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Billing code 21557: Tumor resectionMedicare rate & RVUs

Reports radical removal of a soft-tissue tumor in the neck or anterior thorax when the tumor measures less than 5 cm.

CMS RVU26DEffective Oct 1, 2026109 payment localities446 Medicare services in 2024

Medicare pays $882.45 for 21557 nationally in a facility.

Medicare rate · 21557

Tumor resection

Swap in your local Medicare rate.

Work RVUs
14.38
Total RVUs
26.42
Global days
090

National rate · 2026

$882.45

Facility setting, before claim adjustments.

See every locality for 21557 → · 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 21557 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 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

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

109 of 109 payment localities

21557 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$799.98
Alaska*Unavailable$1,095.18
ArizonaUnavailable$858.21
ArkansasUnavailable$789.90
AtlantaUnavailable$909.61
AustinUnavailable$888.81
BakersfieldUnavailable$879.43
Baltimore/Surr. CntysUnavailable$936.58
BeaumontUnavailable$848.24
BrazoriaUnavailable$860.69

21557 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
21557 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 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.

How the rate is built · 21557

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.38Practice expense 8.92Malpractice 3.12

26.4200 adjusted RVUs×$33.4009 conversion factor=$882.45

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

Payment rules and modifiers for 21557

21557 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21557

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)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 · 21557

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

21557 without 51 · national facility

$882.45

Tumor resection

21557-51 · Second procedure: 50%

$441.23

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

21557 compared with similar codes

Compare codes

21557 vs 21558 vs 21556 vs 21550: national Medicare rates

Swap in your local Medicare rate.

  • 21557
    Tumor resection · 14.38 wRVU
    —
  • 21558
    Tumor resection · 21.04 wRVU
    —
  • 21556
    Tumor excision · 7.47 wRVU
    —
  • 21550
    Soft-tissue biopsy · 2.06 wRVU
    $271.88

How to choose

21558Tumor resection
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 excision
Use 21556 for deep soft-tissue tumor excision under 5 cm when the documented procedure is an excision, not a radical resection.
21550Soft-tissue biopsy
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.

Codes related to 21557
CodeHow it relatesNational office range
Same family
21558Tumor resectionRadical neck or anterior thorax tumor resection when the tumor is 5 cm or greater.No office rate
Used instead
21556Tumor excisionDeep soft-tissue tumor excision under 5 cm, rather than radical resection.No office rate
21554Tumor excisionDeep soft-tissue tumor excision 5 cm or greater, rather than radical resection.No office rate
21550Soft-tissue biopsyBiopsy of a neck or chest mass when sampling, not radical removal, is performed.$239.80–$360.13

21557 billing questions

How is this different from code 21556?

Code 21557 is for radical tumor resection, while 21556 describes a deep soft-tissue tumor excision. The operative report should support the more extensive radical approach, not just the tumor's depth and size.

Does the tumor size include surrounding tissue removed?

Use the tumor's documented size to determine whether it is under 5 cm. Document the tumor measurement separately from the extent of the specimen or margin removed.

What documentation supports reporting 21557?

Document the neck or anterior thorax site, tumor size, depth, and the radical nature and extent of the resection. The operative report should distinguish the service from a biopsy or limited excision.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid for this procedure. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What postoperative care is included?

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

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 21557PPRRVU2026_Oct_nonQPP.csv, line 2,006 (RVU26D)

Open CMS sourceHow we calculate rates

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