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Billing code 21935: Tumor resectionMedicare rate & RVUs

Reports radical removal of a soft-tissue tumor in the back or flank measuring under 5 cm, typically when an oncologic operation requires wider tissue removal.

CMS RVU26DEffective Oct 1, 2026109 payment localities186 Medicare services in 2024

Medicare pays $955.93 for 21935 nationally in a facility.

Medicare rate · 21935

Tumor resection

Swap in your local Medicare rate.

Work RVUs
15.33
Total RVUs
28.62
Global days
090

National rate · 2026

$955.93

Facility setting, before claim adjustments.

See every locality for 21935 → · 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 21935 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 21935 covers

This code describes a radical operation to remove a soft-tissue tumor in the back or flank that measures less than 5 cm. Unlike a limited excision, the procedure involves a wider removal of tumor and surrounding soft tissue for oncologic treatment, such as management of a soft-tissue sarcoma. A surgeon performs it in an operative setting; the operative report should make the location, tumor size, and extent of resection clear.

Report the code when the documented operation is radical, not simply because a mass is deep or requires an incision. Distinguish it from biopsy and less extensive excision codes, and support the size threshold and resection extent in the record. Medicare 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 subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons are paid only with 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 21935 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

21935 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$863.19
Alaska*Unavailable$1,178.83
ArizonaUnavailable$928.55
ArkansasUnavailable$851.87
AtlantaUnavailable$986.88
AustinUnavailable$961.96
BakersfieldUnavailable$949.56
Baltimore/Surr. CntysUnavailable$1,016.31
BeaumontUnavailable$918.27
BrazoriaUnavailable$930.59

21935 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
21935 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 21935 rate is calculated

Each of 21935’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 · 21935

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.33Practice expense 9.68Malpractice 3.61

28.6200 adjusted RVUs×$33.4009 conversion factor=$955.93

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

Payment rules and modifiers for 21935

21935 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21935

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)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 · 21935

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

21935 without 51 · national facility

$955.93

Tumor resection

21935-51 · Second procedure: 50%

$477.97

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

21935 compared with similar codes

Compare codes

21935 vs 21936 vs 21932 vs 21925: national Medicare rates

Swap in your local Medicare rate.

  • 21935
    Tumor resection · 15.33 wRVU
    —
  • 21936
    Back tumor resection · 21.99 wRVU
    —
  • 21932
    Back tumor excision · 9.57 wRVU
    —
  • 21925
    Soft-tissue biopsy · 4.51 wRVU
    $543.10

How to choose

21936Back tumor resection
Use 21936 when the radical back or flank tumor resection is for a tumor measuring 5 cm or greater; 21935 is for one under 5 cm.
21932Back tumor excision
Use 21932 for subfascial tumor excision without the radical oncologic extent represented by 21935.
21925Soft-tissue biopsy
Use 21925 for deep diagnostic tissue sampling. Use 21935 when the documented service is radical removal of the tumor.

Codes related to 21935

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

Codes related to 21935
CodeHow it relatesNational office range
Same family
21936Back tumor resectionRadical back or flank tumor resection for tumors measuring 5 cm or greater.No office rate
Used instead
21930Soft-tissue excisionFor limited removal of a small subcutaneous back or flank lesion, rather than radical resection.$474.92–$693.95
21931Back mass excisionFor limited removal of a larger subcutaneous back or flank lesion.No office rate
21932Back tumor excisionFor subfascial back or flank tumor excision when the operation is not radical.No office rate
21933Back tumor excisionFor a larger subfascial tumor excision that is not a radical resection.No office rate
21925Soft-tissue biopsyFor deep soft-tissue biopsy of the back or flank when sampling, rather than radical removal, is performed.$475.93–$701.97

21935 billing questions

How is this code different from a simple back or flank tumor excision?

This code is for a radical oncologic resection, not a routine removal based only on the mass's location or depth. The operative report should support the wider extent of tissue removal.

Does a tumor under 5 cm qualify based on size alone?

No. The documented operation must be radical, and the tumor must meet the under-5-cm size threshold. Size alone does not distinguish this service from a less extensive excision.

Can a biopsy be reported instead for the same mass?

A biopsy code describes diagnostic tissue sampling, rather than definitive radical removal. Choose based on the service actually performed and documented.

Is modifier 50 appropriate for tumors on both sides of the back?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the 90-day global period affect postoperative visits?

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

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 21935PPRRVU2026_Oct_nonQPP.csv, line 2,039 (RVU26D)

Open CMS sourceHow we calculate rates

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