$376.53
This is the subcutaneous counterpart for a tumor under 2 cm. Use 21012 when the subcutaneous tumor measures 2 cm or more.
On this page
CMS RVU26D · Effective 2026-10-01
21012 Soft-tissue excision Medicare reimbursement rates in Utah
Reports removal of a subcutaneous soft-tissue tumor of the face or scalp measuring at least 2 cm, rather than a smaller or deeper lesion. Compare 21012 office and facility rates across CMS payment localities in Utah.
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 21012 in Utah?
Utah 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
$311.97
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Head and neck surgery
About 21012: Subcutaneous face or scalp tumor excision
Reports removal of a subcutaneous soft-tissue tumor of the face or scalp measuring at least 2 cm, rather than a smaller or deeper lesion.
Code 21012 describes surgical removal of a soft-tissue tumor in the subcutaneous layer of the face or scalp when the lesion measures 2 cm or more. An otolaryngologist, plastic surgeon, or oral and maxillofacial surgeon may perform the procedure in an office procedure room or operating room, depending on the lesion and setting. The word “tumor” identifies the mass being removed; it does not by itself establish malignancy. This code is not selected for a lesion confined to the skin or for a mass removed from a deeper plane.
Choose the code based on the tumor’s documented size and tissue plane, not the incision length. The operative report should identify the face or scalp site, subcutaneous location, and lesion measurement. CMS treats this as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed 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. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21012
- 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 RVU4.34 · 45%
- Practice expense (office) RVU4.45 · 46%
- Malpractice RVU0.91 · 9%
2K
Medicare services in 2024 · #2462 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.
21012 compared with similar codes
Office rates for Utah, from the same CMS release.
$540.76
This code is for a deeper soft-tissue tumor under 2 cm. Code 21012 describes a subcutaneous tumor measuring at least 2 cm.
No office rate
Both codes use the 2 cm-or-larger size category, but 21014 is for a deeper soft-tissue tumor; 21012 is for the subcutaneous plane.
No office rate
This code describes resection of a face or scalp tumor measuring 2 cm or more. Use 21012 for subcutaneous tumor excision when the documented procedure is not a resection.
Compare 21012 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
Utah →
Office / nonfacility
Unavailable
Facility
$311.97
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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 21012 in Utah.
PPRRVU2026_Oct_nonQPP.csv
1,838
- Code
- 21012
- Physician work
- 4.34
- Practice expense
- 4.45
- Malpractice
- 0.91
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.34 | × 1.000 | 4.3400 |
| Practice expense | 4.45 | × 0.940 | 4.1830 |
| Malpractice | 0.91 | × 0.898 | 0.8172 |
| Total RVUs | 9.3402 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$311.97
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.34 | 1 |
| Practice expense | 4.45 | 0.94 |
| Malpractice | 0.91 | 0.898 |
(4.34 × 1 + 4.45 × 0.94 + 0.91 × 0.898) × $33.4009 = $311.97
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.
21012 billing questions
How is 21012 distinguished from 21011?
Both describe subcutaneous tumor excision on the face or scalp. Use 21012 for a lesion measuring 2 cm or more and 21011 for one under 2 cm.
When should 21013 or 21014 be considered instead?
Those codes describe a tumor in a deeper soft-tissue plane. Choose between them by documented depth and size; 21012 is for a subcutaneous tumor measuring at least 2 cm.
Does the incision length determine the size category?
No. Document the tumor’s size, not the length of the skin incision, and identify its subcutaneous plane.
Can modifier 50 be used for tumors on both sides of the face?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy does not support modifier 50.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted under the CMS rules 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.
1,83520999,,Unlisted px muscskel general,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83621010,,Incision of jaw joint,A,,10.76,7.82,NA,7.82,,1.56,20.14,20.14,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83721011,,Exc face les sc <2 cm,A,,2.92,8.38,,4.04,,0.53,11.83,7.49,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83821012,,Exc face les sbq 2 cm/>,A,,4.34,4.45,NA,4.45,,0.91,9.70,9.70,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83921013,,Exc face tum deep < 2 cm,A,,5.28,10.67,,4.87,,0.98,16.93,11.13,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84021014,,Exc face tum deep 2 cm/>,A,,6.95,6.11,NA,6.11,,1.32,14.38,14.38,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84121015,,Resect face/scalp tum < 2 cm,A,,9.64,7.82,NA,7.82,,1.69,19.15,19.15,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985