CPT code 21742: Nuss repair, without thoracoscopy2026 Medicare rate & RVUs in Michigan
Reported for surgical correction of pectus excavatum by Nuss sternal reconstruction when thoracoscopy is not used.
CMS doesn’t publish an office rate for 21742 in Michigan.
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 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 in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
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.
How the rate is built · 21742
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21742
21742 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21742
Nuss repair, without thoracoscopy
| 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) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21742
Nuss repair, without thoracoscopy
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
21742 without 51 · national facility
$0.00
Nuss repair, without thoracoscopy
21742-51 · Second procedure: 50%
$0.00
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%).
21742 compared with similar codes
Compare codes · National
4 codes, side by side
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.
21742 billing questions
How is this code different from 21743?
Use 21742 for the Nuss approach without thoracoscopy. Code 21743 identifies the corresponding repair performed with thoracoscopy.
When would 21740 be considered instead?
Code 21740 describes a different sternal reconstruction approach, including reconstruction for pectus excavatum. Code 21742 identifies the Nuss approach without thoracoscopy.
Are related postoperative visits included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. A bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does Medicare price this service?
Status C means the Medicare Administrative Contractor sets payment for each claim, and CMS publishes no national payment. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation.
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
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