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CPT code 21820: Sternum fracture care, closed, without manipulation2026 Medicare rate & RVUs in Nevada

Reports closed management of a sternum fracture without manipulation, typically when the fracture is treated nonoperatively after chest trauma.

CMS RVU26DEffective Oct 1, 2026One payment locality91 Medicare services in 2024

In Nevada, Medicare pays $178.20 for 21820 in the office and $167.51 when it’s performed in a hospital or facility.

$178.20Office (non-facility)
$167.51Hospital or facility
−0.8%vs the national office rate ($179.70)

Check a contract rate as a % of Medicare · 21820 nationwide

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 21820 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 21820 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 21820 covers

This service covers nonoperative management of a fractured sternum without manipulating the fracture. It is generally performed by a surgeon or trauma physician caring for a patient after blunt chest trauma, such as a motor vehicle collision. Management may include clinical assessment and a plan for conservative care; the fracture site and treatment approach distinguish this service from operative repair.

Report the code when the documented treatment is closed and does not involve manipulation. The note should identify the sternal fracture and support the treatment performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. Medicare does not pay an assistant at surgery for this code; 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.

How Nevada compares for 21820

Across 109 of 109 payment localities, the office rate for 21820 runs from $157.29 in Arkansas to $235.60 in San Benito County, CA. Nevada pays $178.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

21820 in Nevada vs other payment areas
  1. Nevada · this page$178.20
  2. Los Angeles, CA · California$201.25+$23.05
  3. Washington, DC area · District of Columbia$205.54+$27.34
  4. Miami, FL · Florida$199.66+$21.46
  5. Chicago, IL · Illinois$193.18+$14.98
  6. Manhattan, NY · New York$208.56+$30.36
  7. Alaska · Alaska$205.72+$27.52

Other areas in Nevada first, then benchmark localities. Bars start at $0.

Every other payment area

21820 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$159.79$150.44
ArkansasArkansas$157.29$148.11
ArizonaArizona$174.41$164.05
Bakersfield, CACalifornia$188.81$177.10
Chico, CACalifornia$188.01$176.30
El Centro, CACalifornia$188.06$176.35
Fresno, CACalifornia$188.01$176.30
Hanford, CACalifornia$188.01$176.30

21820 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$157.29

$211.81

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
21820 office rate range by state
State / territoryOffice rate rangeLocalities
AK$205.721
AL$159.791
AR$157.291
AZ$174.411
CA$188.01–$235.6029
CO$186.151
CT$192.291
DC$205.541
DE$177.431
FL$179.04–$199.663
GA$167.99–$183.792
GU$192.821
HI$192.821
IA$163.181
ID$164.551
IL$174.22–$193.184
IN$165.551
KS$162.841
KY$164.931
LA$164.85–$173.602
MA$185.10–$204.822
MD$180.85–$205.543
ME$165.99–$174.992
MI$170.02–$181.952
MN$176.521
MO$162.11–$173.693
MS$159.711
MT$179.681
NC$167.791
ND$173.941
NE$164.001
NH$183.641
NJ$193.97–$203.252
NM$171.221
NV$178.201
NY$170.54–$214.585
OH$168.851
OK$164.101
OR$176.32–$191.872
PA$168.87–$187.512
PR$180.931
RI$183.641
SC$168.701
SD$173.271
TN$163.781
TX$167.71–$185.978
UT$171.171
VA$174.71–$205.542
VI$180.931
VT$173.661
WA$184.62–$208.652
WI$167.721
WV$167.421
WY$177.181

See 21820 in every payment locality

How the 21820 rate is calculated

Each of 21820’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 · 21820

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.33

1.33 RVUs× 1.000 GPCI

Practice expense3.76

3.76 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

5.3800

Conversion factor

$33.4009

Medicare rate

$179.70

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

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,030

Code
21820
Physician work
1.33
Practice expense
3.76
Malpractice
0.29

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 21820 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.33× 1.0001.3300
Practice expense3.76× 1.0013.7638
Malpractice0.29× 0.8330.2416
Total RVUs5.3353
Conversion factor× 33.4009

Office rate, Nevada$178.20

Office: (1.33 × 1 + 3.76 × 1.001 + 0.29 × 0.833) × $33.4009 = $178.20

Facility: (1.33 × 1 + 3.44 × 1.001 + 0.29 × 0.833) × $33.4009 = $167.51

Open 21820 in the RVU calculator

Payment rules and modifiers for 21820

21820 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21820

Sternum fracture care, closed, without manipulation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21820

Sternum fracture care, closed, without manipulation

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21820 without 51 · national office

$179.70

Sternum fracture care, closed, without manipulation

21820-51 · Second procedure: 50%

$89.85

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%).

When to use modifier 51

Codes related to 21820

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

Codes related to 21820
CodeHow it relatesOffice range, Nevada
Used instead
21825Sternal fracture repair, open treatmentOpen treatment of a sternal fracture, with or without fixation.No office rate
21811Rib fixation, unilateral, 1-3 ribsFor internal fixation of one to three rib fractures, rather than a sternal fracture.No office rate
21812Rib fracture fixation, four to six ribsFor internal fixation of four to six rib fractures, rather than a sternal fracture.No office rate
21813Rib fracture fixation, seven or more ribsFor internal fixation of seven or more rib fractures, rather than a sternal fracture.No office rate

How 21820 has changed in Nevada

21820 · Office / nonfacility

$178.20

Effective 2026-10-01

The base rate is $25.97 higher than on 2025-10-01, moving from $152.23 to $178.20 (17.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $152.23changed to$178.20

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.36 changed to 1.33
    • Practice expense RVU 3.11 changed to 3.76
    • Malpractice RVU 0.28 changed to 0.29
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $153.95changed to$152.23

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.02 changed to 3.11
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $151.43changed to$153.95

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $156.44changed to$151.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.96 changed to 3.02
    • Malpractice RVU 0.27 changed to 0.29
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $157.51changed to$156.44

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.82 changed to 2.96
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $156.25changed to$157.51

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.76 changed to 2.82
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $152.32changed to$156.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.55 changed to 2.76
    • Malpractice RVU 0.27 changed to 0.26
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $147.87changed to$152.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.48 changed to 2.55
    • Malpractice RVU 0.24 changed to 0.27
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $147.34changed to$147.87

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.47 changed to 2.48

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $146.21changed to$147.34

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.40 changed to 2.47
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $148.44changed to$146.21

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.42 changed to 2.40
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $150.82changed to$148.44

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.45 changed to 2.42
    • Malpractice RVU 0.26 changed to 0.24

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $150.06changed to$150.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $150.90changed to$150.06

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.44 changed to 2.45
    • Malpractice RVU 0.25 changed to 0.26
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $154.00changed to$150.90

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.69 changed to 2.44
    • Malpractice RVU 0.26 changed to 0.25
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$154.00

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$178.20$167.51RVU26D
2026-07-01$178.20$167.51RVU26C
2026-04-01$178.20$167.51RVU26B
2026-01-01$178.20$167.51RVU26A
2025-10-01$152.23$150.94RVU25D
2025-07-01$152.23$150.94RVU25C
2025-04-01$152.23$150.94RVU25B
2025-01-01$152.23$150.94RVU25A
2024-10-01$153.95$151.95RVU24D
2024-07-01$153.95$151.95RVU24C
2024-04-01$153.95$151.95RVU24B
2024-03-09$153.95$151.95RVU24AR
2024-01-01$151.43$149.47RVU24A
2023-10-01$156.44$154.07RVU23D
2023-07-01$156.44$154.07RVU23C
2023-04-01$156.44$154.07RVU23B
2023-01-01$156.44$154.07RVU23A
2022-10-01$157.51$154.40RVU22D
2022-07-01$157.51$154.40RVU22C
2022-04-01$157.51$154.40RVU22B
2022-01-01$157.51$154.40RVU22A
2021-10-01$156.25$153.81RVU21D
2021-07-01$156.25$153.81RVU21C
2021-04-01$156.25$153.81RVU21B
2021-01-01$156.25$153.81RVU21A
2020-10-01$152.32$151.23RVU20D
2020-07-01$152.32$151.23RVU20C
2020-04-01$152.32$151.23RVU20B
2020-01-01$152.32$151.23RVU20A
2019-10-01$147.87$148.60RVU19D
2019-07-01$147.87$148.60RVU19C
2019-04-01$147.87$148.60RVU19B
2019-01-01$147.87$148.60RVU19A
2018-10-01$147.34$149.54RVU18D
2018-07-01$147.34$149.54RVU18C
2018-04-01$147.34$149.54RVU18B
2018-01-01$147.34$149.54RVU18AR1
2017-10-01$146.21$149.92RVU17D
2017-07-01$146.21$149.92RVU17C
2017-04-01$146.21$149.92RVU17B
2017-01-01$146.21$149.92RVU17A
2016-10-01$148.44$152.20RVU16D
2016-07-01$148.44$152.20RVU16C
2016-04-01$148.44$152.20RVU16B
2016-01-01$148.44$152.20RVU16A
2015-10-01$150.82$154.59RVU15D
2015-07-01$150.82$154.59RVU15C
2015-04-01$150.06$153.82RVU15B
2015-01-01$150.06$153.82RVU15A
2014-10-01$150.90$154.68RVU14D
2014-07-01$150.90$154.68RVU14C
2014-04-01$150.90$154.68RVU14B
2014-01-01$150.90$154.68RVU14A
2013-10-01$154.00$157.96RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 21820 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

21820 billing questions

When should this code be chosen over 21825?

Use this code for closed treatment without manipulation. Code 21825 describes open treatment of a sternal fracture, with or without fixation.

What documentation supports reporting this service?

Document the sternum as the fracture site and describe the closed treatment performed without manipulation.

Does the global period include related follow-up care?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

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 21820PPRRVU2026_Oct_nonQPP.csv, line 2,030 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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