No office rate
Both are for deep abdominal wall tumors; choose by tumor size: under 5 cm for 22900, or 5 cm and larger for 22901.
On this page
CMS RVU26D · Effective 2026-10-01
22900 Tumor excision Medicare reimbursement rates in Utah
Reports excision of a deep abdominal wall soft-tissue tumor measuring less than 5 cm, such as a subfascial or intramuscular mass. Compare 22900 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 22900 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
$528.07
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.
Abdominal surgery
About 22900: Deep abdominal wall tumor excision under 5 cm
Reports excision of a deep abdominal wall soft-tissue tumor measuring less than 5 cm, such as a subfascial or intramuscular mass.
This code covers excision of a soft-tissue tumor located deep to the abdominal wall’s superficial tissues, such as a subfascial or intramuscular mass, when the tumor is under 5 cm. A surgeon typically performs the procedure in an operating room, with the operative report describing the abdominal wall site, tissue depth, tumor dimensions, and extent of removal. It is distinct from excision of a lesion confined to subcutaneous tissue.
Select the code based on the tumor’s documented size and depth, not the incision length. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery services may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 22900
- 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 RVU8.11 · 49%
- Practice expense (office) RVU6.30 · 38%
- Malpractice RVU1.98 · 12%
461
Medicare services in 2024 · #3630 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.
22900 compared with similar codes
Office rates for Utah, from the same CMS release.
$493.47
22902 is for a subcutaneous abdominal lesion under 3 cm. Use 22900 when the tumor is deep to the subcutaneous tissue and under 5 cm.
No office rate
22904 describes radical resection of an abdominal tumor under 5 cm. Choose 22900 for the deep tumor excision when radical resection is not the service performed.
Compare 22900 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
$528.07
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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 22900 in Utah.
PPRRVU2026_Oct_nonQPP.csv
2,141
- Code
- 22900
- Physician work
- 8.11
- Practice expense
- 6.30
- Malpractice
- 1.98
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.11 | × 1.000 | 8.1100 |
| Practice expense | 6.30 | × 0.940 | 5.9220 |
| Malpractice | 1.98 | × 0.898 | 1.7780 |
| Total RVUs | 15.8100 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$528.07
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.11 | 1 |
| Practice expense | 6.3 | 0.94 |
| Malpractice | 1.98 | 0.898 |
(8.11 × 1 + 6.3 × 0.94 + 1.98 × 0.898) × $33.4009 = $528.07
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.
22900 billing questions
How does this differ from 22901?
Both describe excision of a deep abdominal wall tumor. Use 22900 for a tumor under 5 cm and 22901 for one 5 cm or larger.
When is 22902 more appropriate?
Use 22902 for an abdominal lesion confined to subcutaneous tissue and under 3 cm. Code 22900 describes a deep tumor, rather than a superficial subcutaneous lesion.
What documentation supports reporting 22900?
The operative report should identify the abdominal wall location, show that the tumor was deep to the subcutaneous tissue, and document its size as under 5 cm.
Should modifier 50 be used for bilateral excisions?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
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.
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.
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10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
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10611302,VA,00,VIRGINIA,1.000,0.983,0.706
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