CPT code 21899: Unlisted procedure, neck or thorax2026 Medicare rate & RVUs in Texas
Reports a neck or thorax operation that lacks a specific CPT code, with Medicare payment determined by the claim’s Medicare Administrative Contractor.
CMS doesn’t publish an office rate for 21899 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 21899 covers
CPT 21899 is used for a surgical procedure involving the neck or thorax when no more specific CPT code describes the work. A surgeon may report it for an uncommon or specialized operation whose anatomy, approach, or extent does not fit a listed procedure. The operative report should describe the treated structures, surgical approach, and work performed; the claim narrative should make clear why a specific code does not fit.
Medicare assigns this code physician fee schedule status C, meaning there is no national payment amount and the Medicare Administrative Contractor prices each claim. The contractor also sets the global period. When multiple procedures are 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.
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 21899 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
How the 21899 rate is calculated
Each of 21899’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 · 21899
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21899
The CMS indicators that decide how 21899 is paid alongside other services.
CMS payment indicators · 21899
Unlisted procedure, neck or thorax
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21899 without 51 · national facility
$0.00
Unlisted procedure, neck or thorax
21899-51 · Second procedure: 50%
$0.00
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%).
21899 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21811Rib fixationUnilateral, 1-3 ribs
- 21811 describes open treatment of 1–3 rib fractures with internal fixation. Use 21899 only when the operation does not fit that listed service or another specific code.
- 21812Rib fracture fixationFour to six ribs
- 21812 is the listed open rib-fracture fixation code for 4–6 ribs. It is selected by the rib count, rather than used as an unlisted procedure code.
- 21813Rib fracture fixationSeven or more ribs
- 21813 covers open rib-fracture fixation involving 7 or more ribs. Choose it when that defined service matches the operation.
- 21825Sternal fracture repairOpen treatment
- 21825 describes open treatment of a sternum fracture, with or without internal fixation. It is the specific choice when the operation matches that service.
21899 billing questions
When should 21899 be used instead of a listed rib or sternum procedure code?
Use 21899 only when no listed CPT code accurately describes the neck or thorax operation. For a procedure matching a specific rib or sternum treatment code, report that listed code instead.
What documentation supports a claim for 21899?
The operative report should identify the anatomy, approach, and work performed. The claim narrative should explain why a specific listed CPT code does not describe the procedure.
How does Medicare price 21899?
Medicare assigns status C: the Medicare Administrative Contractor sets payment for each claim, and CMS publishes no national payment amount.
Who sets the global period for 21899?
The Medicare contractor sets the global period for this code.
How is 21899 treated when multiple procedures occur in one session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
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
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