$551.31
Use 21930 for a subcutaneous back or flank mass under 3 cm. This code is for a mass measuring 3 cm or larger.
On this page
CMS RVU26D · Effective 2026-10-01
21931 Back mass excision Medicare reimbursement rates in Rhode Island
Removal of a subcutaneous soft-tissue mass on the back or flank measuring at least 3 cm, rather than a biopsy or deep-tumor resection. Compare 21931 office and facility rates across CMS payment localities in Rhode Island.
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 21931 in Rhode Island?
Rhode Island 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
No supported rate
Facility setting
$457.60
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 21931: Subcutaneous back tumor excision, 3 cm or larger
Removal of a subcutaneous soft-tissue mass on the back or flank measuring at least 3 cm, rather than a biopsy or deep-tumor resection.
This service removes a soft-tissue mass located in the subcutaneous tissue of the back or flank, with a mass size of 3 cm or greater. A common example is excision of a subcutaneous lipoma. The surgeon opens the skin, dissects the mass from surrounding tissue, removes it, and closes the wound. General surgeons and other surgeons who treat soft-tissue masses may perform the procedure in an office or surgical facility, depending on the case and setting.
Select the code based on the mass’s location, tissue plane, and size—not the length of the incision. The operative report should identify the back or flank site, establish that the mass was subcutaneous, document its size, and describe excision rather than sampling alone. 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 subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted. A bilateral adjustment does not apply, and modifier 50 is inappropriate.
CMS billing rules for 21931
- 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 RVU6.71 · 49%
- Practice expense (office) RVU5.21 · 38%
- Malpractice RVU1.66 · 12%
7.5K
Medicare services in 2024 · #1623 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.
21931 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Use 21932 when the back or flank tumor is deep rather than subcutaneous and measures under 5 cm.
No office rate
Use 21933 for a deep back or flank tumor measuring 5 cm or larger; this code describes a subcutaneous mass.
$270.20
Use 21920 when the service is a soft-tissue biopsy of the back, not excision of the subcutaneous mass.
Compare 21931 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$457.60
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 21931 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,036
- Code
- 21931
- Physician work
- 6.71
- Practice expense
- 5.21
- Malpractice
- 1.66
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.71 | × 1.019 | 6.8375 |
| Practice expense | 5.21 | × 1.033 | 5.3819 |
| Malpractice | 1.66 | × 0.892 | 1.4807 |
| Total RVUs | 13.7001 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$457.60
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.71 | 1.019 |
| Practice expense | 5.21 | 1.033 |
| Malpractice | 1.66 | 0.892 |
(6.71 × 1.019 + 5.21 × 1.033 + 1.66 × 0.892) × $33.4009 = $457.60
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.
21931 billing questions
How is this code distinguished from 21930?
Both describe removal of a subcutaneous soft-tissue mass of the back or flank. Use 21931 when the mass is 3 cm or larger; 21930 is for a mass under 3 cm.
Does this code cover a biopsy of the mass?
No. This code represents excision of the subcutaneous mass. When the service samples tissue rather than removing the mass, consider the applicable back soft-tissue biopsy code.
What documentation supports reporting this code?
Document the back or flank site, the subcutaneous tissue plane, the mass size, and the operative work showing removal. The record should distinguish the service from a biopsy or excision of a deep mass.
Should modifier 50 be used for masses on both sides?
No. CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included in the global period?
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.
2,03321920,,Biopsy soft tissue of back,A,,2.06,5.54,,1.90,,0.30,7.90,4.26,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03421925,,Biopsy soft tissue of back,A,,4.51,10.72,,5.62,,1.03,16.26,11.16,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03521930,,Exc back les sc < 3 cm,A,,4.82,10.30,,4.63,,1.07,16.19,10.52,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03621931,,Exc back les sc 3 cm/>,A,,6.71,5.21,NA,5.21,,1.66,13.58,13.58,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03721932,,Exc back tum deep < 5 cm,A,,9.57,6.96,NA,6.96,,2.25,18.78,18.78,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03821933,,Exc back tum deep 5 cm/>,A,,10.85,7.47,NA,7.47,,2.64,20.96,20.96,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03921935,,Resect back tum < 5 cm,A,,15.33,9.68,NA,9.68,,3.61,28.62,28.62,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537