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CPT code 21615: Rib excision2026 Medicare rate & RVUs

Reports surgical removal of a first rib, cervical rib, or both, commonly to relieve compression associated with thoracic outlet syndrome.

CMS RVU26DEffective Oct 1, 2026109 payment localities123 Medicare services in 2024

Medicare pays $582.51 for 21615 nationally in a facility.

Medicare rate · 21615

Rib excision

Office or facility?

Work RVUs
10.19
Total RVUs
17.44
Global days
090

National rate · 2026

$582.51

Facility setting, before claim adjustments.

See every locality for 21615 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 21615 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 21615 covers

This operation removes a first rib, a cervical rib, or both. It is commonly performed to relieve neurovascular compression associated with thoracic outlet syndrome or symptoms caused by a cervical rib. Thoracic, vascular, or other surgeons experienced in thoracic outlet procedures may perform it in a hospital or surgical facility. The operative report should identify the rib or ribs removed and the clinical reason for excision.

Report 21615 for the rib excision without the sympathectomy included in 21616. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, 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 21615 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

21615 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$526.03
AlaskaUnavailable$724.82
ArizonaUnavailable$565.42
ArkansasUnavailable$519.18
Atlanta, GAUnavailable$603.10
Austin, TXUnavailable$582.65
Bakersfield, CAUnavailable$570.91
Baltimore area, MDUnavailable$619.55
Beaumont, TXUnavailable$562.33
Brazoria, TXUnavailable$565.15

21615 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
21615 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 21615 rate is calculated

Each of 21615’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 · 21615

RVUs × geographic indexes × conversion factor

Office or facility?

Work10.19

10.19 RVUs× 1.000 GPCI

Practice expense4.71

4.71 RVUs× 1.000 GPCI

Malpractice2.54

2.54 RVUs× 1.000 GPCI

Adjusted RVUs

17.4400

Conversion factor

$33.4009

Medicare rate

$582.51

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 21615

21615 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21615

Rib 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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21615

Rib 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.

  • 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 50 · payment effect

With and without the modifier

21615 without 50 · national facility

$582.51

Rib excision

21615-50 · Bilateral: 150%

$873.77

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

21615 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 21615

    Rib excision10.19 wRVU

    Not priced

  • 21616

    Rib excision12.37 wRVU

    Not priced

  • 21600

    Rib excision7.08 wRVU

    Not priced

  • 21700

    Scalene division6.15 wRVU

    Not priced

How to choose

21616Rib excision
21616 includes sympathectomy with the first and/or cervical rib excision. Report 21615 when the rib excision is performed without sympathectomy.
21600Rib excision
21600 describes partial removal of a rib. Use 21615 for excision of a first rib, cervical rib, or both.
21700Scalene division
21700 describes anterior scalenotomy without cervical rib removal. Use 21615 when the operation includes removal of a first and/or cervical rib.

Codes related to 21615

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

Codes related to 21615
CodeHow it relatesNational office range
Same family
21616Rib excisionRib excision with sympathectomy; distinguish it from excision alone.No office rate
21600Rib excisionPartial rib excision, rather than first and/or cervical rib excision.No office rate
Used instead
21700Scalene divisionAnterior scalenotomy without cervical rib removal is another thoracic outlet decompression approach.No office rate

21615 billing questions

When should 21616 be reported instead?

Use 21616 when the first and/or cervical rib excision is performed with sympathectomy. Code 21615 describes the rib excision without that added procedure.

How is bilateral rib excision reported?

For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.

What documentation supports 21615?

The operative report should establish the rib or ribs removed, the side or sides, and the clinical indication, such as thoracic outlet compression or symptoms related to a cervical rib.

What postoperative care is included?

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?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. 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
RVUs for 21615PPRRVU2026_Oct_nonQPP.csv, line 2,013 (RVU26D)

Open CMS sourceHow we calculate rates

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