Billing code 22904: Abdominal tumor resectionMedicare rate & RVUs in Massachusetts
Reports radical removal of a soft-tissue tumor in the abdominal wall measuring less than 5 cm, typically for an oncologic resection.
CMS doesn’t publish an office rate for 22904 in Massachusetts.
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 22904 covers
This code describes radical removal of a soft-tissue tumor arising in the abdominal wall when the tumor measures less than 5 cm. A surgeon, often working in surgical oncology or general surgery, removes the tumor with surrounding tissue as an oncologic resection. The target is abdominal wall soft tissue, such as muscle or related deeper tissues, rather than a tumor within an abdominal organ.
Choose this code when the operative service is radical resection and the documented tumor size is under 5 cm; a limited excision or a larger tumor points to a different code. The operative report should support the tumor’s abdominal wall location, size, and extent of resection. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon and team-surgery payment require supporting documentation. Modifier 50 is not appropriate for this code.
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 22904 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $1,054.95 |
| Rest Of Massachusetts | Unavailable | $985.12 |
How the 22904 rate is calculated
Each of 22904’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 · 22904
RVUs × geographic indexes × conversion factor
Work16.27
16.27 RVUs× 1.000 GPCI
Practice expense9.45
9.45 RVUs× 1.000 GPCI
Malpractice3.78
3.78 RVUs× 1.000 GPCI
Adjusted RVUs
29.5000
Conversion factor
$33.4009
Medicare rate
$985.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22904
22904 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22904
Abdominal 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22904
Abdominal 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
22904 without 51 · national facility
$985.33
Abdominal tumor resection
22904-51 · Second procedure: 50%
$492.67
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%).
22904 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22905Tumor resection
- Both describe radical abdominal wall tumor resection; 22904 is for tumors under 5 cm, while 22905 is for tumors 5 cm or larger.
- 22900Tumor excision
- 22900 describes excision of a deep abdominal wall tumor under 5 cm. Select 22904 when the operative service is a radical resection.
- 22902Abdominal wall excision
- 22902 is for excision of a subcutaneous abdominal lesion under 3 cm. It is not the code for radical resection of a deeper abdominal wall soft-tissue tumor.
22904 billing questions
How is 22904 different from 22900?
22904 is for radical resection of an abdominal wall soft-tissue tumor under 5 cm. Use 22900 for an excision rather than a radical resection when its anatomic and size criteria are met.
When should 22905 be used instead?
22905 is the corresponding radical resection code when the abdominal wall tumor is 5 cm or larger. The operative documentation should establish the tumor size.
Does the 90-day global period include postoperative visits?
It includes related postoperative care for 90 days after surgery, as well as the day-before preoperative visit.
Can modifier 50 be reported for bilateral abdominal wall tumors?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction.
What documentation supports assistant or co-surgeon billing?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.
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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