No office rate
Both concern deep soft-tissue tumors in the neck or anterior thorax; the size distinction is 5 cm or larger for 21554 versus smaller than 5 cm for 21556.
On this page
CMS RVU26D · Effective 2026-10-01
21554 Tumor excision Medicare reimbursement rates in Michigan
Reports excision of a soft-tissue tumor beneath the deep fascia in the neck or anterior thorax when the tumor measures at least 5 cm. Compare 21554 office and facility rates across CMS payment localities in Michigan.
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 21554 in Michigan?
Michigan 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
$670.26–$727.13
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.
Head and neck surgery
About 21554: Deep neck soft-tissue tumor excision, 5 cm or larger
Reports excision of a soft-tissue tumor beneath the deep fascia in the neck or anterior thorax when the tumor measures at least 5 cm.
A surgeon removes a soft-tissue tumor located beneath the deep fascia in the neck or anterior thorax, including an intramuscular mass. The code describes excision, not a limited diagnostic sample; the operative report should make clear that the surgeon removed the tumor and document its site, depth, and size. These procedures are commonly performed by head and neck, general, or other surgeons in an operating room or ambulatory surgery setting.
Select this code when the documented tumor is deep and measures 5 cm or larger. The operative note should support the anatomic location, relationship to the fascia or muscle, tumor measurement, and extent of removal. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are not permitted.
CMS billing rules for 21554
- 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 RVU10.85 · 53%
- Practice expense (office) RVU7.14 · 35%
- Malpractice RVU2.39 · 12%
1.9K
Medicare services in 2024 · #2498 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.
21554 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
21552 applies to a subcutaneous neck lesion measuring 3 cm or larger. This code requires a deep tumor measuring at least 5 cm.
No office rate
21558 is for radical resection of a neck tumor measuring 5 cm or larger. Choose 21554 for excision when the documented operation is not a radical resection.
$256.38–$272.00
21550 is for biopsy of a neck or chest lesion; 21554 represents excision of a qualifying deep tumor.
Compare 21554 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
Detroit →
Office / nonfacility
Unavailable
Facility
$727.13
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$670.26
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21554 billing questions
How does this differ from 21556?
Both describe excision of a deep soft-tissue neck or anterior thorax tumor. Use 21554 for a tumor measuring 5 cm or larger and 21556 for one smaller than 5 cm.
When is 21550 more appropriate?
21550 describes a biopsy of a neck or chest lesion. Use 21554 when the surgeon excises the qualifying deep tumor rather than taking a diagnostic sample.
What documentation supports 21554?
Document the neck or anterior thorax site, deep or subfascial location, tumor size of at least 5 cm, and the excision performed.
Should modifier 50 be added for bilateral tumors?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. CMS does not permit co-surgeons or team surgery 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.
2,00021510,,Inc deep opng b1 crtx thorax,A,,6.05,6.30,NA,6.30,,1.51,13.86,13.86,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00121550,,Biopsy of neck/chest,A,,2.06,5.78,,1.94,,0.30,8.14,4.30,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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