CPT code 21627: Sternal debridement2026 Medicare rate & RVUs in Montana
Surgical removal of devitalized tissue from the sternum, commonly during operative treatment of a deep sternal wound infection after sternotomy.
In Montana, Medicare pays $555.34 for 21627 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 21627 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 21627 covers
The surgeon removes infected or nonviable tissue from the sternum and operative wound, often to control a deep infection or sternal osteomyelitis after median sternotomy. Cardiothoracic and thoracic surgeons typically perform the procedure in a hospital operating room. The work is focused on cleaning the affected sternal area; it is distinct from removing a portion of sternum as an ostectomy or performing a radical resection.
Report the service when the operative note supports debridement of the sternum, including the site and extent of affected tissue addressed and the reason for treatment. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are 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.
How Montana compares for 21627
Across 109 of 109 payment localities, the facility rate for 21627 runs from $491.14 in Arkansas to $670.57 in San Benito County, CA. Montana pays $555.34. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$555.34
- Los Angeles, CA · California$593.87+$38.53
- Washington, DC area · District of Columbia$621.15+$65.81
- Miami, FL · Florida$652.97+$97.63
- Chicago, IL · Illinois$631.96+$76.62
- Manhattan, NY · New York$646.21+$90.87
- Alaska · Alaska$665.83+$110.49
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $498.21 |
| ArkansasArkansas | — | $491.14 |
| ArizonaArizona | — | $539.19 |
| Bakersfield, CACalifornia | — | $562.82 |
| Chico, CACalifornia | — | $558.20 |
| El Centro, CACalifornia | — | $558.48 |
| Fresno, CACalifornia | — | $558.20 |
| Hanford, CACalifornia | — | $558.20 |
| Madera, CACalifornia | — | $558.20 |
| Merced, CACalifornia | — | $558.20 |
| Modesto, CACalifornia | — | $558.20 |
| Napa, CACalifornia | — | $625.46 |
| Oxnard, CACalifornia | — | $588.19 |
| Redding, CACalifornia | — | $558.20 |
| Rest of CaliforniaCalifornia | — | $558.20 |
| Riverside, CACalifornia | — | $576.43 |
| Sacramento, CACalifornia | — | $580.19 |
| Salinas, CACalifornia | — | $577.96 |
| San Diego, CACalifornia | — | $587.71 |
| Marin County, CACalifornia | — | $654.28 |
| San Francisco, CACalifornia | — | $652.35 |
| San Benito County, CACalifornia | — | $670.57 |
| Santa Clara County, CACalifornia | — | $662.68 |
| San Luis Obispo, CACalifornia | — | $569.41 |
| Santa Cruz, CACalifornia | — | $590.19 |
| Santa Maria, CACalifornia | — | $579.07 |
| Santa Rosa, CACalifornia | — | $595.72 |
| Stockton, CACalifornia | — | $558.20 |
| Vallejo, CACalifornia | — | $622.67 |
| Visalia, CACalifornia | — | $558.20 |
| Yuba City, CACalifornia | — | $558.20 |
| ColoradoColorado | — | $562.57 |
| ConnecticutConnecticut | — | $592.22 |
| DelawareDelaware | — | $547.78 |
| Fort Lauderdale, FLFlorida | — | $604.73 |
| Rest of FloridaFlorida | — | $572.54 |
| Atlanta, GAGeorgia | — | $571.76 |
| Rest of GeorgiaGeorgia | — | $538.19 |
| Hawaii, Guam, HIHawaii | — | $567.29 |
| IowaIowa | — | $499.04 |
| IdahoIdaho | — | $504.66 |
| East St. Louis, ILIllinois | — | $592.16 |
| Rest of IllinoisIllinois | — | $564.73 |
| Suburban Chicago, ILIllinois | — | $608.00 |
| IndianaIndiana | — | $507.23 |
| KansasKansas | — | $502.25 |
| KentuckyKentucky | — | $521.67 |
| New Orleans, LALouisiana | — | $547.79 |
| Rest of LouisianaLouisiana | — | $523.07 |
| Metropolitan Boston, MAMassachusetts | — | $609.57 |
| Rest of MassachusettsMassachusetts | — | $561.56 |
| Baltimore area, MDMaryland | — | $591.76 |
| Rest of MarylandMaryland | — | $556.31 |
| Rest of MaineMaine | — | $513.12 |
| Southern Maine, MEMaine | — | $532.16 |
| Detroit, MIMichigan | — | $585.28 |
| Rest of MichiganMichigan | — | $540.09 |
| MinnesotaMinnesota | — | $523.05 |
| Metropolitan Kansas City, MOMissouri | — | $538.24 |
| Metropolitan St. Louis, MOMissouri | — | $543.05 |
| Rest of MissouriMissouri | — | $517.98 |
| MississippiMississippi | — | $504.38 |
| North CarolinaNorth Carolina | — | $517.48 |
| North DakotaNorth Dakota | — | $521.73 |
| NebraskaNebraska | — | $500.05 |
| New HampshireNew Hampshire | — | $559.05 |
| Northern New JerseyNew Jersey | — | $616.04 |
| Rest of New JerseyNew Jersey | — | $594.48 |
| New MexicoNew Mexico | — | $545.22 |
| NevadaNevada | — | $546.24 |
| NYC suburbs and Long Island, NYNew York | — | $668.64 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $602.86 |
| Queens, NYNew York | — | $643.25 |
| Rest of New YorkNew York | — | $525.55 |
| OhioOhio | — | $533.22 |
| OklahomaOklahoma | — | $514.88 |
| Portland, OROregon | — | $573.68 |
| Rest of OregonOregon | — | $537.55 |
| Metropolitan Philadelphia, PAPennsylvania | — | $581.39 |
| Rest of PennsylvaniaPennsylvania | — | $530.94 |
| Puerto RicoPuerto Rico | — | $557.47 |
| Rhode IslandRhode Island | — | $562.45 |
| South CarolinaSouth Carolina | — | $527.11 |
| South DakotaSouth Dakota | — | $517.75 |
| TennesseeTennessee | — | $505.43 |
| Austin, TXTexas | — | $564.59 |
| Beaumont, TXTexas | — | $527.95 |
| Brazoria, TXTexas | — | $542.52 |
| Dallas, TXTexas | — | $548.49 |
| Fort Worth, TXTexas | — | $546.62 |
| Galveston, TXTexas | — | $545.77 |
| Houston, TXTexas | — | $576.88 |
| Rest of TexasTexas | — | $536.65 |
| UtahUtah | — | $534.01 |
| VirginiaVirginia | — | $534.33 |
| Virgin Islands, VIUnited States Virgin Islands | — | $557.47 |
| VermontVermont | — | $524.80 |
| Rest of WashingtonWashington | — | $558.80 |
| King County, WAWashington | — | $616.17 |
| WisconsinWisconsin | — | $505.21 |
| West VirginiaWest Virginia | — | $545.76 |
| WyomingWyoming | — | $540.69 |
21627 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 21627 rate is calculated
Each of 21627’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 · 21627
RVUs × geographic indexes × conversion factor
Work7.12
7.12 RVUs× 1.000 GPCI
Practice expense7.81
7.81 RVUs× 1.000 GPCI
Malpractice1.70
1.70 RVUs× 1.000 GPCI
Adjusted RVUs
16.6300
Conversion factor
$33.4009
Medicare rate
$555.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,016
- Code
- 21627
- Physician work
- 7.12
- Practice expense
- 7.81
- Malpractice
- 1.70
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.12 | × 1.000 | 7.1200 |
| Practice expense | 7.81 | × 1.000 | 7.8100 |
| Malpractice | 1.70 | × 0.998 | 1.6966 |
| Total RVUs | 16.6266 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana$555.34
Facility: (7.12 × 1 + 7.81 × 1 + 1.7 × 0.998) × $33.4009 = $555.34
Payment rules and modifiers for 21627
21627 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21627
Sternal debridement
| 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) | 0 | Not permitted. |
| 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 · 21627
Sternal debridement
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
21627 without 51 · national facility
$555.46
Sternal debridement
21627-51 · Second procedure: 50%
$277.73
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%).
How 21627 has changed in Montana
21627 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $555.34 | RVU26D |
| 2026-07-01 | Not available in this setting | $555.34 | RVU26C |
| 2026-04-01 | Not available in this setting | $555.34 | RVU26B |
| 2026-01-01 | Not available in this setting | $555.34 | RVU26A |
| 2025-10-01 | Not available in this setting | $538.02 | RVU25D |
| 2025-07-01 | Not available in this setting | $538.02 | RVU25C |
| 2025-04-01 | Not available in this setting | $538.02 | RVU25B |
| 2025-01-01 | Not available in this setting | $538.02 | RVU25A |
| 2024-10-01 | Not available in this setting | $549.34 | RVU24D |
| 2024-07-01 | Not available in this setting | $549.34 | RVU24C |
| 2024-04-01 | Not available in this setting | $549.34 | RVU24B |
| 2024-03-09 | Not available in this setting | $549.34 | RVU24AR |
| 2024-01-01 | Not available in this setting | $540.37 | RVU24A |
| 2023-10-01 | Not available in this setting | $552.50 | RVU23D |
| 2023-07-01 | Not available in this setting | $552.50 | RVU23C |
| 2023-04-01 | Not available in this setting | $552.50 | RVU23B |
| 2023-01-01 | Not available in this setting | $552.50 | RVU23A |
| 2022-10-01 | Not available in this setting | $557.24 | RVU22D |
| 2022-07-01 | Not available in this setting | $557.24 | RVU22C |
| 2022-04-01 | Not available in this setting | $557.24 | RVU22B |
| 2022-01-01 | Not available in this setting | $557.24 | RVU22A |
| 2021-10-01 | Not available in this setting | $555.62 | RVU21D |
| 2021-07-01 | Not available in this setting | $555.62 | RVU21C |
| 2021-04-01 | Not available in this setting | $555.62 | RVU21B |
| 2021-01-01 | Not available in this setting | $555.62 | RVU21A |
| 2020-10-01 | Not available in this setting | $579.00 | RVU20D |
| 2020-07-01 | Not available in this setting | $579.00 | RVU20C |
| 2020-04-01 | Not available in this setting | $579.00 | RVU20B |
| 2020-01-01 | Not available in this setting | $579.00 | RVU20A |
| 2019-10-01 | Not available in this setting | $594.40 | RVU19D |
| 2019-07-01 | Not available in this setting | $594.40 | RVU19C |
| 2019-04-01 | Not available in this setting | $594.40 | RVU19B |
| 2019-01-01 | Not available in this setting | $594.40 | RVU19A |
| 2018-10-01 | Not available in this setting | $594.47 | RVU18D |
| 2018-07-01 | Not available in this setting | $594.47 | RVU18C |
| 2018-04-01 | Not available in this setting | $594.47 | RVU18B |
| 2018-01-01 | Not available in this setting | $594.47 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $582.19 | RVU17D |
| 2017-07-01 | Not available in this setting | $582.19 | RVU17C |
| 2017-04-01 | Not available in this setting | $582.19 | RVU17B |
| 2017-01-01 | Not available in this setting | $582.19 | RVU17A |
| 2016-10-01 | Not available in this setting | $571.14 | RVU16D |
| 2016-07-01 | Not available in this setting | $571.14 | RVU16C |
| 2016-04-01 | Not available in this setting | $571.14 | RVU16B |
| 2016-01-01 | Not available in this setting | $571.14 | RVU16A |
| 2015-10-01 | Not available in this setting | $574.83 | RVU15D |
| 2015-07-01 | Not available in this setting | $574.83 | RVU15C |
| 2015-04-01 | Not available in this setting | $571.97 | RVU15B |
| 2015-01-01 | Not available in this setting | $571.97 | RVU15A |
| 2014-10-01 | Not available in this setting | $566.03 | RVU14D |
| 2014-07-01 | Not available in this setting | $566.03 | RVU14C |
| 2014-04-01 | Not available in this setting | $566.03 | RVU14B |
| 2014-01-01 | Not available in this setting | $566.03 | RVU14A |
| 2013-10-01 | Not available in this setting | $563.76 | RVU13D |
| 2013-07-01 | Not available in this setting | $563.76 | RVU13C |
| 2013-04-01 | Not available in this setting | $563.76 | RVU13B |
| 2013-01-01 | Not available in this setting | $563.76 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
21627 billing questions
How does this differ from partial sternal ostectomy, 21620?
21627 describes debridement of affected sternal tissue. Use 21620 when the operative objective is partial removal of sternal bone rather than debridement of a wound.
Can 21627 be reported with 21750?
21750 describes closure of a median sternotomy separation with or without debridement. When the debridement is part of that closure, do not report 21627 separately for the same work.
What should the operative note establish?
Document the sternal site, the infected or nonviable tissue treated, the extent of the debridement, and the clinical reason for the operation.
How is 21627 affected by the 90-day global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
Does modifier 50 apply to bilateral sternal debridement?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
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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