CPT code 21685: Hyoid suspension, myotomy and advancement2026 Medicare rate & RVUs in Florida
Reports hyoid release and anterior suspension to address hypopharyngeal airway obstruction, commonly as part of surgical treatment for obstructive sleep apnea.
CMS doesn’t publish an office rate for 21685 in Florida.
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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On this page 9 sections
What 21685 covers
An otolaryngologist performs this operation in the operating room, typically for obstructive sleep apnea associated with obstruction behind the tongue. The surgeon releases the hyoid through myotomy and suspends it forward, commonly securing it to the thyroid cartilage to enlarge the hypopharyngeal airway. It may be one part of multilevel airway surgery, including a palate procedure, when the operative plan addresses obstruction at more than one level.
Report the service when the operative documentation supports both the hyoid myotomy and suspension; document the indication, airway findings, and steps performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; 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 21685 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $926.11 |
| Miami, FL | Unavailable | $987.73 |
| Rest of Florida | Unavailable | $886.89 |
How the 21685 rate is calculated
Each of 21685’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 · 21685
RVUs × geographic indexes × conversion factor
Work14.88
14.88 RVUs× 1.000 GPCI
Practice expense8.72
8.72 RVUs× 1.000 GPCI
Malpractice2.22
2.22 RVUs× 1.000 GPCI
Adjusted RVUs
25.8200
Conversion factor
$33.4009
Medicare rate
$862.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21685
21685 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21685
Hyoid suspension, myotomy and advancement
| 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) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21685
Hyoid suspension, myotomy and advancement
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
21685 without 51 · national facility
$862.41
Hyoid suspension, myotomy and advancement
21685-51 · Second procedure: 50%
$431.21
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%).
21685 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 41512Tongue suspensionPermanent suture technique
- CPT 41512 describes suture-based tongue-base suspension. Use 21685 for hyoid myotomy and suspension, not for the tongue-base technique alone.
- 42145PalatopharyngoplastyPalate and pharynx repair
- CPT 42145 addresses palatal surgery. It may accompany hyoid suspension when the surgeon treats a separate level of airway obstruction.
- 64582Nerve stimulator implantHypoglossal nerve system
- CPT 64582 reports hypoglossal nerve stimulator implantation, a distinct device-based treatment rather than hyoid release and suspension.
21685 billing questions
How is this different from tongue-base suspension?
This code represents release and anterior suspension of the hyoid. CPT 41512 describes a separate suture-based tongue-base suspension technique.
Can it be reported with a palate procedure?
It may be performed in the same session as palatopharyngoplasty when the surgeon treats obstruction at multiple airway levels. The operative report should support each distinct procedure.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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