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See a sample rate comparisonCPT 21015 Fee Schedule
Medicare rates as of October 2026
CPT 21015 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Radical Resct Of Tumor (Eg Sarcom) Sft Tissue Of Face Or Scalp, Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Face Or Scalp
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | 59Distinct Procedural Service LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5073 - Level 3 Excision/ Biopsy/ Incision and Drainage |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 03600761 |
| Medicare Fee Schedule | $639.63 national non-facility rate (2026)View Medicare rates for 21015 |
| Medicaid Fee Schedule | $507.005 median of the 8 states in the free previewView Medicaid rates for 21015 |
National average reimbursement for CPT 21015 by major payers:
$852.26
BCBS / Anthem
$868.31
UnitedHealthcare
$924.80
Aetna
$1,095.85
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21015.
CPT 21015
5 of 25 sample ratesHigher to lower in this preview
Fairfax Surgical Center, L.P.
Fairfax Surgical Center Lp
$2,591.00Published rateChicago Prostate Cancer Surgery Center, LLC, Dupage Medical Group Surgery Center, Westmont
Chicago Prostate Cancer Surgery Center LLC
$1,137.00Published rateParkside Surgery Center, LLC
Parkside Surgery Center
$800.00Published rateBaptist And Physicians Outpatient Surgery Center Of North Ms, Lp, Oxford Surgery Center
Baptist And Physicians Outpatient Surgery Center Of North Ms Lp
$535.00Published ratePoole Endoscopy Center, LLC
$365.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21015 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21015. 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 21015. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21015 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 21015 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21015 to APC 5073 (Level 3 Excision/ Biopsy/ Incision and Drainage). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 21015 in an ambulatory surgery center?
CMS lists CPT 21015 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21015?
Hospital price transparency files list CPT 21015 under these revenue codes: 0360 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.