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See a sample rate comparisonCPT 21013 Fee Schedule
Last Verified: September 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.
Exc Face Tum Deep 2 Cm, Excision Tumor Soft Tissue Of Face And Scalp Subfascial Eg Subgaleal Intramuscular Less Than 2 Cm
| 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 AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21013 |
| Medicaid Fee Schedule | View Medicaid rates for 21013 |
National average reimbursement for CPT 21013 by major payers:
$683.82
$701.65
$756.04
$689.03
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CPT 21013
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Northwest, LLP, Memorial Hermann Surgery Center Greater Heights
Memorial Hermann Surgery Center Northwest LLP
$2,350.00Published rateGastro Operating Company LLC, (Dba) Meadowbrook Endoscopy Center
Gastro Operating Company, LLC
$895.00Published rateForest Canyon Endoscopy & Surgery Ctr PC
Forest Canyon Endoscopy & Surgery Center, PC
$552.00Published rateNorman Regional Hospital Authority, Medical Plaza Endoscopy
$425.00Published ratePodiatry Group Of Annapolis Ambulatory Surgical Center, Podiatry Group Of Annapolis Ambulatory Surgical Center LLC
Podiatry Group Of Annapolis Ambulatory Surgical Center
$144.00Published rate
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See a sample payer proposalCPT 21013 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21013 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 21013 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 |
|---|---|---|
| 21013-CPT | Moderate | Exc Face Tum Deep 2 Cm, Excision Tumor Soft Tissue Of Face And Scalp Subfascial Eg Subgaleal Intramuscular Less Than 2 Cm |
| 21014-CPT | Moderate | Excision Tumor Soft Tissue O, Excision Tumor Soft Tissue Of Face And Scalp Subfascial (Eg Subgaleal Intramuscular) 2 Cm Or Greater |
| 21015-CPT | Moderate | Radical Resct Of Tumor (Eg Sarcom) Sft Tissue Of Face Or Scalp, Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Face Or Scalp |
| 21016-CPT | High | Radical Resct Of Tumor (Eg Sarcom) Sft Tissue Of Face Or Scalp, Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Face Or Scalp |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21013 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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