$477.75
Both concern superficial neck or anterior chest lesions. The size threshold is the distinction: 21552 is for lesions at least 3 cm; 21555 is for lesions under 3 cm.
On this page
CMS RVU26D · Effective 2026-10-01
21552 Soft-tissue excision Medicare reimbursement rates in Colorado
Report this service for complete removal of a subcutaneous neck or anterior chest soft-tissue lesion measuring at least 3 cm. Compare 21552 office and facility rates across CMS payment localities in Colorado.
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 21552 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$431.50
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Soft-tissue surgery
About 21552: Subcutaneous neck mass excision, 3 cm or larger
Report this service for complete removal of a subcutaneous neck or anterior chest soft-tissue lesion measuring at least 3 cm.
An otolaryngologist, general surgeon, or plastic surgeon may remove a palpable lipoma, cyst, or other soft-tissue mass in the subcutaneous layer of the neck or anterior chest. The operation removes the lesion rather than taking only a diagnostic sample. It may occur in an office procedure room or operating room depending on the lesion and patient’s needs.
Choose 21552 when the lesion is subcutaneous and measures at least 3 cm; its depth and size distinguish it from codes for smaller superficial lesions or deeper tumors. Document the site, size, tissue plane, and excision performed. This major-surgery service includes 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 for this code’s descriptor and anatomy. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21552
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.33 · 49%
- Practice expense (office) RVU5.02 · 39%
- Malpractice RVU1.50 · 12%
4.6K
Medicare services in 2024 · #1931 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.
21552 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
This code is for a deep neck tumor measuring 5 cm or larger. Choose 21552 for a subcutaneous lesion measuring at least 3 cm.
No office rate
This code is for a deep neck tumor under 5 cm. Use 21552 when the lesion is subcutaneous and at least 3 cm.
$282.87
21550 represents a soft-tissue biopsy for diagnosis; 21552 represents excision of the qualifying subcutaneous lesion.
Compare 21552 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$431.50
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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 21552 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,002
- Code
- 21552
- Physician work
- 6.33
- Practice expense
- 5.02
- Malpractice
- 1.50
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.33 | × 1.012 | 6.4060 |
| Practice expense | 5.02 | × 1.064 | 5.3413 |
| Malpractice | 1.50 | × 0.781 | 1.1715 |
| Total RVUs | 12.9187 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$431.50
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.33 | 1.012 |
| Practice expense | 5.02 | 1.064 |
| Malpractice | 1.5 | 0.781 |
(6.33 × 1.012 + 5.02 × 1.064 + 1.5 × 0.781) × $33.4009 = $431.50
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.
21552 billing questions
How is 21552 distinguished from 21555?
Both describe removal of a subcutaneous neck or anterior chest lesion. Use 21552 for a lesion measuring 3 cm or larger and 21555 for one under 3 cm.
When should a deep-tumor code be considered instead?
Use the deep-tumor code family when the operative documentation places the mass beneath the subcutaneous tissue, such as in a deeper soft-tissue plane. Select within that family by its size threshold.
Does 21552 include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral lesions?
No. Modifier 50 is inappropriate for this code’s descriptor and anatomy.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard multiple-procedure 50% reduction.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted 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 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.
1,99921502,,I&d dp abs/hmtm nck rib ostc,A,,7.36,6.11,NA,6.11,,1.85,15.32,15.32,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00021510,,Inc deep opng b1 crtx thorax,A,,6.05,6.30,NA,6.30,,1.51,13.86,13.86,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00121550,,Biopsy of neck/chest,A,,2.06,5.78,,1.94,,0.30,8.14,4.30,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00221552,,Exc neck les sc 3 cm/>,A,,6.33,5.02,NA,5.02,,1.50,12.85,12.85,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00321554,,Exc neck tum deep 5 cm/>,A,,10.85,7.14,NA,7.14,,2.39,20.38,20.38,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00421555,,Exc neck les sc < 3 cm,A,,3.86,9.17,,4.23,,0.82,13.85,8.91,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00521556,,Exc neck tum deep < 5 cm,A,,7.47,5.76,NA,5.76,,1.48,14.71,14.71,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
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