No office rate
Both address subcutaneous face or scalp soft-tissue tumors, but 21012 is for a tumor measuring 2 cm or larger; 21011 is for one under 2 cm.
On this page
CMS RVU26D · Effective 2026-10-01
21011 Facial tumor excision Medicare reimbursement rates in Delaware
Removal of a subcutaneous soft-tissue tumor under 2 cm from the face or scalp, reported when the surgical work is limited to that tissue plane. Compare 21011 office and facility rates across CMS payment localities in Delaware.
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 21011 in Delaware?
Delaware 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
$390.47
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$247.25
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Head and neck surgery
About 21011: Subcutaneous facial soft-tissue tumor excision
Removal of a subcutaneous soft-tissue tumor under 2 cm from the face or scalp, reported when the surgical work is limited to that tissue plane.
This service removes a small soft-tissue tumor located beneath the skin of the face or scalp, such as a subcutaneous lipoma. The surgeon works in the superficial tissue plane rather than beneath the deep fascia. Plastic surgeons, otolaryngologists, and oral and maxillofacial surgeons may perform it in an office or outpatient surgical setting when the mass can be excised without a deeper or radical resection.
Select this code when the tumor is subcutaneous and measures less than 2 cm; use the documented site, tissue depth, and tumor size to distinguish it from larger or deeper masses. The operative report should identify the face or scalp location, depth, size, and extent of removal. CMS assigns a 90-day global period, including 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 reduced to 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21011
- 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 RVU2.92 · 25%
- Practice expense (office) RVU8.38 · 71%
- Malpractice RVU0.53 · 4%
1.9K
Medicare services in 2024 · #2489 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.
21011 compared with similar codes
Office rates for Delaware, from the same CMS release.
$558.78
21013 applies when the tumor lies beneath the deep fascia and is under 2 cm. 21011 is for a subcutaneous tumor.
No office rate
21015 describes radical resection of a face or scalp soft-tissue tumor under 2 cm. Use 21011 for subcutaneous tumor removal without that radical-resection scope.
$140.50
11440 is for excision of a small benign skin lesion on the face. 21011 is for a subcutaneous soft-tissue tumor, not a lesion confined to skin.
Compare 21011 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
Delaware →
Office / nonfacility
$390.47
Facility
$247.25
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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 21011 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,837
- Code
- 21011
- Physician work
- 2.92
- Practice expense
- 8.38
- Malpractice
- 0.53
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.92 | × 1.005 | 2.9346 |
| Practice expense | 8.38 | × 0.988 | 8.2794 |
| Malpractice | 0.53 | × 0.899 | 0.4765 |
| Total RVUs | 11.6905 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$390.47
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.92 | 1.005 |
| Practice expense | 8.38 | 0.988 |
| Malpractice | 0.53 | 0.899 |
(2.92 × 1.005 + 8.38 × 0.988 + 0.53 × 0.899) × $33.4009 = $390.47
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.92 | 1.005 |
| Practice expense | 4.04 | 0.988 |
| Malpractice | 0.53 | 0.899 |
(2.92 × 1.005 + 4.04 × 0.988 + 0.53 × 0.899) × $33.4009 = $247.25
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.
21011 billing questions
When is 21012 used instead?
Use 21012 for a subcutaneous soft-tissue tumor of the face or scalp measuring 2 cm or larger. Code 21011 is for tumors under 2 cm.
How does 21011 differ from 21013?
21011 describes a tumor in the subcutaneous tissue. 21013 is for a tumor beneath the deep fascia that measures under 2 cm.
What should the operative note document?
Document the face or scalp site, the subcutaneous depth, tumor size, and the extent of excision. These details support selection over a larger-size, deeper, or more extensive resection code.
Is modifier 50 appropriate for bilateral excisions?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. CMS applies the standard multiple-procedure reduction when other procedures are performed in the same session.
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.
1,83420985,,Cptr-asst dir ms px,A,,2.44,0.77,NA,0.77,,0.50,3.71,3.71,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83520999,,Unlisted px muscskel general,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
1,83621010,,Incision of jaw joint,A,,10.76,7.82,NA,7.82,,1.56,20.14,20.14,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83721011,,Exc face les sc <2 cm,A,,2.92,8.38,,4.04,,0.53,11.83,7.49,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83821012,,Exc face les sbq 2 cm/>,A,,4.34,4.45,NA,4.45,,0.91,9.70,9.70,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83921013,,Exc face tum deep < 2 cm,A,,5.28,10.67,,4.87,,0.98,16.93,11.13,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84021014,,Exc face tum deep 2 cm/>,A,,6.95,6.11,NA,6.11,,1.32,14.38,14.38,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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