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

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 New Mexico, Medicare pays $257.87 for 21550 in the office and $140.26 when it’s performed in a hospital or facility.

$257.87Office (non-facility)
$140.26Hospital or facility
−5.2%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 New Mexico
  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 New Mexico 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. New Mexico pays $257.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

21550 in New Mexico vs other payment areas
  1. New Mexico · this page$257.87
  2. Los Angeles, CA · California$306.67+$48.80
  3. Washington, DC area · District of Columbia$311.10+$53.23
  4. Miami, FL · Florida$295.12+$37.25
  5. Chicago, IL · Illinois$286.31+$28.44
  6. Manhattan, NY · New York$313.43+$55.56
  7. Alaska · Alaska$314.34+$56.47

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

Every other payment area

21550 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$243.40$131.18
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

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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 21550 in New Mexico
ComponentRVULocality factorAdjusted
Physician work2.06× 1.0002.0600
Practice expense5.78× 0.9175.3003
Malpractice0.30× 1.2010.3603
Total RVUs7.7206
Conversion factor× 33.4009

Office rate, New Mexico$257.87

Office: (2.06 × 1 + 5.78 × 0.917 + 0.3 × 1.201) × $33.4009 = $257.87

Facility: (2.06 × 1 + 1.94 × 0.917 + 0.3 × 1.201) × $33.4009 = $140.26

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, New Mexico
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.$442.69
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 New Mexico

21550 · Office / nonfacility

$257.87

Effective 2026-10-01

The base rate is $15.83 higher than on 2025-10-01, moving from $242.04 to $257.87 (6.5%).

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

    $242.04changed to$257.87

    • 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
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $252.20changed to$242.04

    • 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

    $248.08changed to$252.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $255.47changed to$248.08

    • 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
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172

  5. January 1, 2023

    RVU23A

    $258.98changed to$255.47

    • 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
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $260.63changed to$258.98

    • 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

    $255.80changed to$260.63

    • 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
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $257.26changed to$255.80

    • 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
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $257.31changed to$257.26

    • 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

    $256.62changed to$257.31

    • 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
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $256.33changed to$256.62

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.09 changed to 5.06
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $256.27changed to$256.33

    • 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

    $254.99changed to$256.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $252.54changed to$254.99

    • 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
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $254.62changed to$252.54

    • 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
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $254.62

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$257.87$140.26RVU26D
2026-07-01$257.87$140.26RVU26C
2026-04-01$257.87$140.26RVU26B
2026-01-01$257.87$140.26RVU26A
2025-10-01$242.04$147.18RVU25D
2025-07-01$242.04$147.18RVU25C
2025-04-01$242.04$147.18RVU25B
2025-01-01$242.04$147.18RVU25A
2024-10-01$252.20$151.24RVU24D
2024-07-01$252.20$151.24RVU24C
2024-04-01$252.20$151.24RVU24B
2024-03-09$252.20$151.24RVU24AR
2024-01-01$248.08$148.78RVU24A
2023-10-01$255.47$152.47RVU23D
2023-07-01$255.47$152.47RVU23C
2023-04-01$255.47$152.47RVU23B
2023-01-01$255.47$152.47RVU23A
2022-10-01$258.98$152.94RVU22D
2022-07-01$258.98$152.94RVU22C
2022-04-01$258.98$152.94RVU22B
2022-01-01$258.98$152.94RVU22A
2021-10-01$260.63$152.45RVU21D
2021-07-01$260.63$152.45RVU21C
2021-04-01$260.63$152.45RVU21B
2021-01-01$260.63$152.45RVU21A
2020-10-01$255.80$156.51RVU20D
2020-07-01$255.80$156.51RVU20C
2020-04-01$255.80$156.51RVU20B
2020-01-01$255.80$156.51RVU20A
2019-10-01$257.26$159.35RVU19D
2019-07-01$257.26$159.35RVU19C
2019-04-01$257.26$159.35RVU19B
2019-01-01$257.26$159.35RVU19A
2018-10-01$257.31$159.50RVU18D
2018-07-01$257.31$159.50RVU18C
2018-04-01$257.31$159.50RVU18B
2018-01-01$257.31$159.50RVU18AR1
2017-10-01$256.62$159.22RVU17D
2017-07-01$256.62$159.22RVU17C
2017-04-01$256.62$159.22RVU17B
2017-01-01$256.62$159.22RVU17A
2016-10-01$256.33$158.61RVU16D
2016-07-01$256.33$158.61RVU16C
2016-04-01$256.33$158.61RVU16B
2016-01-01$256.33$158.61RVU16A
2015-10-01$256.27$158.85RVU15D
2015-07-01$256.27$158.85RVU15C
2015-04-01$254.99$158.06RVU15B
2015-01-01$254.99$158.06RVU15A
2014-10-01$252.54$156.18RVU14D
2014-07-01$252.54$156.18RVU14C
2014-04-01$252.54$156.18RVU14B
2014-01-01$252.54$156.18RVU14A
2013-10-01$254.62$153.64RVU13D
2013-07-01$254.62$153.64RVU13C
2013-04-01$254.62$153.64RVU13B
2013-01-01$254.62$153.64RVU13AR

Price 21550 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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 New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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