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

CPT 21813: $868.19–$884.63 facility across 2 localities in Elgin, TX in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20262 payment localities

CMS doesn’t publish an office rate for 21813 in Elgin, Texas.

—Office (non-facility)
$868.19–$884.63Hospital or facility

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

We’ll open 21813 for the payment locality that covers the ZIP.

On this page 6 sections
  1. Rate in Elgin, Texas
  2. By payment locality
  3. City and payment areas
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 21813 pays more and less in Elgin, Texas

Elgin, Texas maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

21813 office and facility rates by payment locality
Payment localityOfficeFacility
Austin, TXUnavailable$884.63
Rest of TexasUnavailable$868.19

How payment areas work in Elgin

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

  • Rest Of State · Bastrop County
  • Austin · Travis County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

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

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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