CPT code 21558: Tumor resection, neck/anterior thorax, 5 cm or larger2026 Medicare rate & RVUs in Madera, CA

Radical resection of a soft-tissue tumor in the neck or anterior thorax measuring at least 5 cm, typically for definitive oncologic treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality650 Medicare services in 2024

In Madera, CA, Medicare pays $1,199.04 for 21558 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,199.04Hospital or facility

Check a contract rate as a % of Medicare · 21558 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 21558 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Madera, CA
  2. What 21558 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 21558 covers

This service covers radical removal of a soft-tissue tumor, such as a sarcoma, in the neck or anterior thorax when the tumor is at least 5 cm. It represents a more extensive oncologic resection than a limited excision or diagnostic biopsy. Head and neck or surgical oncology surgeons commonly perform it in an operating room, with the operative approach and extent guided by the tumor’s location and treatment plan.

Report the code when the operative record supports radical resection and identifies the anatomic site, tumor size, and extent of removal. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For other procedures performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple procedure reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.

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 Madera, CA compares for 21558

Across 109 of 109 payment localities, the facility rate for 21558 runs from $1,096.63 in Arkansas to $1,529.31 in Alaska. Madera, CA pays $1,199.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

21558 in Madera, CA vs other payment areas
  1. Madera, CA · this page$1,199.04
  2. Bakersfield, CA · California$1,211.42+$12.38
  3. Chico, CA · California$1,199.04
  4. El Centro, CA · California$1,199.80+$0.76
  5. Fresno, CA · California$1,199.04
  6. Hanford, CA · California$1,199.04
  7. Los Angeles, CA · California$1,267.20+$68.16

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

Every other payment area

21558 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia—$1,199.04
Modesto, CACalifornia—$1,199.04
Napa, CACalifornia—$1,308.95
Oxnard, CACalifornia—$1,251.53
Redding, CACalifornia—$1,199.04
Rest of CaliforniaCalifornia—$1,199.04
Riverside, CACalifornia—$1,247.39
Sacramento, CACalifornia—$1,237.08

21558 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

View every state and territory as a table
21558 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 21558 in every payment locality

How the 21558 rate is calculated

Each of 21558’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 · 21558

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.04

21.04 RVUs× 1.000 GPCI

Practice expense11.03

11.03 RVUs× 1.000 GPCI

Malpractice4.50

4.50 RVUs× 1.000 GPCI

Adjusted RVUs

36.5700

Conversion factor

$33.4009

Medicare rate

$1,221.47

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

The exact Madera, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,007

Code
21558
Physician work
21.04
Practice expense
11.03
Malpractice
4.50

GPCI2026.csv

14

Locality
Madera, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Facility calculation for 21558 in Madera, CA
ComponentRVULocality factorAdjusted
Physician work21.04× 1.01721.3977
Practice expense11.03× 1.09612.0889
Malpractice4.50× 0.5362.4120
Total RVUs35.8986
Conversion factor× 33.4009

Facility rate, Madera, CA$1199.04

Facility: (21.04 × 1.017 + 11.03 × 1.096 + 4.5 × 0.536) × $33.4009 = $1199.04

Open 21558 in the RVU calculator

Payment rules and modifiers for 21558

21558 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21558

Tumor resection, neck/anterior thorax, 5 cm or larger

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21558

Tumor resection, neck/anterior thorax, 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21558 without 51 · national facility

$1,221.47

Tumor resection, neck/anterior thorax, 5 cm or larger

21558-51 · Second procedure: 50%

$610.74

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

How 21558 has changed in Madera, CA

21558 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,199.04RVU26D
2026-07-01Not available in this setting$1,199.04RVU26C
2026-04-01Not available in this setting$1,199.04RVU26B
2026-01-01Not available in this setting$1,199.04RVU26A
2025-10-01Not available in this setting$1,296.34RVU25D
2025-07-01Not available in this setting$1,296.34RVU25C
2025-04-01Not available in this setting$1,296.34RVU25B
2025-01-01Not available in this setting$1,296.34RVU25A
2024-10-01Not available in this setting$1,325.35RVU24D
2024-07-01Not available in this setting$1,325.35RVU24C
2024-04-01Not available in this setting$1,325.35RVU24B
2024-03-09Not available in this setting$1,325.35RVU24AR
2024-01-01Not available in this setting$1,303.72RVU24A
2023-10-01Not available in this setting$1,348.24RVU23D
2023-07-01Not available in this setting$1,348.24RVU23C
2023-04-01Not available in this setting$1,348.24RVU23B
2023-01-01Not available in this setting$1,348.24RVU23A
2022-10-01Not available in this setting$1,365.12RVU22D
2022-07-01Not available in this setting$1,365.12RVU22C
2022-04-01Not available in this setting$1,365.12RVU22B
2022-01-01Not available in this setting$1,365.12RVU22A
2021-10-01Not available in this setting$1,365.98RVU21D
2021-07-01Not available in this setting$1,365.98RVU21C
2021-04-01Not available in this setting$1,365.98RVU21B
2021-01-01Not available in this setting$1,365.98RVU21A
2020-10-01Not available in this setting$1,387.33RVU20D
2020-07-01Not available in this setting$1,387.33RVU20C
2020-04-01Not available in this setting$1,387.33RVU20B
2020-01-01Not available in this setting$1,387.33RVU20A
2019-10-01Not available in this setting$1,376.87RVU19D
2019-07-01Not available in this setting$1,376.87RVU19C
2019-04-01Not available in this setting$1,376.87RVU19B
2019-01-01Not available in this setting$1,376.87RVU19A
2018-10-01Not available in this setting$1,372.62RVU18D
2018-07-01Not available in this setting$1,372.62RVU18C
2018-04-01Not available in this setting$1,372.62RVU18B
2018-01-01Not available in this setting$1,372.62RVU18AR1
2017-10-01Not available in this setting$1,385.66RVU17D
2017-07-01Not available in this setting$1,385.66RVU17C
2017-04-01Not available in this setting$1,385.66RVU17B
2017-01-01Not available in this setting$1,385.66RVU17A
2016-10-01Not available in this settingRate data unavailableRVU16D
2016-07-01Not available in this settingRate data unavailableRVU16C
2016-04-01Not available in this settingRate data unavailableRVU16B
2016-01-01Not available in this settingRate data unavailableRVU16A
2015-10-01Not available in this settingRate data unavailableRVU15D
2015-07-01Not available in this settingRate data unavailableRVU15C
2015-04-01Not available in this settingRate data unavailableRVU15B
2015-01-01Not available in this settingRate data unavailableRVU15A
2014-10-01Not available in this settingRate data unavailableRVU14D
2014-07-01Not available in this settingRate data unavailableRVU14C
2014-04-01Not available in this settingRate data unavailableRVU14B
2014-01-01Not available in this settingRate data unavailableRVU14A
2013-10-01Not available in this settingRate data unavailableRVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 21558 for an earlier date of service

Where the Madera, CA rate applies

Madera, CA is a Medicare payment area, not a city. Our Census mapping connects it to 17 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Madera
  • Ahwahnee
  • Bass Lake
  • Bonadelle Ranchos
  • Chowchilla
  • Coarsegold
  • Fairmead
  • La Vina

Browse all communities in California

21558 billing questions

How is 21558 different from 21554?

Both concern a deep neck tumor at least 5 cm, but 21558 is for radical resection. Use 21554 for the applicable deep-tumor excision when the documented operation is not a radical resection.

Does the tumor need to measure at least 5 cm?

Yes. This code is for a tumor measuring 5 cm or larger; 21557 is the related radical-resection code for tumors under 5 cm.

What documentation supports reporting 21558?

The operative report should identify the neck or anterior thorax site, tumor size, and the extent of the radical resection. Documentation should distinguish the operation from a limited excision or biopsy.

Can an assistant surgeon be reported?

CMS permits payment for an assistant at surgery with this code. Co-surgeon payment requires supporting documentation.

Can modifier 50 be used for bilateral tumors?

No. The code’s descriptor or anatomy makes modifier 50 inappropriate.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and related postoperative care for 90 days are included in the global period.

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 21558PPRRVU2026_Oct_nonQPP.csv, line 2,007 (RVU26D)
Geographic factors for Madera, CAGPCI2026.csv, line 14 (RVU26D)

Open CMS sourceHow we calculate rates

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