No office rate
Both codes use the 2 cm-or-larger size threshold, but 21012 is for a subcutaneous tumor; 21014 is for a deep tumor.
On this page
CMS RVU26D · Effective 2026-10-01
21014 Tumor excision Medicare reimbursement rates in Illinois
Reports excision of a deep soft-tissue tumor of the face or scalp measuring at least 2 cm, when the procedure does not involve radical resection. Compare 21014 office and facility rates across CMS payment localities in Illinois.
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 21014 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$487.37–$540.05
4 of 4 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.
Where 21014 pays more and less in Illinois
Head and neck surgery
About 21014: Deep facial or scalp tumor excision, 2 cm or larger
Reports excision of a deep soft-tissue tumor of the face or scalp measuring at least 2 cm, when the procedure does not involve radical resection.
This service involves removing a soft-tissue tumor beneath the superficial layer, such as in a subfascial or submuscular plane, on the face or scalp. It is distinct from removing a lesion confined to subcutaneous tissue. Otolaryngologists, plastic surgeons, and oral and maxillofacial surgeons may perform the procedure in an office-based operating room or hospital setting, depending on the tumor and surgical plan.
Select this code when the tumor is deep and measures 2 cm or more; document its location, depth, size, and the excision performed. A more extensive radical resection is reported with a different code. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21014
- 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 RVU6.95 · 48%
- Practice expense (office) RVU6.11 · 42%
- Malpractice RVU1.32 · 9%
1.7K
Medicare services in 2024 · #2597 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.
21014 compared with similar codes
Office rates for Illinois, from the same CMS release.
$552.90–$610.88
Both describe deep face or scalp tumor excision. Choose 21013 for a tumor under 2 cm and 21014 for one measuring 2 cm or more.
No office rate
21016 describes radical resection of a face or scalp soft-tissue tumor measuring 2 cm or more. Use 21014 for the non-radical excision.
Compare 21014 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$540.05
East St. Louis →
Office / nonfacility
Unavailable
Facility
$508.69
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$487.37
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$521.48
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21014 billing questions
How is this code distinguished from 21012?
Use 21014 for a deep tumor measuring 2 cm or more. Code 21012 describes a tumor of that size confined to subcutaneous tissue.
What documentation supports the size and depth selection?
Record the face or scalp site, the tumor's measured size, and the operative findings establishing its deep plane, such as subfascial or submuscular location.
When is 21016 more appropriate?
Use 21016 when the surgeon performs a radical resection of a face or scalp soft-tissue tumor measuring 2 cm or more, rather than the excision reported with 21014.
Should modifier 50 be appended for tumors on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; the descriptor or anatomy makes modifier 50 unsuitable.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple procedure reduction and paid at 50%.
Can an assistant 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.
1,83721011,,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
1,84121015,,Resect face/scalp tum < 2 cm,A,,9.64,7.82,NA,7.82,,1.69,19.15,19.15,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84221016,,Resect face/scalp tum 2 cm/>,A,,14.88,9.36,NA,9.36,,2.75,26.99,26.99,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84321025,,Excision of bone lower jaw,A,,9.78,14.06,,7.28,,1.31,25.15,18.37,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00