Billing code 21016: Tumor resectionMedicare rate & RVUs in Florida
Report this service for radical resection of a soft-tissue tumor of the face or scalp when the tumor measures 2 cm or greater.
CMS doesn’t publish an office rate for 21016 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 21016 covers
This code describes radical removal of a soft-tissue tumor on the face or scalp measuring at least 2 cm. It is distinct from a routine local excision and is used when the surgeon performs a more extensive resection. Plastic surgeons, otolaryngologists, oral and maxillofacial surgeons, and surgical oncologists may perform the procedure in an operating room or another appropriate surgical setting. The code concerns soft tissue, not a tumor arising in facial bone.
Choose the code based on the documented radical extent, soft-tissue location, and tumor size; distinguish it from simple excision codes for subcutaneous or deeper tumors. The operative report should identify the site, size, tissue involved, and extent of resection. This major surgery has 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 subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons and team surgery 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.
Where 21016 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $979.77 |
| Miami | Unavailable | $1,054.75 |
| Rest Of Florida | Unavailable | $933.94 |
How the 21016 rate is calculated
Each of 21016’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 · 21016
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.88Practice expense 9.36Malpractice 2.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21016
21016 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21016
Tumor resection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21016
Tumor resection
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21016 without 51 · national facility
$901.49
Tumor resection
21016-51 · Second procedure: 50%
$450.75
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%).
21016 compared with similar codes
Compare codes
21016 vs 21015 vs 21014 vs 21012 vs 21026: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21015Tumor resection
- Use 21015 for radical resection of a face or scalp soft-tissue tumor under 2 cm; 21016 is for tumors measuring 2 cm or greater.
- 21014Tumor excision
- 21014 is for excision of a deep or subfascial tumor at least 2 cm. Use 21016 when the operation is documented as radical resection.
- 21012Soft-tissue excision
- 21012 applies to a subcutaneous tumor at least 2 cm; 21016 describes radical resection of a soft-tissue tumor of the face or scalp.
- 21026Facial bone excision
- 21026 addresses excision of facial bone. Choose 21016 for a soft-tissue tumor rather than a lesion involving facial bone.
21016 billing questions
How does this differ from 21015?
Both describe radical resection of a soft-tissue tumor of the face or scalp. Use 21016 when the tumor is 2 cm or greater and 21015 when it is less than 2 cm.
When is 21014 a better fit?
21014 describes excision of a deep or subfascial face or scalp tumor measuring 2 cm or greater. Choose 21016 when the documented procedure is a radical resection rather than that excision.
Can modifier 50 be appended for tumors on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the documented services without modifier 50.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
May an assistant or another surgeon be reported?
Assistant-at-surgery payment may be made. 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 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
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