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See a sample rate comparisonCPT 21557 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Radical Resection Of Tumor (Eg, Radical Resection Of Tumor (Eg Malignant Neoplasm) Soft Tissue Of Neck Or Anterior Thorax Less Than 5 Cm
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21557 |
| Medicaid Fee Schedule | View Medicaid rates for 21557 |
National average reimbursement for CPT 21557 by major payers:
$1,098.30
$1,182.27
$1,279.59
$1,480.95
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CPT 21557
5 of 25 sample ratesHigher to lower in this preview
River Ridge Surgical Suites, LLC
River Ridge Surgical Suites LLC
$2,889.00Published rateShore Outpatient Surgicenter LLC
$1,233.00Published rateAlliance Surgery Center At Cumming
$800.00Published rateNs Surgical Center LLC
$570.00Published rateApollo Surgery Center LLC
$296.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21557 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21557 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 21557 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 |
|---|---|---|
| 21557-CPT | High | Radical Resection Of Tumor (Eg, Radical Resection Of Tumor (Eg Malignant Neoplasm) Soft Tissue Of Neck Or Anterior Thorax Less Than 5 Cm |
| 21558-CPT | High | Radical Resection Of Tumor (Eg, Radical Resection Of Tumor (Eg Malignant Neoplasm) Soft Tissue Of Neck Or Anterior Thorax 5 Cm Orgreater |
| 21600-CPT | Moderate | Excision Rib Partial |
| 21602-CPT | High | Surgery For Chest Tumor, Surgery On The Chest To Remove A Tumor Including Nearby Ribs That May Be Involved. The Surgery Can Include Reconstruction Of Ribs And Removal Of Affected Lymph Nodes. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21557. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21557 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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