CPT code 21557: Tumor resection, radical, under 5 cm2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 21557 in California.

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

What 21557 covers

This code describes radical resection of a soft-tissue tumor in the neck or anterior thorax, such as a small soft-tissue sarcoma. The surgeon removes the tumor more extensively than with a limited excision, typically taking it out en bloc with a planned margin of surrounding tissue. These operations are generally performed in a hospital operating room by a surgeon experienced in head and neck or soft-tissue tumor surgery.

Select this code when the operative report supports radical resection and documents a tumor size under 5 cm; a limited deep excision or a biopsy is a different service. Record the site, measured size, depth, extent of removal, and operative technique. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 21557 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 21557 rate is calculated

Each of 21557’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 21557

21557 has a 90-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

21557 compared with similar codes

How to choose

21558Tumor resectionNeck/anterior thorax, 5 cm or larger

Both describe radical tumor resection in the neck or anterior thorax; 21558 is for tumors 5 cm or greater, while 21557 is for tumors under 5 cm.

21556Tumor excisionDeep, under 5 cm

Use 21556 for deep soft-tissue tumor excision under 5 cm when the documented procedure is an excision, not a radical resection.

21550Soft-tissue biopsyDeep neck or thorax

21550 reports biopsy for tissue diagnosis. Use 21557 when the surgeon performs radical removal of the tumor rather than sampling it.

Codes related to 21557

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