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See a sample rate comparisonCPT 21013 Fee Schedule
Medicare rates as of October 2026
CPT 21013 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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 | 22On Campus Outpatient Hospital 11Office |
| Common Modifiers | 59Distinct Procedural Service ASPA/NP/CNS assistant at surgery |
| Hospital Outpatient Group (APC) | APC 5072 - Level 2 Excision/ Biopsy/ Incision and Drainage |
| Surgery Center Payment (ASC) | P3 - Office-based; paid from physician fee schedule practice expense |
| Common Revenue Codes | 03600761Sign up to view all 4 |
| Medicare Fee Schedule | $565.48 national non-facility rate (2026)View Medicare rates for 21013 |
| Medicaid Fee Schedule | $437.305 median of the 8 states in the free previewView Medicaid rates for 21013 |
National average reimbursement for CPT 21013 by major payers:
$683.82
BCBS / Anthem
$701.65
UnitedHealthcare
$756.04
Aetna
$689.03
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21013.
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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Payer Contract Negotiation
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See a sample payer proposalCPT 21013 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21013. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 21013-CPT | Exc Face Tum Deep 2 Cm, Excision Tumor Soft Tissue Of Face And Scalp Subfascial Eg Subgaleal Intramuscular Less Than 2 Cm |
| 21014-CPT | Excision Tumor Soft Tissue O, Excision Tumor Soft Tissue Of Face And Scalp Subfascial (Eg Subgaleal Intramuscular) 2 Cm Or Greater |
| 21015-CPT | 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 | 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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Frequently Asked Questions
What APC is CPT 21013 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21013 to APC 5072 (Level 2 Excision/ Biopsy/ Incision and Drainage). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 21013 in an ambulatory surgery center?
CMS lists CPT 21013 with ASC payment indicator P3: Office-based; paid from physician fee schedule practice expense.
Which revenue codes are billed with CPT 21013?
Hospital price transparency files list CPT 21013 under these revenue codes: 0360, 0761, 0361 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.