CPT code 21550: Soft-tissue biopsy, deep neck or thorax2026 Medicare rate & RVUs in Oregon
Reports a deep soft-tissue biopsy in the neck or thorax when tissue is sampled to establish a diagnosis rather than remove the mass.
Medicare pays $268.14–$291.85 for 21550 in the office in Oregon, from Rest of Oregon to Portland, OR. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | $291.85 | $149.35 |
| Rest of Oregon | $268.14 | $140.39 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
21550 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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