FeeBase
Log inGet started
Menu

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

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 King County, WA, Medicare pays $208.65 for 21820 in the office and $195.54 when it’s performed in a hospital or facility.

$208.65Office (non-facility)
$195.54Hospital or facility
+16.1%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 King County, WA
  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 King County, WA 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. King County, WA pays $208.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

21820 in King County, WA vs other payment areas
  1. King County, WA · this page$208.65
  2. Rest of Washington · Washington$184.62−$24.03
  3. Los Angeles, CA · California$201.25−$7.40
  4. Washington, DC area · District of Columbia$205.54−$3.11
  5. Miami, FL · Florida$199.66−$8.99
  6. Chicago, IL · Illinois$193.18−$15.47
  7. Manhattan, NY · New York$208.56−$0.09

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

Every other payment area

21820 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$205.72$194.34
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

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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 21820 in King County, WA
ComponentRVULocality factorAdjusted
Physician work1.33× 1.0501.3965
Practice expense3.76× 1.2274.6135
Malpractice0.29× 0.8170.2369
Total RVUs6.2470
Conversion factor× 33.4009

Office rate, King County, WA$208.65

Office: (1.33 × 1.05 + 3.76 × 1.227 + 0.29 × 0.817) × $33.4009 = $208.65

Facility: (1.33 × 1.05 + 3.44 × 1.227 + 0.29 × 0.817) × $33.4009 = $195.54

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, King County, WA
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 King County, WA

21820 · Office / nonfacility

$208.65

Effective 2026-10-01

The base rate is $32.31 higher than on 2025-10-01, moving from $176.34 to $208.65 (18.3%).

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

    $176.34changed to$208.65

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $178.10changed to$176.34

    • 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

    $175.19changed to$178.10

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $176.41changed to$175.19

    • 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
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $172.53changed to$176.41

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.82 changed to 2.96
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $171.19changed to$172.53

    • 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

    $166.60changed to$171.19

    • 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 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $160.82changed to$166.60

    • 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 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $160.23changed to$160.82

    • 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

    $155.36changed to$160.23

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.40 changed to 2.47
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $154.24changed to$155.36

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.42 changed to 2.40
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $156.40changed to$154.24

    • 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

    $155.62changed to$156.40

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $156.62changed to$155.62

    • 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
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $159.92changed to$156.62

    • 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
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $159.92

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$208.65$195.54RVU26D
2026-07-01$208.65$195.54RVU26C
2026-04-01$208.65$195.54RVU26B
2026-01-01$208.65$195.54RVU26A
2025-10-01$176.34$174.76RVU25D
2025-07-01$176.34$174.76RVU25C
2025-04-01$176.34$174.76RVU25B
2025-01-01$176.34$174.76RVU25A
2024-10-01$178.10$175.66RVU24D
2024-07-01$178.10$175.66RVU24C
2024-04-01$178.10$175.66RVU24B
2024-03-09$178.10$175.66RVU24AR
2024-01-01$175.19$172.79RVU24A
2023-10-01$176.41$173.55RVU23D
2023-07-01$176.41$173.55RVU23C
2023-04-01$176.41$173.55RVU23B
2023-01-01$176.41$173.55RVU23A
2022-10-01$172.53$168.81RVU22D
2022-07-01$172.53$168.81RVU22C
2022-04-01$172.53$168.81RVU22B
2022-01-01$172.53$168.81RVU22A
2021-10-01$171.19$168.27RVU21D
2021-07-01$171.19$168.27RVU21C
2021-04-01$171.19$168.27RVU21B
2021-01-01$171.19$168.27RVU21A
2020-10-01$166.60$165.33RVU20D
2020-07-01$166.60$165.33RVU20C
2020-04-01$166.60$165.33RVU20B
2020-01-01$166.60$165.33RVU20A
2019-10-01$160.82$161.64RVU19D
2019-07-01$160.82$161.64RVU19C
2019-04-01$160.82$161.64RVU19B
2019-01-01$160.82$161.64RVU19A
2018-10-01$160.23$162.70RVU18D
2018-07-01$160.23$162.70RVU18C
2018-04-01$160.23$162.70RVU18B
2018-01-01$160.23$162.70RVU18AR1
2017-10-01$155.36$159.49RVU17D
2017-07-01$155.36$159.49RVU17C
2017-04-01$155.36$159.49RVU17B
2017-01-01$155.36$159.49RVU17A
2016-10-01$154.24$158.38RVU16D
2016-07-01$154.24$158.38RVU16C
2016-04-01$154.24$158.38RVU16B
2016-01-01$154.24$158.38RVU16A
2015-10-01$156.40$160.55RVU15D
2015-07-01$156.40$160.55RVU15C
2015-04-01$155.62$159.75RVU15B
2015-01-01$155.62$159.75RVU15A
2014-10-01$156.62$160.74RVU14D
2014-07-01$156.62$160.74RVU14C
2014-04-01$156.62$160.74RVU14B
2014-01-01$156.62$160.74RVU14A
2013-10-01$159.92$164.20RVU13D
2013-07-01$159.92$164.20RVU13C
2013-04-01$159.92$164.20RVU13B
2013-01-01$159.92$164.20RVU13AR

Price 21820 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 21820 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 21820 pays in King County, WA?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 21820 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist