CPT code 21820: Sternum fracture care, closed, without manipulation2026 Medicare rate & RVUs in South Dakota
Reports closed management of a sternum fracture without manipulation, typically when the fracture is treated nonoperatively after chest trauma.
In South Dakota, Medicare pays $173.27 for 21820 in the office and $162.58 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $173.27. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$173.27
- Los Angeles, CA · California$201.25+$27.98
- Washington, DC area · District of Columbia$205.54+$32.27
- Miami, FL · Florida$199.66+$26.39
- Chicago, IL · Illinois$193.18+$19.91
- Manhattan, NY · New York$208.56+$35.29
- Alaska · Alaska$205.72+$32.45
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $188.01 | $176.30 |
| Merced, CACalifornia | $188.01 | $176.30 |
| Modesto, CACalifornia | $188.01 | $176.30 |
| Napa, CACalifornia | $217.67 | $203.58 |
| Oxnard, CACalifornia | $200.15 | $187.51 |
| Redding, CACalifornia | $188.01 | $176.30 |
| Rest of CaliforniaCalifornia | $188.01 | $176.30 |
| Riverside, CACalifornia | $191.13 | $179.41 |
| Sacramento, CACalifornia | $197.27 | $184.84 |
| Salinas, CACalifornia | $196.55 | $184.16 |
| San Diego, CACalifornia | $201.21 | $188.43 |
| Marin County, CACalifornia | $230.17 | $215.10 |
| San Francisco, CACalifornia | $229.84 | $214.77 |
| San Benito County, CACalifornia | $235.60 | $220.19 |
| Santa Clara County, CACalifornia | $234.25 | $218.84 |
| San Luis Obispo, CACalifornia | $193.41 | $181.24 |
| Santa Cruz, CACalifornia | $203.14 | $190.15 |
| Santa Maria, CACalifornia | $197.29 | $184.83 |
| Santa Rosa, CACalifornia | $205.17 | $192.04 |
| Stockton, CACalifornia | $188.01 | $176.30 |
| Vallejo, CACalifornia | $217.19 | $203.10 |
| Visalia, CACalifornia | $188.01 | $176.30 |
| Yuba City, CACalifornia | $188.01 | $176.30 |
| ColoradoColorado | $186.15 | $174.77 |
| ConnecticutConnecticut | $192.29 | $180.78 |
| DelawareDelaware | $177.43 | $166.87 |
| Fort Lauderdale, FLFlorida | $189.16 | $178.33 |
| Rest of FloridaFlorida | $179.04 | $168.83 |
| Atlanta, GAGeorgia | $183.79 | $172.93 |
| Rest of GeorgiaGeorgia | $167.99 | $158.46 |
| Hawaii, Guam, HIHawaii | $192.82 | $180.67 |
| IowaIowa | $163.18 | $153.40 |
| IdahoIdaho | $164.55 | $154.71 |
| East St. Louis, ILIllinois | $179.47 | $169.64 |
| Rest of IllinoisIllinois | $174.22 | $164.47 |
| Suburban Chicago, ILIllinois | $190.88 | $179.90 |
| IndianaIndiana | $165.55 | $155.64 |
| KansasKansas | $162.84 | $153.17 |
| KentuckyKentucky | $164.93 | $155.43 |
| New Orleans, LALouisiana | $173.60 | $163.55 |
| Rest of LouisianaLouisiana | $164.85 | $155.39 |
| Metropolitan Boston, MAMassachusetts | $204.82 | $192.05 |
| Rest of MassachusettsMassachusetts | $185.10 | $173.84 |
| Baltimore area, MDMaryland | $191.87 | $180.40 |
| Rest of MarylandMaryland | $180.85 | $170.04 |
| Rest of MaineMaine | $165.99 | $156.16 |
| Southern Maine, MEMaine | $174.99 | $164.40 |
| Detroit, MIMichigan | $181.95 | $171.63 |
| Rest of MichiganMichigan | $170.02 | $160.26 |
| MinnesotaMinnesota | $176.52 | $165.52 |
| Metropolitan Kansas City, MOMissouri | $171.81 | $161.78 |
| Metropolitan St. Louis, MOMissouri | $173.69 | $163.51 |
| Rest of MissouriMissouri | $162.11 | $152.90 |
| MississippiMississippi | $159.71 | $150.51 |
| MontanaMontana | $179.68 | $168.99 |
| North CarolinaNorth Carolina | $167.79 | $157.81 |
| North DakotaNorth Dakota | $173.94 | $163.25 |
| NebraskaNebraska | $164.00 | $154.14 |
| New HampshireNew Hampshire | $183.64 | $172.51 |
| Northern New JerseyNew Jersey | $203.25 | $190.85 |
| Rest of New JerseyNew Jersey | $193.97 | $182.30 |
| New MexicoNew Mexico | $171.22 | $161.42 |
| NevadaNevada | $178.20 | $167.51 |
| NYC suburbs and Long Island, NYNew York | $214.58 | $201.87 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $195.66 | $183.96 |
| Queens, NYNew York | $209.68 | $197.04 |
| Rest of New YorkNew York | $170.54 | $160.39 |
| OhioOhio | $168.85 | $159.09 |
| OklahomaOklahoma | $164.10 | $154.55 |
| Portland, OROregon | $191.87 | $179.99 |
| Rest of OregonOregon | $176.32 | $165.67 |
| Metropolitan Philadelphia, PAPennsylvania | $187.51 | $176.39 |
| Rest of PennsylvaniaPennsylvania | $168.87 | $159.05 |
| Puerto RicoPuerto Rico | $180.93 | $170.13 |
| Rhode IslandRhode Island | $183.64 | $172.60 |
| South CarolinaSouth Carolina | $168.70 | $158.82 |
| TennesseeTennessee | $163.78 | $154.07 |
| Austin, TXTexas | $185.97 | $174.66 |
| Beaumont, TXTexas | $167.71 | $157.98 |
| Brazoria, TXTexas | $176.79 | $166.20 |
| Dallas, TXTexas | $178.22 | $167.57 |
| Fort Worth, TXTexas | $177.09 | $166.55 |
| Galveston, TXTexas | $177.51 | $166.89 |
| Houston, TXTexas | $182.82 | $172.20 |
| Rest of TexasTexas | $172.35 | $162.21 |
| UtahUtah | $171.17 | $161.13 |
| VirginiaVirginia | $174.71 | $164.21 |
| Virgin Islands, VIUnited States Virgin Islands | $180.93 | $170.13 |
| VermontVermont | $173.66 | $163.07 |
| Rest of WashingtonWashington | $184.62 | $173.36 |
| King County, WAWashington | $208.65 | $195.54 |
| WisconsinWisconsin | $167.72 | $157.48 |
| West VirginiaWest Virginia | $167.42 | $158.13 |
| WyomingWyoming | $177.18 | $166.49 |
21820 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $205.72 | 1 |
| AL | $159.79 | 1 |
| AR | $157.29 | 1 |
| AZ | $174.41 | 1 |
| CA | $188.01–$235.60 | 29 |
| CO | $186.15 | 1 |
| CT | $192.29 | 1 |
| DC | $205.54 | 1 |
| DE | $177.43 | 1 |
| FL | $179.04–$199.66 | 3 |
| GA | $167.99–$183.79 | 2 |
| GU | $192.82 | 1 |
| HI | $192.82 | 1 |
| IA | $163.18 | 1 |
| ID | $164.55 | 1 |
| IL | $174.22–$193.18 | 4 |
| IN | $165.55 | 1 |
| KS | $162.84 | 1 |
| KY | $164.93 | 1 |
| LA | $164.85–$173.60 | 2 |
| MA | $185.10–$204.82 | 2 |
| MD | $180.85–$205.54 | 3 |
| ME | $165.99–$174.99 | 2 |
| MI | $170.02–$181.95 | 2 |
| MN | $176.52 | 1 |
| MO | $162.11–$173.69 | 3 |
| MS | $159.71 | 1 |
| MT | $179.68 | 1 |
| NC | $167.79 | 1 |
| ND | $173.94 | 1 |
| NE | $164.00 | 1 |
| NH | $183.64 | 1 |
| NJ | $193.97–$203.25 | 2 |
| NM | $171.22 | 1 |
| NV | $178.20 | 1 |
| NY | $170.54–$214.58 | 5 |
| OH | $168.85 | 1 |
| OK | $164.10 | 1 |
| OR | $176.32–$191.87 | 2 |
| PA | $168.87–$187.51 | 2 |
| PR | $180.93 | 1 |
| RI | $183.64 | 1 |
| SC | $168.70 | 1 |
| SD | $173.27 | 1 |
| TN | $163.78 | 1 |
| TX | $167.71–$185.97 | 8 |
| UT | $171.17 | 1 |
| VA | $174.71–$205.54 | 2 |
| VI | $180.93 | 1 |
| VT | $173.66 | 1 |
| WA | $184.62–$208.65 | 2 |
| WI | $167.72 | 1 |
| WV | $167.42 | 1 |
| WY | $177.18 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.33 | × 1.000 | 1.3300 |
| Practice expense | 3.76 | × 1.000 | 3.7600 |
| Malpractice | 0.29 | × 0.336 | 0.0974 |
| Total RVUs | 5.1874 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$173.27
Office: (1.33 × 1 + 3.76 × 1 + 0.29 × 0.336) × $33.4009 = $173.27
Facility: (1.33 × 1 + 3.44 × 1 + 0.29 × 0.336) × $33.4009 = $162.58
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
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 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.
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%).
How 21820 has changed in South Dakota
21820 · Office / nonfacility
$173.27
Effective 2026-10-01
The base rate is $25.22 higher than on 2025-10-01, moving from $148.05 to $173.27 (17.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$148.05changed to$173.27
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$149.49changed to$148.05
- 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.
March 9, 2024
RVU24AR
$147.05changed to$149.49
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$149.72changed to$147.05
- 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 0.364 changed to 0.382
January 1, 2023
RVU23A
$147.90changed to$149.72
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.82 changed to 2.96
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$146.91changed to$147.90
- 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.
January 1, 2021
RVU21A
$144.70changed to$146.91
- 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
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$141.75changed to$144.70
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$141.24changed to$141.75
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.47 changed to 2.48
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$138.34changed to$141.24
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.40 changed to 2.47
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$138.78changed to$138.34
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.42 changed to 2.40
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$140.64changed to$138.78
- 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.
July 1, 2015
RVU15C
$139.94changed to$140.64
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$139.85changed to$139.94
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$141.61changed to$139.85
- 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
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $141.61
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $173.27 | $162.58 | RVU26D |
| 2026-07-01 | $173.27 | $162.58 | RVU26C |
| 2026-04-01 | $173.27 | $162.58 | RVU26B |
| 2026-01-01 | $173.27 | $162.58 | RVU26A |
| 2025-10-01 | $148.05 | $146.75 | RVU25D |
| 2025-07-01 | $148.05 | $146.75 | RVU25C |
| 2025-04-01 | $148.05 | $146.75 | RVU25B |
| 2025-01-01 | $148.05 | $146.75 | RVU25A |
| 2024-10-01 | $149.49 | $147.49 | RVU24D |
| 2024-07-01 | $149.49 | $147.49 | RVU24C |
| 2024-04-01 | $149.49 | $147.49 | RVU24B |
| 2024-03-09 | $149.49 | $147.49 | RVU24AR |
| 2024-01-01 | $147.05 | $145.08 | RVU24A |
| 2023-10-01 | $149.72 | $147.35 | RVU23D |
| 2023-07-01 | $149.72 | $147.35 | RVU23C |
| 2023-04-01 | $149.72 | $147.35 | RVU23B |
| 2023-01-01 | $149.72 | $147.35 | RVU23A |
| 2022-10-01 | $147.90 | $144.78 | RVU22D |
| 2022-07-01 | $147.90 | $144.78 | RVU22C |
| 2022-04-01 | $147.90 | $144.78 | RVU22B |
| 2022-01-01 | $147.90 | $144.78 | RVU22A |
| 2021-10-01 | $146.91 | $144.47 | RVU21D |
| 2021-07-01 | $146.91 | $144.47 | RVU21C |
| 2021-04-01 | $146.91 | $144.47 | RVU21B |
| 2021-01-01 | $146.91 | $144.47 | RVU21A |
| 2020-10-01 | $144.70 | $143.61 | RVU20D |
| 2020-07-01 | $144.70 | $143.61 | RVU20C |
| 2020-04-01 | $144.70 | $143.61 | RVU20B |
| 2020-01-01 | $144.70 | $143.61 | RVU20A |
| 2019-10-01 | $141.75 | $142.48 | RVU19D |
| 2019-07-01 | $141.75 | $142.48 | RVU19C |
| 2019-04-01 | $141.75 | $142.48 | RVU19B |
| 2019-01-01 | $141.75 | $142.48 | RVU19A |
| 2018-10-01 | $141.24 | $143.40 | RVU18D |
| 2018-07-01 | $141.24 | $143.40 | RVU18C |
| 2018-04-01 | $141.24 | $143.40 | RVU18B |
| 2018-01-01 | $141.24 | $143.40 | RVU18AR1 |
| 2017-10-01 | $138.34 | $141.93 | RVU17D |
| 2017-07-01 | $138.34 | $141.93 | RVU17C |
| 2017-04-01 | $138.34 | $141.93 | RVU17B |
| 2017-01-01 | $138.34 | $141.93 | RVU17A |
| 2016-10-01 | $138.78 | $142.36 | RVU16D |
| 2016-07-01 | $138.78 | $142.36 | RVU16C |
| 2016-04-01 | $138.78 | $142.36 | RVU16B |
| 2016-01-01 | $138.78 | $142.36 | RVU16A |
| 2015-10-01 | $140.64 | $144.24 | RVU15D |
| 2015-07-01 | $140.64 | $144.24 | RVU15C |
| 2015-04-01 | $139.94 | $143.52 | RVU15B |
| 2015-01-01 | $139.94 | $143.52 | RVU15A |
| 2014-10-01 | $139.85 | $143.43 | RVU14D |
| 2014-07-01 | $139.85 | $143.43 | RVU14C |
| 2014-04-01 | $139.85 | $143.43 | RVU14B |
| 2014-01-01 | $139.85 | $143.43 | RVU14A |
| 2013-10-01 | $141.61 | $145.36 | RVU13D |
| 2013-07-01 | $141.61 | $145.36 | RVU13C |
| 2013-04-01 | $141.61 | $145.36 | RVU13B |
| 2013-01-01 | $141.61 | $145.36 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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