CPT code 21550: Soft-tissue biopsy, deep neck or thorax2026 Medicare rate & RVUs

Medicare pays $271.88 for 21550 nationally in the office and $143.62 in a hospital or facility. Local office rates run $239.80–$360.13.

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

What 21550 covers

This code describes surgical sampling of deep soft tissue in the neck or thorax for diagnostic evaluation, such as obtaining tissue from a deep mass. A surgeon, otolaryngologist, or thoracic surgeon may perform the procedure in an office-based setting or hospital operating room, depending on the location and access required. The service is a biopsy, not removal of a neck lesion or tumor as definitive treatment.

Choose the code when the operative record supports a deep soft-tissue biopsy in the specified anatomic region. Document the site, depth, approach, and diagnostic purpose; codes for excising neck lesions or tumors are selected when the tissue is removed rather than sampled. The 10-day global period includes related postoperative visits during that period. 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 for this descriptor and anatomy. CMS does not pay an assistant at surgery for this code, and co-surgeon and team-surgery reporting 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 21550 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

21550 rates by state

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

How the 21550 rate is calculated

Each of 21550’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 21550

21550 has a 10-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

21550 compared with similar codes

How to choose

21552Soft-tissue excisionSubcutaneous, 3 cm or larger

21550 samples deep neck or thorax soft tissue for diagnosis. 21552 removes a subcutaneous neck lesion measuring 3 cm or larger.

21555Mass excisionSubcutaneous, under 3 cm

Choose 21550 for a deep soft-tissue biopsy; 21555 describes removal of a subcutaneous neck lesion smaller than 3 cm.

21554Tumor excisionDeep, 5 cm or larger

21554 is for excision of a deep neck tumor measuring 5 cm or larger, not diagnostic sampling.

21556Tumor excisionDeep, under 5 cm

21556 describes excision of a deep neck tumor smaller than 5 cm; 21550 is for biopsy of deep neck or thorax soft tissue.

Codes related to 21550

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