No office rate
Both describe radical tumor resection in the neck or anterior thorax; 21558 is for tumors 5 cm or greater, while 21557 is for tumors under 5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
21557 Tumor resection Medicare reimbursement rates in Michigan
Reports radical removal of a soft-tissue tumor in the neck or anterior thorax when the tumor measures less than 5 cm. Compare 21557 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 21557 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
$869.97–$943.51
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 procedure
About 21557: Radical neck or anterior thorax tumor resection
Reports radical removal of a soft-tissue tumor in the neck or anterior thorax when the tumor measures less than 5 cm.
This code describes radical resection of a soft-tissue tumor in the neck or anterior thorax, such as a small soft-tissue sarcoma. The surgeon removes the tumor more extensively than with a limited excision, typically taking it out en bloc with a planned margin of surrounding tissue. These operations are generally performed in a hospital operating room by a surgeon experienced in head and neck or soft-tissue tumor surgery.
Select this code when the operative report supports radical resection and documents a tumor size under 5 cm; a limited deep excision or a biopsy is a different service. Record the site, measured size, depth, extent of removal, and operative technique. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21557
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.38 · 54%
- Practice expense (office) RVU8.92 · 34%
- Malpractice RVU3.12 · 12%
446
Medicare services in 2024 · #3654 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.
21557 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
Use 21556 for deep soft-tissue tumor excision under 5 cm when the documented procedure is an excision, not a radical resection.
$256.38–$272.00
21550 reports biopsy for tissue diagnosis. Use 21557 when the surgeon performs radical removal of the tumor rather than sampling it.
Compare 21557 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
$943.51
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$869.97
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21557 billing questions
How is this different from code 21556?
Code 21557 is for radical tumor resection, while 21556 describes a deep soft-tissue tumor excision. The operative report should support the more extensive radical approach, not just the tumor's depth and size.
Does the tumor size include surrounding tissue removed?
Use the tumor's documented size to determine whether it is under 5 cm. Document the tumor measurement separately from the extent of the specimen or margin removed.
What documentation supports reporting 21557?
Document the neck or anterior thorax site, tumor size, depth, and the radical nature and extent of the resection. The operative report should distinguish the service from a biopsy or limited excision.
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 paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid for this procedure. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,00321554,,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
2,00921601,,Exc chest wall tumor w/ribs,A,,17.34,11.50,NA,11.50,,4.44,33.28,33.28,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00