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Billing code 21936: Back tumor resectionMedicare rate & RVUs

Reports resection of a deep soft tissue tumor of the back or flank measuring at least 5 cm, such as a tumor beneath the fascia.

CMS RVU26DEffective Oct 1, 2026109 payment localities393 Medicare services in 2024

Medicare pays $1,307.98 for 21936 nationally in a facility.

Medicare rate · 21936

Back tumor resection

Swap in your local Medicare rate.

Work RVUs
21.99
Total RVUs
39.16
Global days
090

National rate · 2026

$1,307.98

Facility setting, before claim adjustments.

See every locality for 21936 → · 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 21936 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 21936 covers

This code describes operative resection of a large soft tissue tumor in the back or flank that lies beneath the fascia, including an intramuscular tumor. It is used for therapeutic removal, not for taking a diagnostic sample alone. Surgeons, including general and surgical oncology specialists, may perform the procedure in a hospital or other surgical setting. The operative report should establish the tumor’s deep location, size, and the resection performed.

Choose this code when the resected tumor is 5 cm or larger and the procedure meets the resection service represented by this code. Distinguish it from codes for smaller deep tumors, excision rather than resection, and superficial lesions; document the size and tissue plane. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this service. An assistant at surgery may be paid; co-surgeons require 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 21936 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

21936 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,182.31
Alaska*Unavailable$1,622.71
ArizonaUnavailable$1,270.46
ArkansasUnavailable$1,167.02
AtlantaUnavailable$1,351.68
AustinUnavailable$1,312.66
BakersfieldUnavailable$1,291.92
Baltimore/Surr. CntysUnavailable$1,390.24
BeaumontUnavailable$1,259.68
BrazoriaUnavailable$1,271.83

21936 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
21936 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 21936 rate is calculated

Each of 21936’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 · 21936

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.99Practice expense 11.94Malpractice 5.23

39.1600 adjusted RVUs×$33.4009 conversion factor=$1,307.98

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

Payment rules and modifiers for 21936

21936 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21936

Back 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 · 21936

Back 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

21936 without 51 · national facility

$1,307.98

Back tumor resection

21936-51 · Second procedure: 50%

$653.99

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

21936 compared with similar codes

Compare codes

21936 vs 21935 vs 21933 vs 21925 vs 21931: national Medicare rates

Swap in your local Medicare rate.

  • 21936
    Back tumor resection · 21.99 wRVU
    —
  • 21935
    Tumor resection · 15.33 wRVU
    —
  • 21933
    Back tumor excision · 10.85 wRVU
    —
  • 21925
    Soft-tissue biopsy · 4.51 wRVU
    $543.10
  • 21931
    Back mass excision · 6.71 wRVU
    —

How to choose

21935Tumor resection
This code is for a deep back or flank tumor resection measuring 5 cm or larger; 21935 is the corresponding resection code for a tumor under 5 cm.
21933Back tumor excision
Both concern a deep back or flank tumor at least 5 cm. Choose 21936 for a resection service and 21933 when the documented procedure is an excision.
21925Soft-tissue biopsy
21925 reports a diagnostic biopsy of deep back soft tissue. This code reports resection of a large deep tumor, not sampling alone.
21931Back mass excision
21931 concerns excision of a subcutaneous back or flank lesion measuring 3 cm or larger. This code is for a deep tumor at least 5 cm and a resection service.

Codes related to 21936

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

Codes related to 21936
CodeHow it relatesNational office range
Same family
21935Tumor resectionDeep back or flank tumor resection for a tumor under 5 cm.No office rate
Used instead
21933Back tumor excisionDeep back or flank tumor excision for a tumor 5 cm or larger.No office rate
21932Back tumor excisionDeep back or flank tumor excision for a tumor under 5 cm.No office rate
21925Soft-tissue biopsyBiopsy of deep soft tissue of the back rather than tumor resection.$475.93–$701.97
21931Back mass excisionExcision of a subcutaneous back or flank tumor measuring 3 cm or larger.No office rate

21936 billing questions

How is this code distinguished from 21935?

Both describe resection of a deep back or flank tumor. Use 21936 for a tumor measuring 5 cm or larger and 21935 for one under 5 cm.

How does this differ from 21933?

21933 describes excision of a deep back or flank tumor measuring 5 cm or larger. Select between the codes based on the procedure actually performed and documented, not size alone.

Can a biopsy be reported with the resection?

A separate diagnostic biopsy is not represented by this resection code. Code 21925 describes biopsy of deep soft tissue of the back; report separate services only when independently performed and supported by the record.

What documentation supports code selection?

Document the tumor’s back or flank location, its relationship to the fascia or muscle, its size, and the resection performed. The record should support the distinction from a superficial or smaller tumor service.

Can modifier 50 be used for tumors on both sides?

No. Modifier 50 is not appropriate for this back or flank tumor resection.

How does the multiple-procedure reduction affect payment?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% reduction.

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 21936PPRRVU2026_Oct_nonQPP.csv, line 2,040 (RVU26D)

Open CMS sourceHow we calculate rates

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