CPT code 21720: Neck muscle repair, SCM plastic operation2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 21720 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.

What 21720 covers

This service involves surgically reshaping or lengthening the sternocleidomastoid (SCM) to address a fixed neck tilt or restricted motion, often from congenital muscular torticollis. It is typically performed in an operating room by an otolaryngologist, pediatric orthopedic surgeon, or plastic surgeon. The operative work is a plastic reconstructive procedure on the muscle, rather than simply dividing it.

Choose this code when the operative report supports plastic reconstruction of the SCM. Documentation should identify the treated muscle, the reconstructive work performed, and the condition being treated. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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’s descriptor and anatomy. 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 21720 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

How the 21720 rate is calculated

Each of 21720’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.

Payment rules and modifiers for 21720

21720 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

21720 compared with similar codes

How to choose

21700Scalene divisionWithout cervical rib resection

Choose 21700 when the documented procedure is division of the SCM for torticollis. Use 21720 for plastic reconstructive work on the muscle.

21705Neck muscle surgeryMuscle resection

This code describes a division-based procedure involving extensive dissection. It is not the same as the plastic SCM reconstruction reported with 21720.

21725Neck muscle revisionSternocleidomastoid muscle

Both codes concern SCM surgery, but the documented operative approach determines which applies. Do not select 21720 solely because the indication is torticollis.

Codes related to 21720

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates