CPT code 21558: Tumor resection, neck/anterior thorax, 5 cm or larger2026 Medicare rate & RVUs in Maryland
Radical resection of a soft-tissue tumor in the neck or anterior thorax measuring at least 5 cm, typically for definitive oncologic treatment.
CMS doesn’t publish an office rate for 21558 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
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.
Where 21558 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,295.23 |
| Rest of Maryland | Unavailable | $1,220.59 |
| Washington, DC area | Unavailable | $1,341.98 |
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
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.
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
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 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.
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%).
21558 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21557Tumor resectionRadical, under 5 cm
- Both describe radical resection in the neck or anterior thorax; 21557 is for tumors under 5 cm, while 21558 is for tumors 5 cm or larger.
- 21554Tumor excisionDeep, 5 cm or larger
- Use 21554 for a deep neck tumor at least 5 cm when the documented procedure is an excision, rather than the radical resection represented by 21558.
- 21550Soft-tissue biopsyDeep neck or thorax
- 21550 describes biopsy of a neck or chest lesion. It is for diagnostic tissue sampling, not definitive radical tumor resection.
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
Fee sheets · Coming soon
Put 21558 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist