Billing code 21011: Facial tumor excisionMedicare rate & RVUs

Medicare pays $395.13 for 21011 nationally in the office and $250.17 in a hospital or facility. Local office rates run $347.08–$521.36.

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

What 21011 covers

This service removes a small soft-tissue tumor located beneath the skin of the face or scalp, such as a subcutaneous lipoma. The surgeon works in the superficial tissue plane rather than beneath the deep fascia. Plastic surgeons, otolaryngologists, and oral and maxillofacial surgeons may perform it in an office or outpatient surgical setting when the mass can be excised without a deeper or radical resection.

Select this code when the tumor is subcutaneous and measures less than 2 cm; use the documented site, tissue depth, and tumor size to distinguish it from larger or deeper masses. The operative report should identify the face or scalp location, depth, size, and extent of removal. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 21011 pays more and less

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

109 of 109 payment localities

21011 rates by state

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

How the 21011 rate is calculated

Each of 21011’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 21011

21011 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

21011 compared with similar codes

How to choose

21012Soft-tissue excision

Both address subcutaneous face or scalp soft-tissue tumors, but 21012 is for a tumor measuring 2 cm or larger; 21011 is for one under 2 cm.

21013Tumor excision

21013 applies when the tumor lies beneath the deep fascia and is under 2 cm. 21011 is for a subcutaneous tumor.

21015Tumor resection

21015 describes radical resection of a face or scalp soft-tissue tumor under 2 cm. Use 21011 for subcutaneous tumor removal without that radical-resection scope.

11440Lesion excision

11440 is for excision of a small benign skin lesion on the face. 21011 is for a subcutaneous soft-tissue tumor, not a lesion confined to skin.

Codes related to 21011

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