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Billing code 21558: Tumor resectionMedicare rate & RVUs

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, 2026109 payment localities650 Medicare services in 2024

Medicare pays $1,221.47 for 21558 nationally in a facility.

Medicare rate · 21558

Tumor resection

Swap in your local Medicare rate.

Work RVUs
21.04
Total RVUs
36.57
Global days
090

National rate · 2026

$1,221.47

Facility setting, before claim adjustments.

See every locality for 21558 → · 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 21558 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 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

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

109 of 109 payment localities

21558 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,110.19
Alaska*Unavailable$1,529.31
ArizonaUnavailable$1,188.41
ArkansasUnavailable$1,096.63
AtlantaUnavailable$1,259.68
AustinUnavailable$1,227.11
BakersfieldUnavailable$1,211.42
Baltimore/Surr. CntysUnavailable$1,295.23
BeaumontUnavailable$1,177.64
BrazoriaUnavailable$1,190.71

21558 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
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

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

Swap in your local Medicare rate.

Work 21.04Practice expense 11.03Malpractice 4.50

36.5700 adjusted RVUs×$33.4009 conversion factor=$1,221.47

All indexes start 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

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

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

21558 without 51 · national facility

$1,221.47

Tumor resection

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

21558 compared with similar codes

Compare codes

21558 vs 21557 vs 21554 vs 21550: national Medicare rates

Swap in your local Medicare rate.

  • 21558
    Tumor resection · 21.04 wRVU
    —
  • 21557
    Tumor resection · 14.38 wRVU
    —
  • 21554
    Tumor excision · 10.85 wRVU
    —
  • 21550
    Soft-tissue biopsy · 2.06 wRVU
    $271.88

How to choose

21557Tumor resection
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 excision
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 biopsy
21550 describes biopsy of a neck or chest lesion. It is for diagnostic tissue sampling, not definitive radical tumor resection.

Codes related to 21558

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

Codes related to 21558
CodeHow it relatesNational office range
Same family
21557Tumor resectionRadical resection of a neck or anterior thorax tumor under 5 cm.No office rate
Used instead
21554Tumor excisionDeep neck tumor excision at least 5 cm when the operation is not a radical resection.No office rate
21556Tumor excisionDeep neck tumor excision under 5 cm rather than radical resection.No office rate

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)

Open CMS sourceHow we calculate rates

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