86

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$397.95$251.39RVU26D
2026-07-01$397.95$251.39RVU26C
2026-04-01$397.95$251.39RVU26B
2026-01-01$397.95$251.39RVU26A
2025-10-01$366.97$260.13RVU25D
2025-07-01$366.97$260.13RVU25C
2025-04-01$366.97$260.13RVU25B
2025-01-01$366.97$260.13RVU25A
2024-10-01$377.66$264.03RVU24D
2024-07-01$377.66$264.03RVU24C
2024-04-01$377.66$264.03RVU24B
2024-03-09$377.66$264.03RVU24AR
2024-01-01$371.50$259.72RVU24A
2023-10-01$383.06$265.55RVU23D
2023-07-01$381.23$264.66RVU23C
2023-04-01$381.23$264.66RVU23B
2023-01-01$381.23$264.66RVU23A
2022-10-01$388.75$265.97RVU22D
2022-07-01$388.75$265.97RVU22C
2022-04-01$388.75$265.97RVU22B
2022-01-01$388.75$265.97RVU22A
2021-10-01$384.97$264.32RVU21D
2021-07-01$384.97$264.32RVU21C
2021-04-01$384.97$264.32RVU21B
2021-01-01$384.97$264.32RVU21A
2020-10-01$375.28$267.24RVU20D
2020-07-01$375.28$267.24RVU20C
2020-04-01$375.28$267.24RVU20B
2020-01-01$375.28$267.24RVU20A
2019-10-01$366.19$267.11RVU19D
2019-07-01$366.19$267.11RVU19C
2019-04-01$366.19$267.11RVU19B
2019-01-01$366.19$267.11RVU19A
2018-10-01$358.17$268.27RVU18D
2018-07-01$358.17$268.27RVU18C
2018-04-01$358.17$268.27RVU18B
2018-01-01$358.17$268.27RVU18AR1
2017-10-01$316.28$240.10RVU17D
2017-07-01$316.28$240.10RVU17C
2017-04-01$316.28$240.10RVU17B
2017-01-01$316.28$240.10RVU17A
2016-10-01$274.37$211.52RVU16D
2016-07-01$274.37$211.52RVU16C
2016-04-01$274.37$211.52RVU16B
2016-01-01$274.37$211.52RVU16A
2015-10-01$275.41$211.82RVU15D
2015-07-01$275.41$211.82RVU15C
2015-04-01$274.04$210.77RVU15B
2015-01-01$274.04$210.77RVU15A
2014-10-01$267.95$207.22RVU14D
2014-07-01$267.95$207.22RVU14C
2014-04-01$267.95$207.22RVU14B
2014-01-01$267.95$207.22RVU14A
2013-10-01$268.86$204.96RVU13D
2013-07-01$268.86$204.96RVU13C
2013-04-01$268.86$204.96RVU13B
2013-01-01$268.86$204.96RVU13AR

Price 21011 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

21011 billing questions

When is 21012 used instead?

Use 21012 for a subcutaneous soft-tissue tumor of the face or scalp measuring 2 cm or larger. Code 21011 is for tumors under 2 cm.

How does 21011 differ from 21013?

21011 describes a tumor in the subcutaneous tissue. 21013 is for a tumor beneath the deep fascia that measures under 2 cm.

What should the operative note document?

Document the face or scalp site, the subcutaneous depth, tumor size, and the extent of excision. These details support selection over a larger-size, deeper, or more extensive resection code.

Is modifier 50 appropriate for bilateral excisions?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. CMS applies the standard multiple-procedure reduction when other procedures are performed in the same session.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 21011PPRRVU2026_Oct_nonQPP.csv, line 1,837 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 21011 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 21011 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist