No office rate
Both codes describe subcutaneous soft-tissue mass excision in the neck or anterior thorax. Select 21555 for a mass under 3 cm and 21552 for one measuring 3 cm or more.
On this page
CMS RVU26D · Effective 2026-10-01
21555 Mass excision Medicare reimbursement rates in Nebraska
Report this code for surgical removal of a subcutaneous soft-tissue mass in the neck or anterior thorax measuring under 3 cm. Compare 21555 office and facility rates across CMS payment localities in Nebraska.
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 21555 in Nebraska?
Nebraska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$421.98
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$269.69
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
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.
Soft tissue surgery
About 21555: Subcutaneous neck or chest mass excision under 3 cm
Report this code for surgical removal of a subcutaneous soft-tissue mass in the neck or anterior thorax measuring under 3 cm.
This service covers surgical excision of a soft-tissue tumor beneath the skin in the neck or anterior thorax when the lesion is smaller than 3 cm. A common example is removal of a palpable superficial mass, such as a suspected lipoma, by a surgeon or other qualified physician in an office procedure room or operating room. Code selection depends on both the lesion’s depth and size; a deeper mass or one measuring 3 cm or more falls into a different code path.
The operative note should identify the site, show that the mass was subcutaneous rather than deep, support the size category, and describe the excision. A diagnostic sample alone is reported as a biopsy service. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgery and team surgery are not permitted.
CMS billing rules for 21555
- 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 RVU3.86 · 28%
- Practice expense (office) RVU9.17 · 66%
- Malpractice RVU0.82 · 6%
3.4K
Medicare services in 2024 · #2095 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.
21555 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$250.79
21550 is the biopsy pathway for a neck or chest lesion. Use 21555 when the service is excision of a subcutaneous mass under 3 cm.
No office rate
21556 applies to a deep soft-tissue tumor under 5 cm. This code is for a subcutaneous mass under 3 cm.
Compare 21555 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.
1 of 1 payment localities
Nebraska →
Office / nonfacility
$421.98
Facility
$269.69
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21555 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,004
- Code
- 21555
- Physician work
- 3.86
- Practice expense
- 9.17
- Malpractice
- 0.82
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.86 | × 1.000 | 3.8600 |
| Practice expense | 9.17 | × 0.923 | 8.4639 |
| Malpractice | 0.82 | × 0.378 | 0.3100 |
| Total RVUs | 12.6339 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$421.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.86 | 1 |
| Practice expense | 9.17 | 0.923 |
| Malpractice | 0.82 | 0.378 |
(3.86 × 1 + 9.17 × 0.923 + 0.82 × 0.378) × $33.4009 = $421.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.86 | 1 |
| Practice expense | 4.23 | 0.923 |
| Malpractice | 0.82 | 0.378 |
(3.86 × 1 + 4.23 × 0.923 + 0.82 × 0.378) × $33.4009 = $269.69
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
21555 billing questions
How is this code distinguished from the 3 cm-or-larger subcutaneous excision code?
Use this code for a subcutaneous neck or anterior thorax mass under 3 cm. A subcutaneous mass measuring 3 cm or more is reported with 21552.
Can this code be used when the surgeon takes only a biopsy?
No. This code describes excision of the mass; a procedure limited to obtaining a diagnostic sample follows the biopsy code pathway, such as 21550.
Does this code include related postoperative visits?
Medicare’s 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be used for masses on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does Medicare handle multiple procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be billed for this procedure?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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.
2,00121550,,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
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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068