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See a sample rate comparisonCPT 21935 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 Resct Of Tumor (Eg Sarcom) Sft Tissue Of Bck Or Flank, Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Back Or Flank
| 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 59 - Distinct Procedural Service 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21935 |
| Medicaid Fee Schedule | View Medicaid rates for 21935 |
National average reimbursement for CPT 21935 by major payers:
$1,464.52
$1,424.46
$1,408.74
$1,685.07
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CPT 21935
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Richmond, LLC, Memorial Hermann Surgery Center Richmond
$2,817.00Published rateQueen Creek Surgical Center, LLC
Queen Creek Surgical Center LLC
$947.00Published rateEndoscopy Center Of Knoxville Lp, The Endoscopy Center West
Endoscopy Center Of Knoxville Lp
$687.00Published rateBoston Ivf, Inc., The Surgery Center Of Waltham
Boston Ivf, LLC
$544.00Published rateLaplata Ambulatory Urological Center, L.L.C.
Laplata Ambulatory Urological Center LLC
$356.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21935 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21935 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 21935 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 |
|---|---|---|
| 21933-CPT | High | Xcision Tumor Sft Tissue Of Bck Or Flank Subfasc (Eg Myomecto, Excision Tumor Soft Tissue Of Back Or Flank Subfascial (Eg Intramu |
| 21935-CPT | High | Radical Resct Of Tumor (Eg Sarcom) Sft Tissue Of Bck Or Flank, Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Back Or Flank |
| 21936-CPT | High | Radical Resct Of Tumor (Eg Sarcom) Sft Tissue Of Bck Or Flank, Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Back Or Flank |
| 22010-CPT | High | I D P Spine C T Cerv Thor, Incision And Drainage Open Of Deep Abscess Subfascial Posterior Spine Cervical Thoracic Or Cervicothoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21935. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21935 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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