CPT code 21620: Sternal ostectomy, partial sternum removal2026 Medicare rate & RVUs in Missouri
Reports limited removal of sternal bone, including xiphoidectomy, for a focal problem such as persistent pain at the xiphoid process.
CMS doesn’t publish an office rate for 21620 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 21620 covers
A surgeon removes a limited portion of the sternum. A familiar use is xiphoidectomy for persistent, localized pain arising from the xiphoid process; the procedure may also address another focal sternal bony problem when partial bone removal is performed. It is generally performed in an operating room by a thoracic or general surgeon, rather than as an office procedure.
Report the code when the operative report supports partial removal of sternal bone, not simply soft-tissue work or cleaning infected tissue. Documentation should identify the sternal site, the reason for surgery, and the extent of bone removed. Distinguish limited removal from sternal debridement and from a more extensive radical resection. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 21620 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $486.47 |
| Metropolitan St. Louis, MO | Unavailable | $490.58 |
| Rest of Missouri | Unavailable | $470.46 |
How the 21620 rate is calculated
Each of 21620’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 21620
RVUs × geographic indexes × conversion factor
Work7.10
7.10 RVUs× 1.000 GPCI
Practice expense6.16
6.16 RVUs× 1.000 GPCI
Malpractice1.72
1.72 RVUs× 1.000 GPCI
Adjusted RVUs
14.9800
Conversion factor
$33.4009
Medicare rate
$500.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21620
21620 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21620
Sternal ostectomy, partial sternum removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21620
Sternal ostectomy, partial sternum removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21620 without 51 · national facility
$500.35
Sternal ostectomy, partial sternum removal
21620-51 · Second procedure: 50%
$250.18
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
21620 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21600Rib excisionPartial rib removal
- This code concerns partial removal of a rib. Use 21620 when the operative target is sternal bone, including the xiphoid process.
- 21627Sternal debridement
- 21627 describes sternal debridement. Choose based on whether the documented operation is debridement or limited removal of sternal bone.
- 21630Sternum resectionRadical resection
- 21630 is for radical sternal resection. This code is for a limited portion of the sternum rather than a radical resection.
21620 billing questions
When is this code appropriate for xiphoidectomy?
Use it when the surgeon removes part of the sternum at the xiphoid for a focal problem such as persistent localized xiphoid pain. The operative report should establish that sternal bone was removed.
How does this differ from sternal debridement?
This code represents partial sternal bone removal. When the documented service is debridement of the sternum, compare it with 21627 rather than selecting this code based only on the fact that bone was treated.
When should a more extensive sternum resection be considered?
Compare with 21630 when the operation involves radical resection of the sternum rather than limited removal. The operative report should support the extent of resection.
Can modifier 50 be reported for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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