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See a sample rate comparisonCPT 21552 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 Nck Or Anterio Thorax Subcutane, Excision Tumor Soft Tissue Of Neck Or Anterior Thorax Subcutaneous;
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21552 |
| Medicaid Fee Schedule | View Medicaid rates for 21552 |
National average reimbursement for CPT 21552 by major payers:
$576.43
$612.82
$637.23
$746.54
Compare published rates across providers.
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CPT 21552
5 of 25 sample ratesHigher to lower in this preview
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC, Iu Health Surgery Center Fort Wayne
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC
$8,705.00Published rateOhio Specialty Surgical Suites, LLC
Ohio Specialty Surgical Suites LLC
$2,750.00Published rateWest Bend Surgery Center LLC
$2,222.00Published rateJames Butler
$1,156.47Published ratePlastic Surgery Specialists, PC
Plastic Surgery Specialists, P.C.
$513.00Published rate
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See a sample payer proposalCPT 21552 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21552 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 21552 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 |
|---|---|---|
| 21552-CPT | Moderate | Xcision Tumor Sft Tissue Of Nck Or Anterio Thorax Subcutane, Excision Tumor Soft Tissue Of Neck Or Anterior Thorax Subcutaneous; |
| 21554-CPT | Moderate | Excision Tumor Soft Tissue O, Excision Tumor Soft Tissue Of Neck Or Anterior Thorax Subfascial (Eg Intramuscular) 5 Cm Or Greater |
| 21555-CPT | Moderate | Xcision Tumor Sft Tissue Of Nck Or Anterio Thorax Subcutane, Excision Tumor Soft Tissue Of Neck Or Anterior Thorax Subcutaneous; |
| 21600-CPT | Moderate | Excision Rib Partial |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21552 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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