Billing code 22905: Tumor resectionMedicare rate & RVUs in Utah
Reports radical removal of a tumor measuring at least 5 cm from the abdominal wall, with broader tissue resection than a limited excision.
CMS doesn’t publish an office rate for 22905 in Utah.
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 22905 covers
Radical resection removes a tumor measuring 5 cm or larger from the abdominal wall, taking a broader extent of tissue than a limited tumor excision. It is typically performed in an operating room by a surgeon, such as a general surgeon or surgical oncologist, for a sizable abdominal-wall soft-tissue tumor. The operative report should establish the tumor’s size and describe the radical extent of removal and tissues involved.
Choose this code for the radical procedure at the 5 cm threshold, rather than a limited deep-tumor excision or the smaller radical-resection level. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same 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-surgeon and team-surgery payment require supporting documentation.
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.
22905 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,198.64 |
How the 22905 rate is calculated
Each of 22905’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 · 22905
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.04Practice expense 11.18Malpractice 4.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22905
22905 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22905
Tumor resection
| 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22905
Tumor resection
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
22905 without 51 · national facility
$1,237.50
Tumor resection
22905-51 · Second procedure: 50%
$618.75
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%).
22905 compared with similar codes
Compare codes
22905 vs 22901 vs 22904 vs 22900 vs 22903: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22901Tumor excision
- Both cover tumors at least 5 cm, but 22905 is for radical resection; 22901 is for a less extensive deep-tumor excision.
- 22904Abdominal tumor resection
- Use 22904 for radical resection below 5 cm and 22905 at 5 cm or larger.
- 22900Tumor excision
- 22900 covers a less extensive deep-tumor excision below 5 cm; 22905 is for radical resection at 5 cm or larger.
- 22903Tumor excision
- 22903 concerns a subcutaneous abdominal-wall lesion, not the radical resection of a tumor at least 5 cm covered by 22905.
22905 billing questions
How does this differ from 22901?
Both concern a deep abdominal-wall tumor measuring at least 5 cm. Use 22905 for radical resection; 22901 describes a less extensive excision.
When is 22904 the better choice?
Use 22904 for a radical resection of a deep abdominal-wall tumor smaller than 5 cm. The size threshold separates it from 22905.
What should the operative report document?
Document the tumor’s size and location, the extent of tissue removed, and why the operation was a radical resection rather than a limited excision.
Does the code include routine postoperative care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon and team-surgery payment require supporting documentation.
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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