CPT code 21705: Neck muscle surgery, muscle resection2026 Medicare rate & RVUs in California
Reports resection of sternocleidomastoid muscle, typically to address congenital muscular torticollis when muscle excision is performed.
CMS doesn’t publish an office rate for 21705 in California.
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 21705 covers
This open operation removes sternocleidomastoid muscle tissue to release persistent restriction, most commonly in a patient with congenital muscular torticollis. The surgeon works through the neck to resect the involved muscle; the operative report should identify the muscle treated and describe the excision. The service is generally performed in an operating room rather than an office setting.
Select this code when the documented procedure is muscle resection, not simply division or release, and distinguish it from repair or reconstruction of a congenital muscle abnormality. The operative note should support the indication, side, extent of resection, and work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral reporting with modifier 50, payment is at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. 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.
Where 21705 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $476.58 |
| Chico, CA | Unavailable | $469.89 |
| El Centro, CA | Unavailable | $470.30 |
| Fresno, CA | Unavailable | $469.89 |
| Hanford, CA | Unavailable | $469.89 |
| Los Angeles, CA | Unavailable | $495.94 |
| Madera, CA | Unavailable | $469.89 |
| Marin County, CA | Unavailable | $516.49 |
| Merced, CA | Unavailable | $469.89 |
| Modesto, CA | Unavailable | $469.89 |
| Napa, CA | Unavailable | $502.07 |
| Oxnard, CA | Unavailable | $488.26 |
| Redding, CA | Unavailable | $469.89 |
| Rest of California | Unavailable | $469.89 |
| Riverside, CA | Unavailable | $496.47 |
| Sacramento, CA | Unavailable | $481.95 |
| Salinas, CA | Unavailable | $479.98 |
| San Benito County, CA | Unavailable | $530.55 |
| San Diego, CA | Unavailable | $483.43 |
| San Francisco, CA | Unavailable | $513.68 |
| San Luis Obispo, CA | Unavailable | $473.69 |
| Santa Clara County, CA | Unavailable | $519.04 |
| Santa Cruz, CA | Unavailable | $481.71 |
| Santa Maria, CA | Unavailable | $479.63 |
| Santa Rosa, CA | Unavailable | $485.77 |
| Stockton, CA | Unavailable | $469.89 |
| Vallejo, CA | Unavailable | $498.02 |
| Visalia, CA | Unavailable | $469.89 |
| Yuba City, CA | Unavailable | $469.89 |
How the 21705 rate is calculated
Each of 21705’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 · 21705
RVUs × geographic indexes × conversion factor
Work9.67
9.67 RVUs× 1.000 GPCI
Practice expense2.65
2.65 RVUs× 1.000 GPCI
Malpractice2.48
2.48 RVUs× 1.000 GPCI
Adjusted RVUs
14.8000
Conversion factor
$33.4009
Medicare rate
$494.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21705
21705 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21705
Neck muscle surgery, muscle resection
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 21705
Neck muscle surgery, muscle resection
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 50 · payment effect
With and without the modifier
21705 without 50 · national facility
$494.33
Neck muscle surgery, muscle resection
21705-50 · Bilateral: 150%
$741.50
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
21705 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21700Scalene divisionWithout cervical rib resection
- 21700 describes division of the sternocleidomastoid muscle. Report 21705 when the documented operation resects muscle tissue.
- 21720Neck muscle repairSCM plastic operation
- 21720 concerns repair of a congenital sternocleidomastoid muscle abnormality; 21705 is for resection of the muscle.
- 21725Neck muscle revisionSternocleidomastoid muscle
- 21725 is a related congenital muscle repair code, whereas 21705 describes muscle resection rather than repair.
21705 billing questions
How does 21705 differ from 21700?
Use 21705 for resection of sternocleidomastoid muscle tissue. Code 21700 describes division of the muscle, so the operative technique documented determines the choice.
What documentation supports reporting 21705?
The operative report should identify the sternocleidomastoid muscle, the side, the reason for surgery, and the resection performed. A diagnosis of torticollis alone does not establish that muscle resection occurred.
Can 21705 be reported bilaterally?
CMS identifies this as a bilateral procedure; report modifier 50 when the procedure is performed bilaterally. Payment is at 150%.
Are postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for 21705?
CMS indicates that an assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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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