CPT code 21011: Facial tumor excision2026 Medicare rate & RVUs in Ohio
Removal of a subcutaneous soft-tissue tumor under 2 cm from the face or scalp, reported when the surgical work is limited to that tissue plane.
Medicare pays $370.92 for 21011 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 21011 covers
This service removes a small soft-tissue tumor located beneath the skin of the face or scalp, such as a subcutaneous lipoma. The surgeon works in the superficial tissue plane rather than beneath the deep fascia. Plastic surgeons, otolaryngologists, and oral and maxillofacial surgeons may perform it in an office or outpatient surgical setting when the mass can be excised without a deeper or radical resection.
Select this code when the tumor is subcutaneous and measures less than 2 cm; use the documented site, tissue depth, and tumor size to distinguish it from larger or deeper masses. The operative report should identify the face or scalp location, depth, size, and extent of removal. CMS assigns a 90-day global period, including 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 reduced to 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
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.
21011 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $370.92 | $238.57 |
How the 21011 rate is calculated
Each of 21011’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 · 21011
RVUs × geographic indexes × conversion factor
Work2.92
2.92 RVUs× 1.000 GPCI
Practice expense8.38
8.38 RVUs× 1.000 GPCI
Malpractice0.53
0.53 RVUs× 1.000 GPCI
Adjusted RVUs
11.8300
Conversion factor
$33.4009
Medicare rate
$395.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21011
21011 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21011
Facial tumor excision
| 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21011
Facial tumor excision
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
21011 without 51 · national office
$395.13
Facial tumor excision
21011-51 · Second procedure: 50%
$197.57
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%).
21011 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21012Soft-tissue excision
- Both address subcutaneous face or scalp soft-tissue tumors, but 21012 is for a tumor measuring 2 cm or larger; 21011 is for one under 2 cm.
- 21013Tumor excision
- 21013 applies when the tumor lies beneath the deep fascia and is under 2 cm. 21011 is for a subcutaneous tumor.
- 21015Tumor resection
- 21015 describes radical resection of a face or scalp soft-tissue tumor under 2 cm. Use 21011 for subcutaneous tumor removal without that radical-resection scope.
- 11440Lesion excision
- 11440 is for excision of a small benign skin lesion on the face. 21011 is for a subcutaneous soft-tissue tumor, not a lesion confined to skin.
21011 billing questions
When is 21012 used instead?
Use 21012 for a subcutaneous soft-tissue tumor of the face or scalp measuring 2 cm or larger. Code 21011 is for tumors under 2 cm.
How does 21011 differ from 21013?
21011 describes a tumor in the subcutaneous tissue. 21013 is for a tumor beneath the deep fascia that measures under 2 cm.
What should the operative note document?
Document the face or scalp site, the subcutaneous depth, tumor size, and the extent of excision. These details support selection over a larger-size, deeper, or more extensive resection code.
Is modifier 50 appropriate for bilateral excisions?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. CMS applies the standard multiple-procedure reduction when other procedures are performed in the same session.
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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