No office rate
This code applies to a deep soft-tissue tumor under 5 cm; 21554 is for a tumor 5 cm or larger.
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CMS RVU26D · Effective 2026-10-01
21556 Tumor excision Medicare reimbursement rates in Georgia
Report this service for excision of a subfascial soft-tissue tumor in the neck or anterior thorax when the tumor measures less than 5 cm. Compare 21556 office and facility rates across CMS payment localities in Georgia.
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 21556 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$480.04–$505.09
2 of 2 localities have a supported rate.
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.
Surgical oncology
About 21556: Deep soft-tissue neck tumor excision under 5 cm
Report this service for excision of a subfascial soft-tissue tumor in the neck or anterior thorax when the tumor measures less than 5 cm.
This code describes removal of a soft-tissue tumor beneath the superficial fascia, such as a lesion within muscle, in the neck or anterior thorax. It is used when the surgeon excises the tumor and its size is under 5 cm. Head and neck surgeons and general surgeons may perform the procedure in an operating room or another setting equipped for surgical excision. The code is for a deep tumor, not a subcutaneous lesion or a limited diagnostic sample.
Choose the code based on the tumor’s depth, location, size, and the work actually performed. Document the anatomic site, subfascial plane, tumor measurement, and extent of removal; distinguish excision from a more extensive resection. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same 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. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 21556
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.47 · 51%
- Practice expense (office) RVU5.76 · 39%
- Malpractice RVU1.48 · 10%
2K
Medicare services in 2024 · #2446 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.
21556 compared with similar codes
Office rates for Georgia, from the same CMS release.
No office rate
Both involve a deep soft-tissue tumor under 5 cm, but 21557 represents resection rather than excision.
No office rate
21552 is for a subcutaneous lesion 3 cm or larger. Use 21556 when the tumor is beneath the superficial fascia.
$252.96–$277.19
21550 represents biopsy for diagnostic sampling. This code represents excision of a deep tumor under 5 cm.
Compare 21556 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
Unavailable
Facility
$505.09
Rest Of Georgia →
Office / nonfacility
Unavailable
Facility
$480.04
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21556 billing questions
How does this differ from 21554?
Both describe deep soft-tissue tumor excision in the neck or anterior thorax. Use 21556 for a tumor under 5 cm and 21554 for one 5 cm or larger.
When would 21552 or 21555 be more appropriate?
Those codes describe excision of a subcutaneous lesion. This code is for a tumor beneath the superficial fascia, such as one within muscle.
Can a diagnostic biopsy of the same tumor be reported with the excision?
When the tumor is excised during the same session, a separate biopsy of that same lesion generally is not separately reported as an additional procedure.
What documentation supports reporting 21556?
Record the neck or anterior thorax site, the tumor’s subfascial location, its size, and the extent of excision. The record should support that the tumor measures less than 5 cm.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
2,00221552,,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
2,00621557,,Resect neck thorax tumor<5cm,A,,14.38,8.92,NA,8.92,,3.12,26.42,26.42,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00721558,,Resect neck tumor 5 cm/>,A,,21.04,11.03,NA,11.03,,4.50,36.57,36.57,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00821600,,Partial removal of rib,A,,7.08,8.24,NA,8.24,,1.68,17.00,17.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00