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See a sample rate comparisonCPT 21012 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Xcision Tumor Sft Tissue Of Face Or Scalp Subcutane 2 Cm, Excision Tumor Soft Tissue Of Face Or Scalp Subcutaneous; 2 Cm Or G
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21012 |
| Medicaid Fee Schedule | View Medicaid rates for 21012 |
National average reimbursement for CPT 21012 by major payers:
$468.44
$461.75
$481.03
$572.39
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CPT 21012
5 of 25 sample ratesHigher to lower in this preview
South Emerson Surgery Center, LLC
$3,968.00Published rateSurgcenter Northeast LLC
Surgcenter Northeast, LLC
$967.00Published rateSurgicare Of Wichita, LLC
Surgicare Of Wichita LLC
$610.00Published rateNorth River Surgery Center, LLC
North River Surgery Center LLC
$405.00Published rateSurgery Center At Gateway LLC
$150.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21012 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21012 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 21012 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 20974-CPT | Low | Electronic Fracture Therapy, Therapy Using Electrodes Placed Over The Skin And Administration Of Low Voltage Current To Stimulate Bone Healing. |
| 21010-CPT | High | Arthrotomy Temporomandibular Unil |
| 21011-CPT | Moderate | Xcision Tumor Sft Tissue Of Face Or Scalp Subcutane Less Than, Excision Tumor Soft Tissue Of Face Or Scalp Subcutaneous; Less Than |
| 21012-CPT | Moderate | Xcision Tumor Sft Tissue Of Face Or Scalp Subcutane 2 Cm, Excision Tumor Soft Tissue Of Face Or Scalp Subcutaneous; 2 Cm Or G |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21012. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21012 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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