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Billing code 21015: Tumor resectionMedicare rate & RVUs

Reports resection of a soft-tissue tumor beneath the fascia of the face or scalp when the tumor measures less than 2 cm.

CMS RVU26DEffective Oct 1, 2026109 payment localities305 Medicare services in 2024

Medicare pays $639.63 for 21015 nationally in a facility.

Medicare rate · 21015

Tumor resection

Swap in your local Medicare rate.

Work RVUs
9.64
Total RVUs
19.15
Global days
090

National rate · 2026

$639.63

Facility setting, before claim adjustments.

See every locality for 21015 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 21015 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21015 covers

This code describes resection of a soft-tissue tumor in the face or scalp that lies beneath the fascia, including a submuscular location, and measures less than 2 cm. Head and neck, plastic, or other surgeons may perform the operation in a hospital or ambulatory surgical setting. The operative report should identify the facial or scalp site, the tumor’s subfascial depth, its size, and the resection performed.

Select this code when the documented depth, size, and resection approach match; a superficial lesion or a larger tumor belongs to a different code in the family. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting 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 21015 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

21015 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$582.48
Alaska*Unavailable$792.25
ArizonaUnavailable$623.40
ArkansasUnavailable$575.42
AtlantaUnavailable$656.12
AustinUnavailable$648.99
BakersfieldUnavailable$648.75
Baltimore/Surr. CntysUnavailable$677.22
BeaumontUnavailable$612.11
BrazoriaUnavailable$627.43

21015 rates by state

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

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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
21015 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

How the 21015 rate is calculated

Each of 21015’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 · 21015

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.64Practice expense 7.82Malpractice 1.69

19.1500 adjusted RVUs×$33.4009 conversion factor=$639.63

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 21015

21015 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21015

Tumor resection

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 21015

Tumor resection

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

21015 without 51 · national facility

$639.63

Tumor resection

21015-51 · Second procedure: 50%

$319.82

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

21015 compared with similar codes

Compare codes

21015 vs 21013 vs 21016 vs 21011: national Medicare rates

Swap in your local Medicare rate.

  • 21015
    Tumor resection · 9.64 wRVU
    —
  • 21013
    Tumor excision · 5.28 wRVU
    $565.48
  • 21016
    Tumor resection · 14.88 wRVU
    —
  • 21011
    Facial tumor excision · 2.92 wRVU
    $395.13

How to choose

21013Tumor excision
Both address subfascial face or scalp tumors under 2 cm, but 21013 is for excision. Report 21015 when the operative documentation supports resection.
21016Tumor resection
This code is for a subfascial tumor under 2 cm; 21016 is for one measuring 2 cm or greater.
21011Facial tumor excision
21011 concerns a subcutaneous face or scalp tumor under 2 cm. This code requires a subfascial location and a resection.

Codes related to 21015

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21015
CodeHow it relatesNational office range
Same family
21016Tumor resectionSubfascial face or scalp tumor resection when the tumor measures 2 cm or greater.No office rate
Used instead
21013Tumor excisionFor a subfascial face or scalp tumor under 2 cm when the documented procedure is excision.$499.35–$727.21
21014Tumor excisionFor excision of a subfascial face or scalp tumor measuring 2 cm or greater.No office rate
21011Facial tumor excisionFor excision of a subcutaneous face or scalp tumor under 2 cm.$347.08–$521.36
21012Soft-tissue excisionFor excision of a subcutaneous face or scalp tumor measuring 2 cm or greater.No office rate

21015 billing questions

How is this different from 21013?

Both concern a subfascial face or scalp tumor under 2 cm. This code is for resection; 21013 describes excision, so the operative report must support the procedure performed.

When should 21016 be used instead?

Use 21016 when the subfascial face or scalp tumor is 2 cm or greater. This code is for a tumor measuring less than 2 cm.

Does a subcutaneous tumor qualify?

No. This code is for a tumor beneath the fascia, including a submuscular location; subcutaneous face or scalp tumors are represented by other codes.

Can modifier 50 be reported for tumors on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

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 21015PPRRVU2026_Oct_nonQPP.csv, line 1,841 (RVU26D)

Open CMS sourceHow we calculate rates

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