CPT code 21012: Soft-tissue excision, subcutaneous, 2 cm or larger2026 Medicare rate & RVUs

Medicare pays $323.99 for 21012 nationally in a facility.

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

What 21012 covers

Code 21012 describes surgical removal of a soft-tissue tumor in the subcutaneous layer of the face or scalp when the lesion measures 2 cm or more. An otolaryngologist, plastic surgeon, or oral and maxillofacial surgeon may perform the procedure in an office procedure room or operating room, depending on the lesion and setting. The word “tumor” identifies the mass being removed; it does not by itself establish malignancy. This code is not selected for a lesion confined to the skin or for a mass removed from a deeper plane.

Choose the code based on the tumor’s documented size and tissue plane, not the incision length. The operative report should identify the face or scalp site, subcutaneous location, and lesion measurement. CMS treats this as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. 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.

Where 21012 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21012 rates by state

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

How the 21012 rate is calculated

Each of 21012’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.

Payment rules and modifiers for 21012

21012 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

21012 compared with similar codes

How to choose

21011Facial tumor excisionSubcutaneous, under 2 cm

This is the subcutaneous counterpart for a tumor under 2 cm. Use 21012 when the subcutaneous tumor measures 2 cm or more.

21013Tumor excisionDeep, under 2 cm

This code is for a deeper soft-tissue tumor under 2 cm. Code 21012 describes a subcutaneous tumor measuring at least 2 cm.

21014Tumor excisionDeep, 2 cm or larger

Both codes use the 2 cm-or-larger size category, but 21014 is for a deeper soft-tissue tumor; 21012 is for the subcutaneous plane.

21016Tumor resectionFace or scalp, 2 cm or larger

This code describes resection of a face or scalp tumor measuring 2 cm or more. Use 21012 for subcutaneous tumor excision when the documented procedure is not a resection.

Codes related to 21012

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

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

Open CMS sourceHow we calculate rates