CPT code 21742: Nuss repair, without thoracoscopy2026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 21742 covers

This procedure is the Nuss method of reconstructing the sternum to correct pectus excavatum without thoracoscopy. The surgeon places a curved support bar beneath the sternum through small incisions to reshape the chest wall. It is generally performed in a hospital operating room by a thoracic or pediatric surgeon. Code 21743 distinguishes the Nuss procedure performed with thoracoscopy; code 21740 describes a different sternal reconstruction approach.

Medicare assigns physician fee schedule status C, so the Medicare Administrative Contractor sets payment claim by claim and CMS publishes no national payment. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and payment for the others is reduced. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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 21742 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21742 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 21742 rate is calculated

Each of 21742’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 21742

21742 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

21742 compared with similar codes

How to choose

21743Nuss repairWith thoracoscopy

Both identify Nuss repair of pectus excavatum. Choose 21742 when thoracoscopy is not performed and 21743 when it is performed.

21740Sternal reconstructionOpen reconstruction

Code 21742 identifies Nuss sternal reconstruction without thoracoscopy. Code 21740 describes a different sternal reconstruction approach, including for pectus excavatum.

21750Sternal repairPostoperative separation

Code 21750 addresses repair of separation of the sternum. It is not the Nuss reconstruction for pectus excavatum.

Codes related to 21742

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