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

Reports a deep soft-tissue biopsy in the neck or thorax when tissue is sampled to establish a diagnosis rather than remove the mass.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3K Medicare services in 2024

In Washington, DC area, Medicare pays $311.10 for 21550 in the office and $160.01 when it’s performed in a hospital or facility.

$311.10Office (non-facility)
$160.01Hospital or facility
+14.4%vs the national office rate ($271.88)

Check a contract rate as a % of Medicare · 21550 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 21550 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 21550 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 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.

How Washington, DC area compares for 21550

Across 109 of 109 payment localities, the office rate for 21550 runs from $239.80 in Arkansas to $360.13 in San Benito County, CA. Washington, DC area pays $311.10. The RVUs are the same everywhere; the geographic indexes change the dollars.

21550 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$311.10
  2. Los Angeles, CA · California$306.67−$4.43
  3. Miami, FL · Florida$295.12−$15.98
  4. Chicago, IL · Illinois$286.31−$24.79
  5. Manhattan, NY · New York$313.43+$2.33
  6. Alaska · Alaska$314.34+$3.24
  7. Alabama · Alabama$243.40−$67.70

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

21550 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$239.80$129.63
ArizonaArizona$264.46$140.17
Bakersfield, CACalifornia$287.81$147.23
Chico, CACalifornia$286.94$146.36
El Centro, CACalifornia$286.99$146.41
Fresno, CACalifornia$286.94$146.36
Hanford, CACalifornia$286.94$146.36
Madera, CACalifornia$286.94$146.36

21550 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.

$239.80

$323.53

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

View every state and territory as a table
21550 office rate range by state
State / territoryOffice rate rangeLocalities
AK$314.341
AL$243.401
AR$239.801
AZ$264.461
CA$286.94–$360.1329
CO$282.871
CT$290.231
DC$311.101
DE$268.901
FL$268.43–$295.123
GA$252.96–$277.192
GU$294.111
HI$294.111
IA$249.431
ID$251.161
IL$260.73–$286.314
IN$252.641
KS$248.381
KY$249.601
LA$249.26–$261.862
MA$281.18–$311.062
MD$274.07–$311.103
ME$252.65–$266.452
MI$256.38–$272.002
MN$270.431
MO$244.98–$262.643
MS$242.431
MT$271.861
NC$255.331
ND$265.931
NE$250.791
NH$278.551
NJ$293.37–$307.792
NM$257.871
NV$270.401
NY$259.25–$321.365
OH$255.171
OK$248.991
OR$268.14–$291.852
PA$255.50–$282.972
PR$273.861
RI$278.481
SC$255.711
SD$265.231
TN$249.681
TX$253.80–$282.088
UT$259.281
VA$265.66–$311.102
VI$273.861
VT$265.001
WA$280.61–$317.312
WI$256.841
WV$250.911
WY$269.281

See 21550 in every payment locality

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.

How the rate is built · 21550

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.06

2.06 RVUs× 1.000 GPCI

Practice expense5.78

5.78 RVUs× 1.000 GPCI

Malpractice0.30

0.30 RVUs× 1.000 GPCI

Adjusted RVUs

8.1400

Conversion factor

$33.4009

Medicare rate

$271.88

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,001

Code
21550
Physician work
2.06
Practice expense
5.78
Malpractice
0.30

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 21550 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.06× 1.0542.1712
Practice expense5.78× 1.1786.8088
Malpractice0.30× 1.1130.3339
Total RVUs9.3140
Conversion factor× 33.4009

Office rate, Washington, DC area$311.10

Office: (2.06 × 1.054 + 5.78 × 1.178 + 0.3 × 1.113) × $33.4009 = $311.10

Facility: (2.06 × 1.054 + 1.94 × 1.178 + 0.3 × 1.113) × $33.4009 = $160.01

Open 21550 in the RVU calculator

Payment rules and modifiers for 21550

21550 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21550

Soft-tissue biopsy, deep neck or thorax

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21550

Soft-tissue biopsy, deep neck or thorax

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21550 without 51 · national office

$271.88

Soft-tissue biopsy, deep neck or thorax

21550-51 · Second procedure: 50%

$135.94

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 21550

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

Codes related to 21550
CodeHow it relatesOffice range, Washington, DC area
Used instead
21552Soft-tissue excision, subcutaneous, 3 cm or largerExcises a subcutaneous neck lesion measuring 3 cm or larger rather than sampling deep tissue.No office rate
21555Mass excision, subcutaneous, under 3 cmExcises a subcutaneous neck lesion smaller than 3 cm rather than sampling deep tissue.$527.18
21554Tumor excision, deep, 5 cm or largerFor excision of a deep neck tumor measuring 5 cm or larger.No office rate
21556Tumor excision, deep, under 5 cmFor excision of a deep neck tumor smaller than 5 cm.No office rate

How 21550 has changed in Washington, DC area

21550 · Office / nonfacility

$311.10

Effective 2026-10-01

The base rate is $14.40 higher than on 2025-10-01, moving from $296.70 to $311.10 (4.9%).

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

    $296.70changed to$311.10

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.11 changed to 2.06
    • Practice expense RVU 5.53 changed to 5.78
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $309.29changed to$296.70

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.62 changed to 5.53
    • Malpractice RVU 0.31 changed to 0.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $304.24changed to$309.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $319.63changed to$304.24

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.63 changed to 5.62
    • Malpractice RVU 0.30 changed to 0.31
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $330.33changed to$319.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.62 changed to 5.63
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $332.60changed to$330.33

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.63 changed to 5.62
    • Malpractice RVU 0.27 changed to 0.29

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $317.96changed to$332.60

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.11 changed to 5.63
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $312.43changed to$317.96

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.04 changed to 5.11
    • Malpractice RVU 0.31 changed to 0.28
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $312.52changed to$312.43

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.05 changed to 5.04

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $312.78changed to$312.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.06 changed to 5.05
    • Malpractice RVU 0.32 changed to 0.31
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $313.67changed to$312.78

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.09 changed to 5.06
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $313.50changed to$313.67

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.06 changed to 5.09

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $311.94changed to$313.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $308.90changed to$311.94

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.04 changed to 5.06
    • Malpractice RVU 0.29 changed to 0.32
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $312.65changed to$308.90

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.54 changed to 5.04
    • Malpractice RVU 0.30 changed to 0.29
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $312.65

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$311.10$160.01RVU26D
2026-07-01$311.10$160.01RVU26C
2026-04-01$311.10$160.01RVU26B
2026-01-01$311.10$160.01RVU26A
2025-10-01$296.70$172.16RVU25D
2025-07-01$296.70$172.16RVU25C
2025-04-01$296.70$172.16RVU25B
2025-01-01$296.70$172.16RVU25A
2024-10-01$309.29$176.76RVU24D
2024-07-01$309.29$176.76RVU24C
2024-04-01$309.29$176.76RVU24B
2024-03-09$309.29$176.76RVU24AR
2024-01-01$304.24$173.88RVU24A
2023-10-01$319.63$180.99RVU23D
2023-07-01$319.63$180.99RVU23C
2023-04-01$319.63$180.99RVU23B
2023-01-01$319.63$180.99RVU23A
2022-10-01$330.33$184.05RVU22D
2022-07-01$330.33$184.05RVU22C
2022-04-01$330.33$184.05RVU22B
2022-01-01$330.33$184.05RVU22A
2021-10-01$332.60$183.38RVU21D
2021-07-01$332.60$183.38RVU21C
2021-04-01$332.60$183.38RVU21B
2021-01-01$332.60$183.38RVU21A
2020-10-01$317.96$184.44RVU20D
2020-07-01$317.96$184.44RVU20C
2020-04-01$317.96$184.44RVU20B
2020-01-01$317.96$184.44RVU20A
2019-10-01$312.43$184.32RVU19D
2019-07-01$312.43$184.32RVU19C
2019-04-01$312.43$184.32RVU19B
2019-01-01$312.43$184.32RVU19A
2018-10-01$312.52$184.55RVU18D
2018-07-01$312.52$184.55RVU18C
2018-04-01$312.52$184.55RVU18B
2018-01-01$312.52$184.55RVU18AR1
2017-10-01$312.78$185.21RVU17D
2017-07-01$312.78$185.21RVU17C
2017-04-01$312.78$185.21RVU17B
2017-01-01$312.78$185.21RVU17A
2016-10-01$313.67$185.53RVU16D
2016-07-01$313.67$185.53RVU16C
2016-04-01$313.67$185.53RVU16B
2016-01-01$313.67$185.53RVU16A
2015-10-01$313.50$185.77RVU15D
2015-07-01$313.50$185.77RVU15C
2015-04-01$311.94$184.84RVU15B
2015-01-01$311.94$184.84RVU15A
2014-10-01$308.90$182.74RVU14D
2014-07-01$308.90$182.74RVU14C
2014-04-01$308.90$182.74RVU14B
2014-01-01$308.90$182.74RVU14A
2013-10-01$312.65$180.59RVU13D
2013-07-01$312.65$180.59RVU13C
2013-04-01$312.65$180.59RVU13B
2013-01-01$312.65$180.59RVU13AR

Price 21550 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

21550 billing questions

How does this differ from a neck tumor excision code?

Use 21550 when the procedure samples deep soft tissue for diagnosis. When the surgeon removes a neck lesion or tumor, consider the applicable excision code instead.

Can modifier 50 be used for biopsies on both sides?

No. Modifier 50 is inappropriate for this descriptor and anatomy.

Are related postoperative visits separately paid during the global period?

Related postoperative visits during the 10-day global period are included in the procedure payment.

How is this code affected when another procedure is performed in the same session?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.

Can an assistant surgeon or co-surgeon be reported?

CMS does not pay an assistant at surgery for this code. Co-surgeon and team-surgery reporting are not permitted.

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 21550PPRRVU2026_Oct_nonQPP.csv, line 2,001 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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