Billing code 21013: Tumor excisionMedicare rate & RVUs in Alaska

Reports removal of a small soft-tissue tumor beneath the fascia of the face or scalp, including deep or intramuscular lesions.

CMS RVU26DEffective Oct 1, 20261 payment locality630 Medicare services in 2024

Medicare pays $662.12 for 21013 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$662.12Office (non-facility)
$455.81Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21013 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 21013 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 21013 covers

This code describes excision of a soft-tissue tumor beneath the fascia in the face or scalp, including a lesion within muscle, when the tumor is smaller than 2 cm. The surgeon removes the deep mass rather than a superficial skin or subcutaneous lesion. Otolaryngologists, plastic surgeons, and oral and maxillofacial surgeons may perform this procedure in an operating room or an appropriately equipped outpatient setting.

Select the code using the tumor’s depth and size, not the skin incision length: the operative report should identify the facial or scalp site, the tissue plane or muscle involved, and the tumor measurement. This major surgery has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery services may be paid; co-surgeon and team-surgery billing are 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.

21013 in Alaska*

21013 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$662.12$455.81

How the 21013 rate is calculated

Each of 21013’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 · 21013

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.28Practice expense 10.67Malpractice 0.98

16.9300 adjusted RVUs×$33.4009 conversion factor=$565.48

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

Payment rules and modifiers for 21013

21013 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21013

Tumor excision

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)0Not permitted.
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 · 21013

Tumor excision

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

21013 without 51 · national office

$565.48

Tumor excision

21013-51 · Second procedure: 50%

$282.74

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

21013 compared with similar codes

Compare codes

21013 vs 21011 vs 21014 vs 21015: national Medicare rates

Swap in your local Medicare rate.

  • 21013
    Tumor excision · 5.28 wRVU
    $565.48
  • 21011
    Facial tumor excision · 2.92 wRVU
    $395.13−$170.35
  • 21014
    Tumor excision · 6.95 wRVU
    —
  • 21015
    Tumor resection · 9.64 wRVU
    —

How to choose

21011Facial tumor excision
21011 describes a small tumor in the subcutaneous plane. Use 21013 when the tumor lies beneath the fascia, including within muscle.
21014Tumor excision
Both codes describe deep facial or scalp soft-tissue tumors; 21013 is for tumors under 2 cm, while 21014 is for tumors 2 cm or larger.
21015Tumor resection
21015 describes radical resection of a face or scalp soft-tissue tumor. Use 21013 for excision of a deep tumor under 2 cm when radical resection is not performed.

21013 billing questions

How is this code distinguished from a superficial facial lesion excision?

Use this code for a tumor beneath the fascia, including an intramuscular mass, that is under 2 cm. A lesion limited to the subcutaneous plane belongs to the superficial-lesion code family.

Which size measurement supports code selection?

Document the tumor measurement and its tissue depth in the operative report. The 2 cm threshold concerns the tumor, not the incision.

Does the code include the related postoperative visits?

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

How are other procedures paid when performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery services may be paid. CMS does not permit co-surgeon or team-surgery billing for this code.

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 21013PPRRVU2026_Oct_nonQPP.csv, line 1,839 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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