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CPT code 21813: Rib fracture fixation, seven or more ribs2026 Medicare rate & RVUs

Reports operative internal fixation of seven or more rib fractures, including thoracoscopic visualization when performed, for patients requiring surgical stabilization.

CMS RVU26DEffective Oct 1, 2026109 payment localities68 Medicare services in 2024

Medicare pays $891.47 for 21813 nationally in a facility.

Medicare rate · 21813

Rib fracture fixation, seven or more ribs

Office or facility?

Work RVUs
17.17
Total RVUs
26.69
Global days
000

National rate · 2026

$891.47

Facility setting, before claim adjustments.

See every locality for 21813 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 21813 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21813 covers

This code describes operative stabilization of seven or more fractured ribs using internal fixation. Thoracic or trauma surgeons typically perform the procedure in a hospital operating room for patients whose rib injuries require surgical stabilization. Thoracoscopic visualization, when used during the operation, is included in the service. The code is selected by the number of ribs treated with fixation, not simply the total number of fractured ribs documented.

The operative report should identify the ribs treated and describe the fixation performed. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When another procedure is performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays this procedure at 150%. 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 21813 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

21813 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$804.25
AlaskaUnavailable$1,119.91
ArizonaUnavailable$864.25
ArkansasUnavailable$793.78
Atlanta, GAUnavailable$926.70
Austin, TXUnavailable$884.63
Bakersfield, CAUnavailable$858.07
Baltimore area, MDUnavailable$949.06
Beaumont, TXUnavailable$865.77
Brazoria, TXUnavailable$860.78

21813 rates by state

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

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
21813 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 21813 rate is calculated

Each of 21813’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 · 21813

RVUs × geographic indexes × conversion factor

Office or facility?

Work17.17

17.17 RVUs× 1.000 GPCI

Practice expense4.92

4.92 RVUs× 1.000 GPCI

Malpractice4.60

4.60 RVUs× 1.000 GPCI

Adjusted RVUs

26.6900

Conversion factor

$33.4009

Medicare rate

$891.47

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 21813

The CMS indicators that decide how 21813 is paid alongside other services.

CMS payment indicators · 21813

Rib fracture fixation, seven or more ribs

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

21813 without 50 · national facility

$891.47

Rib fracture fixation, seven or more ribs

21813-50 · Bilateral: 150%

$1,337.21

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).

When to use modifier 50

21813 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 21813

    Rib fracture fixation, seven or more ribs17.17 wRVU

    Not priced

  • 21811

    Rib fixation, unilateral, 1-3 ribs10.52 wRVU

    Not priced

  • 21812

    Rib fracture fixation, four to six ribs12.68 wRVU

    Not priced

  • 21820

    Sternum fracture care, closed, without manipulation1.33 wRVU

    $179.70

  • 21825

    Sternal fracture repair, open treatment7.57 wRVU

    Not priced

How to choose

21811Rib fixationUnilateral, 1-3 ribs
Use 21811 for internal fixation of one to three ribs; 21813 requires fixation of seven or more.
21812Rib fracture fixationFour to six ribs
Use 21812 when four to six ribs are treated with internal fixation; 21813 is the seven-or-more-rib level.
21820Sternum fracture careClosed, without manipulation
This code concerns treatment of a sternum fracture, not rib-fracture fixation.
21825Sternal fracture repairOpen treatment
This code is for open treatment of a sternum fracture; 21813 is for internal fixation of seven or more ribs.

Codes related to 21813

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

Codes related to 21813
CodeHow it relatesNational office range
Same family
21811Rib fixation, unilateral, 1-3 ribsSame internal-fixation service for one to three treated ribs.No office rate
21812Rib fracture fixation, four to six ribsSame internal-fixation service for four to six treated ribs.No office rate
Used instead
21899Unlisted procedure, neck or thoraxUnlisted neck or thorax procedure code when no specific code describes the operation.No office rate

21813 billing questions

How is 21813 distinguished from 21811 and 21812?

Choose by the number of ribs treated with internal fixation: 21813 is for seven or more, 21812 for four to six, and 21811 for one to three.

Does the code include thoracoscopic visualization?

Yes. Thoracoscopic visualization, when performed as part of the rib-fracture fixation, is included.

What documentation supports reporting 21813?

The operative report should identify the ribs actually treated and document internal fixation. The count must support treatment of seven or more ribs.

How is bilateral treatment reported?

For a bilateral procedure, report modifier 50; CMS pays the procedure at 150%.

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.

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
RVUs for 21813PPRRVU2026_Oct_nonQPP.csv, line 2,029 (RVU26D)

Open CMS sourceHow we calculate rates

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