CPT code 60521: Thymectomy, sternotomy or transthoracic approach2026 Medicare rate & RVUs in Missouri
Reports partial or total thymus removal through a median sternotomy or transthoracic approach, including surgery for conditions such as myasthenia gravis.
CMS doesn’t publish an office rate for 60521 in Missouri.
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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What 60521 covers
A surgeon removes part or all of the thymus through a median sternotomy or another transthoracic approach. Thymectomy may be performed for conditions such as myasthenia gravis; when a mediastinal tumor is removed, distinguish the service from the tumor-specific thymectomy code. This operation is generally performed in a hospital operating room by a thoracic or other surgeon experienced in mediastinal surgery.
Report this code when the operative approach and work support thymectomy by sternotomy or transthoracic access. The operative report should identify the approach and extent of thymus removal and describe any mediastinal tumor. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For procedures performed in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
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 60521 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,059.28 |
| Metropolitan St. Louis, MO | Unavailable | $1,067.09 |
| Rest of Missouri | Unavailable | $1,035.69 |
How the 60521 rate is calculated
Each of 60521’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 · 60521
RVUs × geographic indexes × conversion factor
Work18.70
18.70 RVUs× 1.000 GPCI
Practice expense8.99
8.99 RVUs× 1.000 GPCI
Malpractice4.68
4.68 RVUs× 1.000 GPCI
Adjusted RVUs
32.3700
Conversion factor
$33.4009
Medicare rate
$1,081.19
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 60521
60521 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 60521
Thymectomy, sternotomy or transthoracic approach
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.82/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 60521
Thymectomy, sternotomy or transthoracic approach
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
60521 without 51 · national facility
$1,081.19
Thymectomy, sternotomy or transthoracic approach
60521-51 · Second procedure: 50%
$540.60
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%).
60521 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 60520ThymectomyTranscervical approach
- Choose 60520 for a transcervical thymectomy. Choose 60521 when the thymus is removed through a median sternotomy or transthoracic approach.
- 60522Thymus removalWith radical tumor resection
- 60522 is the thymectomy code associated with removal of a mediastinal tumor; 60521 describes thymectomy by sternotomy or transthoracic approach without that tumor-specific distinction.
- 60505Parathyroid explorationMediastinal exploration
- 60505 describes mediastinal exploration or removal involving parathyroid tissue through a transthoracic approach, not thymus removal.
60521 billing questions
How does this differ from 60520?
60521 is for thymectomy through a median sternotomy or transthoracic approach. 60520 describes a transcervical approach.
When should 60522 be considered instead?
Use 60522 when the thymectomy includes removal of a mediastinal tumor. The operative report should establish the tumor and the work performed.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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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