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Billing code 21602: Chest wall tumor excisionMedicare rate & RVUs

Reports surgical removal of a chest wall tumor, including involved ribs, when the operation does not include mediastinal lymphadenectomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities152 Medicare services in 2024

Medicare pays $1,529.09 for 21602 nationally in a facility.

Medicare rate · 21602

Chest wall tumor excision

Swap in your local Medicare rate.

Work RVUs
21.64
Total RVUs
45.78
Global days
090

National rate · 2026

$1,529.09

Facility setting, before claim adjustments.

See every locality for 21602 → · 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 21602 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 21602 covers

A thoracic surgeon or surgical oncologist reports this service for removal of a chest wall tumor that involves the ribs, without mediastinal lymphadenectomy. A typical setting is an operating room, with the operative report describing the tumor’s site and extent, the chest wall structures removed, and the absence of mediastinal node dissection. Rib removal performed as part of the tumor resection is included in the service; this is not a code for an isolated rib resection.

Select this code based on the operation actually performed, distinguishing it from the related tumor-excision service that includes mediastinal lymphadenectomy. The operative report should support the tumor excision and its extent, including any rib resection. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Modifier 50 is inappropriate, and team surgery is 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 21602 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

21602 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,373.50
Alaska*Unavailable$1,851.74
ArizonaUnavailable$1,484.06
ArkansasUnavailable$1,354.39
AtlantaUnavailable$1,576.97
AustinUnavailable$1,546.80
BakersfieldUnavailable$1,533.86
Baltimore/Surr. CntysUnavailable$1,628.60
BeaumontUnavailable$1,459.90
BrazoriaUnavailable$1,490.20

21602 rates by state

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

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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
21602 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 21602 rate is calculated

Each of 21602’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 · 21602

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.64Practice expense 18.83Malpractice 5.31

45.7800 adjusted RVUs×$33.4009 conversion factor=$1,529.09

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

Payment rules and modifiers for 21602

21602 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21602

Chest wall tumor excision

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21602

Chest wall tumor excision

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

21602 without 51 · national facility

$1,529.09

Chest wall tumor excision

21602-51 · Second procedure: 50%

$764.55

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

21602 compared with similar codes

Compare codes

21602 vs 21603 vs 21600 vs 21630: national Medicare rates

Swap in your local Medicare rate.

  • 21602
    Chest wall tumor excision · 21.64 wRVU
    —
  • 21603
    Chest wall tumor excision · 24.54 wRVU
    —
  • 21600
    Rib excision · 7.08 wRVU
    —
  • 21630
    Sternum resection · 18.7 wRVU
    —

How to choose

21603Chest wall tumor excision
The key distinction is mediastinal lymphadenectomy: this code is for tumor excision without it; 21603 includes it.
21600Rib excision
21600 describes costochondral resection. Use this code for chest wall tumor excision, not isolated removal of a costochondral segment.
21630Sternum resection
21630 is for radical resection of the sternum. This code is for chest wall tumor excision without mediastinal lymphadenectomy.

Codes related to 21602

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

Codes related to 21602
CodeHow it relatesNational office range
Same family
21603Chest wall tumor excisionRelated chest wall tumor excision when mediastinal lymphadenectomy is performed.No office rate
Used instead
21600Rib excisionFor costochondral resection rather than chest wall tumor excision.No office rate
21630Sternum resectionFor radical sternal resection when the tumor operation requires sternum removal.No office rate

21602 billing questions

How does this code differ from 21603?

This code describes chest wall tumor excision without mediastinal lymphadenectomy. Use 21603 when the operation also includes mediastinal lymphadenectomy.

Can the rib resection be reported separately?

When rib removal is part of the chest wall tumor resection, it is included in this service. This code is not for an isolated rib resection.

What documentation supports reporting this code?

The operative report should identify the chest wall tumor, the structures removed, any involved ribs resected, and whether mediastinal lymphadenectomy was performed.

Should modifier 50 be used for bilateral work?

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

How does the 90-day global period affect postoperative billing?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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
RVUs for 21602PPRRVU2026_Oct_nonQPP.csv, line 2,010 (RVU26D)

Open CMS sourceHow we calculate rates

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