$527.86
Both address subfascial face or scalp tumors under 2 cm, but 21013 is for excision. Report 21015 when the operative documentation supports resection.
On this page
CMS RVU26D · Effective 2026-10-01
21015 Tumor resection Medicare reimbursement rates in Wisconsin
Reports resection of a soft-tissue tumor beneath the fascia of the face or scalp when the tumor measures less than 2 cm. Compare 21015 office and facility rates across CMS payment localities in Wisconsin.
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 21015 in Wisconsin?
Wisconsin 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
$589.60
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 21015: Subfascial face or scalp tumor resection
Reports resection of a soft-tissue tumor beneath the fascia of the face or scalp when the tumor measures less than 2 cm.
This code describes resection of a soft-tissue tumor in the face or scalp that lies beneath the fascia, including a submuscular location, and measures less than 2 cm. Head and neck, plastic, or other surgeons may perform the operation in a hospital or ambulatory surgical setting. The operative report should identify the facial or scalp site, the tumor’s subfascial depth, its size, and the resection performed.
Select this code when the documented depth, size, and resection approach match; a superficial lesion or a larger tumor belongs to a different code in the family. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 21015
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.64 · 50%
- Practice expense (office) RVU7.82 · 41%
- Malpractice RVU1.69 · 9%
305
Medicare services in 2024 · #3981 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.
21015 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
This code is for a subfascial tumor under 2 cm; 21016 is for one measuring 2 cm or greater.
$371.13
21011 concerns a subcutaneous face or scalp tumor under 2 cm. This code requires a subfascial location and a resection.
Compare 21015 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$589.60
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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 21015 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
1,841
- Code
- 21015
- Physician work
- 9.64
- Practice expense
- 7.82
- Malpractice
- 1.69
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.64 | × 1.000 | 9.6400 |
| Practice expense | 7.82 | × 0.958 | 7.4916 |
| Malpractice | 1.69 | × 0.308 | 0.5205 |
| Total RVUs | 17.6521 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$589.60
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.64 | 1 |
| Practice expense | 7.82 | 0.958 |
| Malpractice | 1.69 | 0.308 |
(9.64 × 1 + 7.82 × 0.958 + 1.69 × 0.308) × $33.4009 = $589.60
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.
21015 billing questions
How is this different from 21013?
Both concern a subfascial face or scalp tumor under 2 cm. This code is for resection; 21013 describes excision, so the operative report must support the procedure performed.
When should 21016 be used instead?
Use 21016 when the subfascial face or scalp tumor is 2 cm or greater. This code is for a tumor measuring less than 2 cm.
Does a subcutaneous tumor qualify?
No. This code is for a tumor beneath the fascia, including a submuscular location; subcutaneous face or scalp tumors are represented by other codes.
Can modifier 50 be reported for tumors on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
1,83821012,,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
1,84221016,,Resect face/scalp tum 2 cm/>,A,,14.88,9.36,NA,9.36,,2.75,26.99,26.99,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84321025,,Excision of bone lower jaw,A,,9.78,14.06,,7.28,,1.31,25.15,18.37,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,84421026,,Excision of facial bone(s),A,,5.56,10.94,,6.07,,0.75,17.25,12.38,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,