Excision of a subfascial (deep) soft tissue tumor of the face or scalp measuring 2 cm or greater in greatest diameter plus required margin.

Verified May 8, 2026 · 5 sources ↓

Medicare: $480.30
Total RVUs: 14.38
Global, days: 90
Region: Other

Drawn from AAPCFacsFindacodeMdclarityCMS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Operative note must specify the anatomic depth — explicitly subfascial, subgaleal, or intramuscular — not just 'deep' or 'below skin'.
Record the measured size of the tumor plus excision margin at the time of surgery; this combined measurement must be 2 cm or greater.
Document the anatomic location on the face or scalp with sufficient specificity to support laterality modifiers if applicable.
Pathology report or specimen submission confirming the tissue was sent for analysis, supporting medical necessity and ruling out malignancy.
Preoperative diagnosis and clinical rationale for excision, including any imaging findings that support deep (subfascial) tumor characterization.
Confirm in the note that the lesion is not of cutaneous origin (not a sebaceous cyst, epidermal inclusion cyst, or cutaneous malignancy) to justify using a musculoskeletal excision code rather than an integumentary code.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 21014 covers surgical removal of a deep soft tissue tumor of the face or scalp — specifically subfascial tumors (subgaleal, intramuscular, or below the fascia) where the tumor plus the margin required for complete excision measures 2 cm or more. Tumor size is measured at the time of excision as the greatest diameter of the tumor combined with the narrowest adequate margin, per the surgeon's judgment. That combined measurement, not the tumor alone, determines code selection.

This code sits in the musculoskeletal system subsection, not the integumentary section. Cutaneous-origin lesions — sebaceous cysts, epidermal inclusions, melanoma requiring soft tissue excision — do not belong here. Those belong to the 11400–11446 or 11600–11646 ranges. If the tumor is superficial (above the fascia), look to 21013 regardless of size.

The 90-day global period applies. All routine post-op visits, wound checks, and stitch removals through day 90 are bundled. Anything unrelated in that window needs modifier 24 or 25. Otolaryngology and plastic/reconstructive surgery are the top billing specialties for this code, though oral/maxillofacial surgeons also bill it frequently.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	6.95
Practice expense RVU	6.11
Malpractice RVU	1.32
Total RVU	14.38
Medicare national rate	$480.30
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$480.30
HOPD (APC 5073) Hospital outpatient department	$2,967.63
ASC (PI R2) Ambulatory surgical center (freestanding)	$1,248.36

Common denial reasons

The recurring reasons claims for CPT 21014 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Code billed for a superficial (above fascia) tumor — that maps to 21013, not 21014; depth documentation is insufficient.
Tumor size documented as less than 2 cm, or size recorded for the tumor alone without including the required excision margin.
Cutaneous-origin lesion excised and billed here — sebaceous cysts and epidermal inclusions must be coded from the 11400–11446 integumentary range.
Routine post-op visit billed separately during the 90-day global period without modifier 24, triggering a global period denial.
Missing or inadequate operative note — payers and auditors reject claims where depth (subfascial vs. subcutaneous) is not explicitly documented.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What's the difference between 21013 and 21014?

Size plus depth. 21013 is for subfascial tumors under 2 cm; 21014 is for subfascial tumors 2 cm or greater. If the tumor is above the fascia, neither code applies — use the subcutaneous codes in the same family.

02How is tumor size calculated for code selection?

Measure the greatest diameter of the tumor plus the narrowest margin required for complete excision, at the time of surgery. That combined number — not the pathology specimen size — determines whether you're in the 21013 or 21014 range.

03Can I bill 21014 for a sebaceous cyst on the face?

No. Sebaceous cysts and other cutaneous-origin lesions belong in the 11400–11446 range. 21014 is strictly for soft tissue tumors of subfascial depth; using it for a cutaneous lesion is a misuse that will draw audit attention.

04What modifiers apply when two face tumors are excised in the same session?

Use modifier 51 on the lower-RVU procedure. If the tumors are on distinct anatomic structures and you need to bypass an NCCI edit, add modifier 59 or XS. Apply LT or RT when the two tumors are on opposite sides.

05Does the 90-day global period affect post-op office visits?

Yes. All routine post-op visits through day 90 are bundled into the global. If you see the patient for an unrelated problem during that window, use modifier 24 (E/M) or 79 (unrelated procedure) to get reimbursed separately.

06What site of service difference should I expect between HOPD and ASC?

There is a meaningful payment gap between the HOPD and ASC rates for 21014. See the Site of Service comparison table on this page for the current 2026 figures — that delta is worth factoring into scheduling decisions for elective cases.

07When is modifier 22 appropriate for 21014?

Use modifier 22 when the procedure required substantially increased work beyond the typical excision — for example, a tumor with extensive involvement of adjacent structures or unusually complex dissection. The operative note must describe the specific factors that made the work atypical; a blanket 22 without documentation support will be denied.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the surgeon's dictated tumor depth (subfascial, subgaleal, intramuscular), the intraoperative measurement of tumor plus excision margin, and the anatomic location on the face or scalp. It also flags whether the lesion is described as cutaneous in origin — the most common reason a 21014 claim gets rerouted to an integumentary code and denied on re-audit.

See how Mira captures CPT 21014 documentation