CPT code 21554: Tumor excision, deep, 5 cm or larger2026 Medicare rate & RVUs in Texas
Reports excision of a soft-tissue tumor beneath the deep fascia in the neck or anterior thorax when the tumor measures at least 5 cm.
CMS doesn’t publish an office rate for 21554 in Texas.
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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What 21554 covers
A surgeon removes a soft-tissue tumor located beneath the deep fascia in the neck or anterior thorax, including an intramuscular mass. The code describes excision, not a limited diagnostic sample; the operative report should make clear that the surgeon removed the tumor and document its site, depth, and size. These procedures are commonly performed by head and neck, general, or other surgeons in an operating room or ambulatory surgery setting.
Select this code when the documented tumor is deep and measures 5 cm or larger. The operative note should support the anatomic location, relationship to the fascia or muscle, tumor measurement, and extent of removal. CMS assigns a 90-day global period, including 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% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery 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 21554 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $686.17 |
| Beaumont, TX | Unavailable | $653.58 |
| Brazoria, TX | Unavailable | $663.90 |
| Dallas, TX | Unavailable | $671.68 |
| Fort Worth, TX | Unavailable | $670.34 |
| Galveston, TX | Unavailable | $668.21 |
| Houston, TX | Unavailable | $711.96 |
| Rest of Texas | Unavailable | $660.80 |
How the 21554 rate is calculated
Each of 21554’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 · 21554
RVUs × geographic indexes × conversion factor
Work10.85
10.85 RVUs× 1.000 GPCI
Practice expense7.14
7.14 RVUs× 1.000 GPCI
Malpractice2.39
2.39 RVUs× 1.000 GPCI
Adjusted RVUs
20.3800
Conversion factor
$33.4009
Medicare rate
$680.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21554
21554 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21554
Tumor excision, deep, 5 cm or larger
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 2 | Paid. |
| 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) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21554
Tumor excision, deep, 5 cm or larger
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21554 without 51 · national facility
$680.71
Tumor excision, deep, 5 cm or larger
21554-51 · Second procedure: 50%
$340.36
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%).
21554 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21556Tumor excisionDeep, under 5 cm
- Both concern deep soft-tissue tumors in the neck or anterior thorax; the size distinction is 5 cm or larger for 21554 versus smaller than 5 cm for 21556.
- 21552Soft-tissue excisionSubcutaneous, 3 cm or larger
- 21552 applies to a subcutaneous neck lesion measuring 3 cm or larger. This code requires a deep tumor measuring at least 5 cm.
- 21558Tumor resectionNeck/anterior thorax, 5 cm or larger
- 21558 is for radical resection of a neck tumor measuring 5 cm or larger. Choose 21554 for excision when the documented operation is not a radical resection.
- 21550Soft-tissue biopsyDeep neck or thorax
- 21550 is for biopsy of a neck or chest lesion; 21554 represents excision of a qualifying deep tumor.
21554 billing questions
How does this differ from 21556?
Both describe excision of a deep soft-tissue neck or anterior thorax tumor. Use 21554 for a tumor measuring 5 cm or larger and 21556 for one smaller than 5 cm.
When is 21550 more appropriate?
21550 describes a biopsy of a neck or chest lesion. Use 21554 when the surgeon excises the qualifying deep tumor rather than taking a diagnostic sample.
What documentation supports 21554?
Document the neck or anterior thorax site, deep or subfascial location, tumor size of at least 5 cm, and the excision performed.
Should modifier 50 be added for bilateral tumors?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. CMS does not permit co-surgeons or team surgery 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
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