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CPT code 21013: Tumor excision, deep, under 2 cm2026 Medicare rate & RVUs in Connecticut

Reports removal of a small soft-tissue tumor beneath the fascia of the face or scalp, including deep or intramuscular lesions.

CMS RVU26DEffective Oct 1, 2026One payment locality630 Medicare services in 2024

In Connecticut, Medicare pays $603.32 for 21013 in the office and $394.68 when it’s performed in a hospital or facility.

$603.32Office (non-facility)
$394.68Hospital or facility
+6.7%vs the national office rate ($565.48)

Check a contract rate as a % of Medicare · 21013 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 21013 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 21013 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 21013 covers

This code describes excision of a soft-tissue tumor beneath the fascia in the face or scalp, including a lesion within muscle, when the tumor is smaller than 2 cm. The surgeon removes the deep mass rather than a superficial skin or subcutaneous lesion. Otolaryngologists, plastic surgeons, and oral and maxillofacial surgeons may perform this procedure in an operating room or an appropriately equipped outpatient setting.

Select the code using the tumor’s depth and size, not the skin incision length: the operative report should identify the facial or scalp site, the tissue plane or muscle involved, and the tumor measurement. This major surgery has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery services may be paid; co-surgeon and team-surgery billing 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 Connecticut compares for 21013

Across 109 of 109 payment localities, the office rate for 21013 runs from $499.35 in Arkansas to $727.21 in San Benito County, CA. Connecticut pays $603.32. The RVUs are the same everywhere; the geographic indexes change the dollars.

21013 in Connecticut vs other payment areas
  1. Connecticut · this page$603.32
  2. Los Angeles, CA · California$626.93+$23.61
  3. Washington, DC area · District of Columbia$642.14+$38.82
  4. Miami, FL · Florida$630.14+$26.82
  5. Chicago, IL · Illinois$610.88+$7.56
  6. Manhattan, NY · New York$653.68+$50.36
  7. Alaska · Alaska$662.12+$58.80

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

Every other payment area

21013 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$506.72$337.21
ArkansasArkansas$499.35$332.94
ArizonaArizona$549.72$362.00
Bakersfield, CACalifornia$590.24$377.92
Chico, CACalifornia$587.50$375.18
El Centro, CACalifornia$587.66$375.34
Fresno, CACalifornia$587.50$375.18
Hanford, CACalifornia$587.50$375.18

21013 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.

$499.35

$662.12

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

View every state and territory as a table
21013 office rate range by state
State / territoryOffice rate rangeLocalities
AK$662.121
AL$506.721
AR$499.351
AZ$549.721
CA$587.50–$727.2129
CO$583.231
CT$603.321
DC$642.141
DE$558.781
FL$566.26–$630.143
GA$533.27–$578.292
GU$600.521
HI$600.521
IA$515.451
ID$519.721
IL$552.90–$610.884
IN$522.641
KS$515.031
KY$523.141
LA$523.12–$548.902
MA$580.54–$638.252
MD$568.83–$642.143
ME$524.59–$550.192
MI$538.69–$575.462
MN$552.771
MO$515.44–$548.443
MS$507.401
MT$565.411
NC$529.781
ND$546.031
NE$517.681
NH$576.001
NJ$608.49–$635.842
NM$542.481
NV$560.371
NY$537.94–$672.175
OH$534.731
OK$520.041
OR$554.33–$599.482
PA$534.45–$589.582
PR$568.911
RI$577.051
SC$533.481
SD$543.741
TN$517.891
TX$531.08–$582.778
UT$540.761
VA$549.80–$642.142
VI$568.911
VT$545.741
WA$578.84–$649.202
WI$527.861
WV$532.901
WY$556.971

See 21013 in every payment locality

How the 21013 rate is calculated

Each of 21013’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 · 21013

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.28

5.28 RVUs× 1.000 GPCI

Practice expense10.67

10.67 RVUs× 1.000 GPCI

Malpractice0.98

0.98 RVUs× 1.000 GPCI

Adjusted RVUs

16.9300

Conversion factor

$33.4009

Medicare rate

$565.48

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,839

Code
21013
Physician work
5.28
Practice expense
10.67
Malpractice
0.98

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 21013 in Connecticut
ComponentRVULocality factorAdjusted
Physician work5.28× 1.0205.3856
Practice expense10.67× 1.07711.4916
Malpractice0.98× 1.2101.1858
Total RVUs18.0630
Conversion factor× 33.4009

Office rate, Connecticut$603.32

Office: (5.28 × 1.02 + 10.67 × 1.077 + 0.98 × 1.21) × $33.4009 = $603.32

Facility: (5.28 × 1.02 + 4.87 × 1.077 + 0.98 × 1.21) × $33.4009 = $394.68

Open 21013 in the RVU calculator

Payment rules and modifiers for 21013

21013 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21013

Tumor excision, deep, 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 · 21013

Tumor excision, deep, 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

21013 without 51 · national office

$565.48

Tumor excision, deep, under 2 cm

21013-51 · Second procedure: 50%

$282.74

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 21013

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

Codes related to 21013
CodeHow it relatesOffice range, Connecticut
Same family
21011Facial tumor excision, subcutaneous, under 2 cmFacial or scalp soft-tissue tumor in the subcutaneous plane, under 2 cm.$422.35
21012Soft-tissue excision, subcutaneous, 2 cm or largerFacial or scalp soft-tissue tumor in the subcutaneous plane, 2 cm or larger.No office rate
21014Tumor excision, deep, 2 cm or largerDeep facial or scalp soft-tissue tumor, 2 cm or larger.No office rate
Used instead
21015Tumor resection, subfascial, under 2 cmFor a radical resection of a small face or scalp soft-tissue tumor.No office rate

How 21013 has changed in Connecticut

21013 · Office / nonfacility

$603.32

Effective 2026-10-01

The base rate is $44.39 higher than on 2025-10-01, moving from $558.93 to $603.32 (7.9%).

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

    $558.93changed to$603.32

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.42 changed to 5.28
    • Practice expense RVU 9.71 changed to 10.67
    • Malpractice RVU 0.95 changed to 0.98
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $578.14changed to$558.93

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.78 changed to 9.71
    • Malpractice RVU 0.96 changed to 0.95

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $568.70changed to$578.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $589.21changed to$568.70

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $597.17changed to$589.21

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.64 changed to 9.78
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $597.19changed to$597.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.53 changed to 9.64
    • Malpractice RVU 0.94 changed to 0.96

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $592.70changed to$597.19

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.86 changed to 9.53
    • Malpractice RVU 0.90 changed to 0.94
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $589.46changed to$592.70

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.66 changed to 8.86
    • Malpractice RVU 0.95 changed to 0.90
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $581.20changed to$589.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.47 changed to 8.66

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $580.14changed to$581.20

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.45 changed to 8.47
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $579.82changed to$580.14

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.44 changed to 8.45
    • Malpractice RVU 0.96 changed to 0.95
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $581.39changed to$579.82

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.46 changed to 8.44
    • Malpractice RVU 0.93 changed to 0.96

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $578.49changed to$581.39

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $567.12changed to$578.49

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.35 changed to 8.46
    • Malpractice RVU 0.78 changed to 0.93
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $577.15changed to$567.12

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.37 changed to 8.35
    • Malpractice RVU 0.82 changed to 0.78
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $577.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$603.32$394.68RVU26D
2026-07-01$603.32$394.68RVU26C
2026-04-01$603.32$394.68RVU26B
2026-01-01$603.32$394.68RVU26A
2025-10-01$558.93$423.06RVU25D
2025-07-01$558.93$423.06RVU25C
2025-04-01$558.93$423.06RVU25B
2025-01-01$558.93$423.06RVU25A
2024-10-01$578.14$433.23RVU24D
2024-07-01$578.14$433.23RVU24C
2024-04-01$578.14$433.23RVU24B
2024-03-09$578.14$433.23RVU24AR
2024-01-01$568.70$426.16RVU24A
2023-10-01$589.21$437.22RVU23D
2023-07-01$589.21$437.22RVU23C
2023-04-01$589.21$437.22RVU23B
2023-01-01$589.21$437.22RVU23A
2022-10-01$597.17$437.95RVU22D
2022-07-01$597.17$437.95RVU22C
2022-04-01$597.17$437.95RVU22B
2022-01-01$597.17$437.95RVU22A
2021-10-01$597.19$437.04RVU21D
2021-07-01$597.19$437.04RVU21C
2021-04-01$597.19$437.04RVU21B
2021-01-01$597.19$437.04RVU21A
2020-10-01$592.70$446.49RVU20D
2020-07-01$592.70$446.49RVU20C
2020-04-01$592.70$446.49RVU20B
2020-01-01$592.70$446.49RVU20A
2019-10-01$589.46$449.99RVU19D
2019-07-01$589.46$449.99RVU19C
2019-04-01$589.46$449.99RVU19B
2019-01-01$589.46$449.99RVU19A
2018-10-01$581.20$448.70RVU18D
2018-07-01$581.20$448.70RVU18C
2018-04-01$581.20$448.70RVU18B
2018-01-01$581.20$448.70RVU18AR1
2017-10-01$580.14$448.66RVU17D
2017-07-01$580.14$448.66RVU17C
2017-04-01$580.14$448.66RVU17B
2017-01-01$580.14$448.66RVU17A
2016-10-01$579.82$448.17RVU16D
2016-07-01$579.82$448.17RVU16C
2016-04-01$579.82$448.17RVU16B
2016-01-01$579.82$448.17RVU16A
2015-10-01$581.39$448.46RVU15D
2015-07-01$581.39$448.46RVU15C
2015-04-01$578.49$446.23RVU15B
2015-01-01$578.49$446.23RVU15A
2014-10-01$567.12$437.99RVU14D
2014-07-01$567.12$437.99RVU14C
2014-04-01$567.12$437.99RVU14B
2014-01-01$567.12$437.99RVU14A
2013-10-01$577.15$437.42RVU13D
2013-07-01$577.15$437.42RVU13C
2013-04-01$577.15$437.42RVU13B
2013-01-01$577.15$437.42RVU13AR

Price 21013 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

21013 billing questions

How is this code distinguished from a superficial facial lesion excision?

Use this code for a tumor beneath the fascia, including an intramuscular mass, that is under 2 cm. A lesion limited to the subcutaneous plane belongs to the superficial-lesion code family.

Which size measurement supports code selection?

Document the tumor measurement and its tissue depth in the operative report. The 2 cm threshold concerns the tumor, not the incision.

Does the code include the related postoperative visits?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other procedures paid when performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery services may be paid. CMS does not permit co-surgeon or team-surgery billing for this code.

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 21013PPRRVU2026_Oct_nonQPP.csv, line 1,839 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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