No office rate
Both describe radical abdominal wall tumor resection; 22904 is for tumors under 5 cm, while 22905 is for tumors 5 cm or larger.
On this page
CMS RVU26D · Effective 2026-10-01
22904 Abdominal tumor resection Medicare reimbursement rates in California
Reports radical removal of a soft-tissue tumor in the abdominal wall measuring less than 5 cm, typically for an oncologic resection. Compare 22904 office and facility rates across CMS payment localities in California.
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.
What does Medicare pay for 22904 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$966.28–$1126.03
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $159.75 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 22904 pays more and less in California
Surgical oncology
About 22904: Radical abdominal wall tumor resection
Reports radical removal of a soft-tissue tumor in the abdominal wall measuring less than 5 cm, typically for an oncologic resection.
This code describes radical removal of a soft-tissue tumor arising in the abdominal wall when the tumor measures less than 5 cm. A surgeon, often working in surgical oncology or general surgery, removes the tumor with surrounding tissue as an oncologic resection. The target is abdominal wall soft tissue, such as muscle or related deeper tissues, rather than a tumor within an abdominal organ.
Choose this code when the operative service is radical resection and the documented tumor size is under 5 cm; a limited excision or a larger tumor points to a different code. The operative report should support the tumor’s abdominal wall location, size, and extent of resection. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon and team-surgery payment require supporting documentation. Modifier 50 is not appropriate for this code.
CMS billing rules for 22904
- 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 paid only with supporting documentation.
Where the value comes from
- Work RVU16.27 · 55%
- Practice expense (office) RVU9.45 · 32%
- Malpractice RVU3.78 · 13%
131
Medicare services in 2024 · #4656 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.
22904 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
22900 describes excision of a deep abdominal wall tumor under 5 cm. Select 22904 when the operative service is a radical resection.
$535.66–$665.89
22902 is for excision of a subcutaneous abdominal lesion under 3 cm. It is not the code for radical resection of a deeper abdominal wall soft-tissue tumor.
Compare 22904 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $976.59 |
| Chico | Office Unavailable | Facility $966.28 |
| El Centro | Office Unavailable | Facility $966.91 |
| Fresno | Office Unavailable | Facility $966.28 |
| Hanford-Corcoran | Office Unavailable | Facility $966.28 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1022.95 |
| Madera | Office Unavailable | Facility $966.28 |
| Merced | Office Unavailable | Facility $966.28 |
| Modesto | Office Unavailable | Facility $966.28 |
| Napa | Office Unavailable | Facility $1057.82 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1010.39 |
| Redding | Office Unavailable | Facility $966.28 |
| Rest Of California | Office Unavailable | Facility $966.28 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1006.85 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $997.76 |
| Salinas | Office Unavailable | Facility $993.78 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1005.67 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1098.06 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1093.77 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1126.03 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1108.48 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $979.86 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1006.02 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $994.36 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1015.01 |
| Stockton | Office Unavailable | Facility $966.28 |
| Vallejo | Office Unavailable | Facility $1051.63 |
| Visalia | Office Unavailable | Facility $966.28 |
| Yuba City | Office Unavailable | Facility $966.28 |
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22904 billing questions
How is 22904 different from 22900?
22904 is for radical resection of an abdominal wall soft-tissue tumor under 5 cm. Use 22900 for an excision rather than a radical resection when its anatomic and size criteria are met.
When should 22905 be used instead?
22905 is the corresponding radical resection code when the abdominal wall tumor is 5 cm or larger. The operative documentation should establish the tumor size.
Does the 90-day global period include postoperative visits?
It includes related postoperative care for 90 days after surgery, as well as the day-before preoperative visit.
Can modifier 50 be reported for bilateral abdominal wall tumors?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction.
What documentation supports assistant or co-surgeon billing?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.
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.
2,14222901,,Exc abdl tum deep 5 cm/>,A,,9.86,6.88,NA,6.88,,2.47,19.21,19.21,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14322902,,Exc abd les sc < 3 cm,A,,4.31,10.11,,4.54,,1.07,15.49,9.92,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14422903,,Exc abd les sc 3 cm/>,A,,6.23,5.05,NA,5.05,,1.56,12.84,12.84,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14522904,,Radical resect abd tumor<5cm,A,,16.27,9.45,NA,9.45,,3.78,29.50,29.50,0,090,0.09,0.81,0.10,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14622905,,Rad resect abd tumor 5 cm/>,A,,21.04,11.18,NA,11.18,,4.83,37.05,37.05,0,090,0.09,0.81,0.10,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14722999,,Unlisted px abdomen muscskel,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14823000,,Rmvl sbdltd clcreous dep opn,A,,4.37,12.04,,4.99,,0.70,17.11,10.06,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00