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CMS RVU26D · Effective 2026-10-01

22901 Tumor excision Medicare reimbursement rates in Connecticut

Reports removal of a deep abdominal wall tumor measuring at least 5 cm, such as a mass beneath the fascia or within muscle. Compare 22901 office and facility rates across CMS payment localities in Connecticut.

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 22901 in Connecticut?

Connecticut 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

$683.24

1 of 1 localities have a supported rate.

Payment area: Connecticut

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.

Find 22901 in your payment locality →

Surgical excision

About 22901: Deep abdominal wall tumor excision, large

Reports removal of a deep abdominal wall tumor measuring at least 5 cm, such as a mass beneath the fascia or within muscle.

This service involves surgically removing a tumor located deep in the abdominal wall, such as beneath the fascia or within muscle, when it measures 5 cm or larger. A surgeon typically performs the excision in an operating room, with the specimen sent for pathologic examination. The code distinguishes a large deep tumor from a smaller deep mass and from a superficial abdominal wall lesion.

Select the code based on the tumor’s documented size and depth, and describe its location and the operative work in the report. The 90-day global period 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 a 50% reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 22901

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 RVU9.86 · 51%
  • Practice expense (office) RVU6.88 · 36%
  • Malpractice RVU2.47 · 13%

520

Medicare services in 2024 · #3529 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.

22901 compared with similar codes

Office rates for Connecticut, from the same CMS release.

22900

Tumor excision

Deep, under 5 cm

No office rate

Both describe deep abdominal wall tumor excision; select between them by tumor size. This code is for 5 cm or larger, while 22900 is for smaller than 5 cm.

22903

Tumor excision

Subcutaneous, 3 cm or larger

No office rate

Code 22903 is for a superficial abdominal lesion measuring 3 cm or larger. This code requires a deep tumor measuring at least 5 cm.

22905

Tumor resection

Abdominal wall, 5 cm or larger

No office rate

Code 22905 describes radical resection of a large abdominal tumor. Choose this code for deep tumor excision when the procedure is not a radical resection.

Compare 22901 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

Office and facility base rates · shared scale starting at $0

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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 22901 in Connecticut.

PPRRVU2026_Oct_nonQPP.csv

2,142

Code
22901
Physician work
9.86
Practice expense
6.88
Malpractice
2.47

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 22901 in Connecticut
ComponentRVULocality factorAdjusted
Physician work9.86× 1.02010.0572
Practice expense6.88× 1.0777.4098
Malpractice2.47× 1.2102.9887
Total RVUs20.4557
Conversion factor× 33.4009

Facility rate, Connecticut$683.24

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work9.861.02
Practice expense6.881.077
Malpractice2.471.21

(9.86 × 1.02 + 6.88 × 1.077 + 2.47 × 1.21) × $33.4009 = $683.24

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.

22901 billing questions

When should I choose this code instead of 22900?

Use this code for a deep abdominal wall tumor measuring 5 cm or larger. Code 22900 is for a deep tumor smaller than 5 cm.

How does this differ from codes 22902 and 22903?

Those codes describe excision of a superficial abdominal lesion. This code is for a tumor in a deep plane, such as beneath fascia or within muscle.

How does this differ from 22905?

Code 22905 describes radical resection of a large abdominal tumor. This code describes excision of a deep tumor of that size; the operative approach and extent of resection guide code selection.

What documentation supports reporting this code?

Document the tumor’s dimensions, its deep location in the abdominal wall, and the excision performed. The operative report should distinguish a deep mass from a superficial lesion.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

How does the 90-day global period affect postoperative billing?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, standard multiple-procedure reduction applies.

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.

RVUs for 22901PPRRVU2026_Oct_nonQPP.csv, line 2,142 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet