CPT code 21720: Neck muscle repair, SCM plastic operation2026 Medicare rate & RVUs in Missouri
Reports plastic reconstruction of the sternocleidomastoid muscle, commonly to correct fixed neck tilt caused by congenital muscular torticollis.
CMS doesn’t publish an office rate for 21720 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 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 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 | $554.00 |
| Metropolitan St. Louis, MO | Unavailable | $559.97 |
| Rest of Missouri | Unavailable | $530.21 |
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.
How the rate is built · 21720
RVUs × geographic indexes × conversion factor
Work5.66
5.66 RVUs× 1.000 GPCI
Practice expense9.16
9.16 RVUs× 1.000 GPCI
Malpractice2.38
2.38 RVUs× 1.000 GPCI
Adjusted RVUs
17.2000
Conversion factor
$33.4009
Medicare rate
$574.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21720
21720 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21720
Neck muscle repair, SCM plastic operation
| 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 · 21720
Neck muscle repair, SCM plastic operation
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
21720 without 51 · national facility
$574.50
Neck muscle repair, SCM plastic operation
21720-51 · Second procedure: 50%
$287.25
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%).
21720 compared with similar codes
Compare codes · National
4 codes, side by side
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.
21720 billing questions
How is this different from an SCM division code?
This code represents plastic reconstructive work on the SCM. Codes 21700 and 21705 describe division-based procedures, so select according to the operative work documented.
Should modifier 50 be appended for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction.
What should the operative note describe?
Document the SCM treated, the plastic reconstructive work performed, and the clinical problem, such as fixed neck tilt from congenital muscular torticollis.
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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