No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
21936 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1289.22
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Soft tissue surgery
About 21936: Deep back tumor resection, 5 cm or larger
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.
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.
CMS billing rules for 21936
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.99 · 56%
- Practice expense (office) RVU11.94 · 30%
- Malpractice RVU5.23 · 13%
393
Medicare services in 2024 · #3751 by national volume
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.
21936 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
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.
$536.08
21925 reports a diagnostic biopsy of deep back soft tissue. This code reports resection of a large deep tumor, not sampling alone.
No office rate
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.
The same code, a different location
How does Delaware compare?
21936 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 21936
Office
Unavailable
Facility
$1182.31
No comparable office rate is available.
Arkansas
Arkansas · 21936
Office
Unavailable
Facility
$1167.02
No comparable office rate is available.
Arizona
Arizona · 21936
Office
Unavailable
Facility
$1270.46
No comparable office rate is available.
Bakersfield
California · 21936
Office
Unavailable
Facility
$1291.92
No comparable office rate is available.
Chico
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
El Centro
California · 21936
Office
Unavailable
Facility
$1278.57
No comparable office rate is available.
Fresno
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Hanford-Corcoran
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Madera
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Merced
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Modesto
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Napa
California · 21936
Office
Unavailable
Facility
$1395.13
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 21936
Office
Unavailable
Facility
$1335.27
No comparable office rate is available.
Redding
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Rest Of California
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 21936
Office
Unavailable
Facility
$1333.81
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 21936
Office
Unavailable
Facility
$1318.37
No comparable office rate is available.
Salinas
California · 21936
Office
Unavailable
Facility
$1313.10
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 21936
Office
Unavailable
Facility
$1328.17
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21936
Office
Unavailable
Facility
$1446.76
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21936
Office
Unavailable
Facility
$1440.82
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21936
Office
Unavailable
Facility
$1483.99
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21936
Office
Unavailable
Facility
$1459.71
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 21936
Office
Unavailable
Facility
$1294.85
No comparable office rate is available.
Santa Cruz-Watsonville
California · 21936
Office
Unavailable
Facility
$1328.09
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 21936
Office
Unavailable
Facility
$1313.69
No comparable office rate is available.
Santa Rosa-Petaluma
California · 21936
Office
Unavailable
Facility
$1339.89
No comparable office rate is available.
Stockton
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Vallejo
California · 21936
Office
Unavailable
Facility
$1386.57
No comparable office rate is available.
Visalia
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Yuba City
California · 21936
Office
Unavailable
Facility
$1277.70
No comparable office rate is available.
Colorado
Colorado · 21936
Office
Unavailable
Facility
$1304.06
No comparable office rate is available.
Connecticut
Connecticut · 21936
Office
Unavailable
Facility
$1390.06
No comparable office rate is available.
Fort Lauderdale
Florida · 21936
Office
Unavailable
Facility
$1454.31
No comparable office rate is available.
Rest Of Florida
Florida · 21936
Office
Unavailable
Facility
$1378.30
No comparable office rate is available.
Atlanta
Georgia · 21936
Office
Unavailable
Facility
$1351.68
No comparable office rate is available.
Rest Of Georgia
Georgia · 21936
Office
Unavailable
Facility
$1298.45
No comparable office rate is available.
Hawaii, Guam
Hawaii · 21936
Office
Unavailable
Facility
$1289.07
No comparable office rate is available.
Iowa
Iowa · 21936
Office
Unavailable
Facility
$1168.74
No comparable office rate is available.
Idaho
Idaho · 21936
Office
Unavailable
Facility
$1184.01
No comparable office rate is available.
East St. Louis
Illinois · 21936
Office
Unavailable
Facility
$1453.21
No comparable office rate is available.
Rest Of Illinois
Illinois · 21936
Office
Unavailable
Facility
$1371.63
No comparable office rate is available.
Suburban Chicago
Illinois · 21936
Office
Unavailable
Facility
$1458.75
No comparable office rate is available.
Indiana
Indiana · 21936
Office
Unavailable
Facility
$1189.08
No comparable office rate is available.
Kansas
Kansas · 21936
Office
Unavailable
Facility
$1183.05
No comparable office rate is available.
Kentucky
Kentucky · 21936
Office
Unavailable
Facility
$1248.86
No comparable office rate is available.
New Orleans
Louisiana · 21936
Office
Unavailable
Facility
$1308.21
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 21936
Office
Unavailable
Facility
$1254.78
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 21936
Office
Unavailable
Facility
$1396.25
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 21936
Office
Unavailable
Facility
$1305.41
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 21936
Office
Unavailable
Facility
$1390.24
No comparable office rate is available.
Rest Of Maryland
Maryland · 21936
Office
Unavailable
Facility
$1305.79
No comparable office rate is available.
Rest Of Maine
Maine · 21936
Office
Unavailable
Facility
$1210.04
No comparable office rate is available.
Southern Maine
Maine · 21936
Office
Unavailable
Facility
$1239.93
No comparable office rate is available.
Detroit
Michigan · 21936
Office
Unavailable
Facility
$1413.86
No comparable office rate is available.
Rest Of Michigan
Michigan · 21936
Office
Unavailable
Facility
$1295.82
No comparable office rate is available.
Minnesota
Minnesota · 21936
Office
Unavailable
Facility
$1196.57
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 21936
Office
Unavailable
Facility
$1279.63
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 21936
Office
Unavailable
Facility
$1289.19
No comparable office rate is available.
Rest Of Missouri
Missouri · 21936
Office
Unavailable
Facility
$1248.40
No comparable office rate is available.
Mississippi
Mississippi · 21936
Office
Unavailable
Facility
$1206.95
No comparable office rate is available.
Montana**
Montana · 21936
Office
Unavailable
Facility
$1307.63
No comparable office rate is available.
North Carolina
North Carolina · 21936
Office
Unavailable
Facility
$1218.20
No comparable office rate is available.
North Dakota**
North Dakota · 21936
Office
Unavailable
Facility
$1204.22
No comparable office rate is available.
Nebraska
Nebraska · 21936
Office
Unavailable
Facility
$1168.62
No comparable office rate is available.
New Hampshire
New Hampshire · 21936
Office
Unavailable
Facility
$1302.49
No comparable office rate is available.
Northern Nj
New Jersey · 21936
Office
Unavailable
Facility
$1429.94
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 21936
Office
Unavailable
Facility
$1390.99
No comparable office rate is available.
New Mexico
New Mexico · 21936
Office
Unavailable
Facility
$1309.99
No comparable office rate is available.
Nevada**
Nevada · 21936
Office
Unavailable
Facility
$1279.21
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 21936
Office
Unavailable
Facility
$1580.07
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 21936
Office
Unavailable
Facility
$1415.60
No comparable office rate is available.
Queens
New York · 21936
Office
Unavailable
Facility
$1504.78
No comparable office rate is available.
Rest Of New York
New York · 21936
Office
Unavailable
Facility
$1236.16
No comparable office rate is available.
Ohio
Ohio · 21936
Office
Unavailable
Facility
$1274.68
No comparable office rate is available.
Oklahoma
Oklahoma · 21936
Office
Unavailable
Facility
$1226.35
No comparable office rate is available.
Portland
Oregon · 21936
Office
Unavailable
Facility
$1319.28
No comparable office rate is available.
Rest Of Oregon
Oregon · 21936
Office
Unavailable
Facility
$1254.50
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 21936
Office
Unavailable
Facility
$1371.27
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 21936
Office
Unavailable
Facility
$1265.67
No comparable office rate is available.
Puerto Rico
Puerto Rico · 21936
Office
Unavailable
Facility
$1309.75
No comparable office rate is available.
Rhode Island
Rhode Island · 21936
Office
Unavailable
Facility
$1316.23
No comparable office rate is available.
South Carolina
South Carolina · 21936
Office
Unavailable
Facility
$1251.47
No comparable office rate is available.
South Dakota**
South Dakota · 21936
Office
Unavailable
Facility
$1191.99
No comparable office rate is available.
Tennessee
Tennessee · 21936
Office
Unavailable
Facility
$1190.81
No comparable office rate is available.
Austin
Texas · 21936
Office
Unavailable
Facility
$1312.66
No comparable office rate is available.
Beaumont
Texas · 21936
Office
Unavailable
Facility
$1259.68
No comparable office rate is available.
Brazoria
Texas · 21936
Office
Unavailable
Facility
$1271.83
No comparable office rate is available.
Dallas
Texas · 21936
Office
Unavailable
Facility
$1288.19
No comparable office rate is available.
Fort Worth
Texas · 21936
Office
Unavailable
Facility
$1286.47
No comparable office rate is available.
Galveston
Texas · 21936
Office
Unavailable
Facility
$1281.02
No comparable office rate is available.
Houston
Texas · 21936
Office
Unavailable
Facility
$1376.75
No comparable office rate is available.
Rest Of Texas
Texas · 21936
Office
Unavailable
Facility
$1270.70
No comparable office rate is available.
Utah
Utah · 21936
Office
Unavailable
Facility
$1266.23
No comparable office rate is available.
Virginia
Virginia · 21936
Office
Unavailable
Facility
$1249.84
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 21936
Office
Unavailable
Facility
$1309.75
No comparable office rate is available.
Vermont
Vermont · 21936
Office
Unavailable
Facility
$1217.70
No comparable office rate is available.
Rest Of Washington
Washington · 21936
Office
Unavailable
Facility
$1296.91
No comparable office rate is available.
Seattle (King Cnty)
Washington · 21936
Office
Unavailable
Facility
$1403.26
No comparable office rate is available.
Wisconsin
Wisconsin · 21936
Office
Unavailable
Facility
$1170.35
No comparable office rate is available.
West Virginia
West Virginia · 21936
Office
Unavailable
Facility
$1331.03
No comparable office rate is available.
Wyoming**
Wyoming · 21936
Office
Unavailable
Facility
$1262.56
No comparable office rate is available.
See how rates vary across the country
21936 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21936 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1418.14
$1289.22 × 110% = $1418.14
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21936 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,040
- Code
- 21936
- Physician work
- 21.99
- Practice expense
- 11.94
- Malpractice
- 5.23
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.99 | × 1.005 | 22.0999 |
| Practice expense | 11.94 | × 0.988 | 11.7967 |
| Malpractice | 5.23 | × 0.899 | 4.7018 |
| Total RVUs | 38.5984 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1289.22
Open 21936 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.99 | 1.005 |
| Practice expense | 11.94 | 0.988 |
| Malpractice | 5.23 | 0.899 |
(21.99 × 1.005 + 11.94 × 0.988 + 5.23 × 0.899) × $33.4009 = $1289.22
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
21936 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1289.22 | RVU26D |
| 2026-07-01 | Not available in this setting | $1289.22 | RVU26C |
| 2026-04-01 | Not available in this setting | $1289.22 | RVU26B |
| 2026-01-01 | Not available in this setting | $1289.22 | RVU26A |
| 2025-10-01 | Not available in this setting | $1374.13 | RVU25D |
| 2025-07-01 | Not available in this setting | $1374.13 | RVU25C |
| 2025-04-01 | Not available in this setting | $1374.13 | RVU25B |
| 2025-01-01 | Not available in this setting | $1374.13 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,03721932,,Exc back tum deep < 5 cm,A,,9.57,6.96,NA,6.96,,2.25,18.78,18.78,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03821933,,Exc back tum deep 5 cm/>,A,,10.85,7.47,NA,7.47,,2.64,20.96,20.96,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03921935,,Resect back tum < 5 cm,A,,15.33,9.68,NA,9.68,,3.61,28.62,28.62,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04021936,,Resect back tum 5 cm/>,A,,21.99,11.94,NA,11.94,,5.23,39.16,39.16,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04122010,,I&d p-spine c/t/cerv-thor,A,,12.43,12.05,NA,12.05,,3.99,28.47,28.47,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04222015,,I&d abscess p-spine l/s/ls,A,,12.32,11.66,NA,11.66,,3.62,27.60,27.60,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04322100,,Remove part of neck vertebra,A,,10.73,14.53,NA,14.53,,4.51,29.77,29.77,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503