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Billing code 21510: Thoracic I&DMedicare rate & RVUs

Reports deep drainage of a thoracic infection or collection when the surgeon opens bone cortex to reach or treat the involved area.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $462.94 for 21510 nationally in a facility.

Medicare rate · 21510

Thoracic I&D

Swap in your local Medicare rate.

Work RVUs
6.05
Total RVUs
13.86
Global days
090

National rate · 2026

$462.94

Facility setting, before claim adjustments.

See every locality for 21510 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 21510 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21510 covers

This service involves surgically reaching a deep collection in the thorax and opening the cortex of bone as part of the drainage. It is generally performed by a surgeon in an operating room or other facility setting when a superficial approach is inadequate. The procedure is distinct from draining a deep soft-tissue collection without cortical opening and from sampling a lesion for diagnosis alone.

Report the code when the operative record supports deep thoracic drainage and documents that bone cortex was opened. The CMS global period is 90 days, including the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; 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.

Where 21510 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21510 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$414.74
Alaska*Unavailable$555.01
ArizonaUnavailable$449.15
ArkansasUnavailable$408.81
AtlantaUnavailable$477.05
AustinUnavailable$469.80
BakersfieldUnavailable$467.26
Baltimore/Surr. CntysUnavailable$493.48
BeaumontUnavailable$440.42
BrazoriaUnavailable$451.56

21510 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
21510 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 21510 rate is calculated

Each of 21510’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 · 21510

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.05Practice expense 6.30Malpractice 1.51

13.8600 adjusted RVUs×$33.4009 conversion factor=$462.94

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 21510

21510 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21510

Thoracic I&D

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)0Not paid without supporting documentation.
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 · 21510

Thoracic I&D

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

21510 without 51 · national facility

$462.94

Thoracic I&D

21510-51 · Second procedure: 50%

$231.47

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

21510 compared with similar codes

Compare codes

21510 vs 21501 vs 21502 vs 21550: national Medicare rates

Swap in your local Medicare rate.

  • 21510
    Thoracic I&D · 6.05 wRVU
    —
  • 21501
    Deep abscess drainage · 3.88 wRVU
    $517.71
  • 21502
    Deep abscess drainage · 7.36 wRVU
    —
  • 21550
    Soft-tissue biopsy · 2.06 wRVU
    $271.88

How to choose

21501Deep abscess drainage
21501 covers deep drainage in neck or thoracic soft tissues. 21510 is distinguished by opening bone cortex during deep thoracic drainage.
21502Deep abscess drainage
21502 is the related drainage code for a case involving rib osteomyelitis. Choose based on the documented anatomy, condition, and procedure rather than treating the codes as interchangeable.
21550Soft-tissue biopsy
21550 is for biopsy of a neck or chest lesion to obtain diagnostic tissue. It does not describe drainage with cortical bone opening.

Codes related to 21510

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

Codes related to 21510
CodeHow it relatesNational office range
Same family
21501Deep abscess drainageDeep neck or thoracic soft-tissue drainage without the cortical bone-opening distinction.$453.45–$678.40
21502Deep abscess drainageDeep drainage associated with rib osteomyelitis; distinguish by the documented condition and procedure.No office rate
Used instead
21550Soft-tissue biopsyFor diagnostic tissue sampling of a neck or chest lesion when the procedure is biopsy rather than drainage.$239.80–$360.13

21510 billing questions

How does this differ from 21501?

21501 describes deep drainage of neck or thoracic soft tissues. Use 21510 when the thoracic procedure also involves opening bone cortex.

When should 21502 be considered instead?

21502 describes deep drainage associated with rib osteomyelitis. Distinguish it from 21510 by the documented procedure and the rib osteomyelitis context.

What documentation supports reporting 21510?

The operative report should establish the thoracic site, the deep collection being drained, and the opening of bone cortex as part of the procedure.

Can modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted under the CMS rules for this code.

What is included in the global period?

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

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 21510PPRRVU2026_Oct_nonQPP.csv, line 2,000 (RVU26D)

Open CMS sourceHow we calculate rates

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