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See a sample rate comparisonCPT 21555 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 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21555 |
| Medicaid Fee Schedule | View Medicaid rates for 21555 |
National average reimbursement for CPT 21555 by major payers:
$533.10
$558.88
$608.97
$508.61
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CPT 21555
5 of 25 sample ratesHigher to lower in this preview
Carmel Specialty Surgery Center LLC
Carmel Specialty Surgery Center, LLC
$2,832.00Published rateStonegate Surgery Center Lp
$1,200.00Published rateWestern Washington Endoscopy Centers LLC, Digestive Health Network Endoscopy Center
Western Washington Endoscopy Centers LLC
$734.00Published rateKuresmart Pain Management Surgery Center-Catonsville LLC, Clearway Surgery Center Of Catonsville
Kuresmart Pain Management Surgery Centercatonsville LLC
$611.00Published rateJoyce Bussard
Deaconess Hospital Inc
$336.39Published rate
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See a sample payer proposalCPT 21555 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21555 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 21555 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 |
|---|---|---|
| 21550-CPT | Moderate | Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy). |
| 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; |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21555. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21555 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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