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Billing code 21630: Sternum resectionMedicare rate & RVUs

Report radical sternum resection for an extensive operation removing the sternum, such as for a tumor involving the bone, rather than partial removal or debridement.

CMS RVU26DEffective Oct 1, 2026109 payment localities40 Medicare services in 2024

Medicare pays $1,170.70 for 21630 nationally in a facility.

Medicare rate · 21630

Sternum resection

Swap in your local Medicare rate.

Work RVUs
18.7
Total RVUs
35.05
Global days
090

National rate · 2026

$1,170.70

Facility setting, before claim adjustments.

See every locality for 21630 → · 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 21630 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 21630 covers

billing code 21630 describes a radical operation to remove the sternum. It is typically performed by a thoracic or surgical oncologist in an operating room when disease, such as a tumor involving the sternum, requires extensive resection. The operative report should establish the resection’s radical extent; the diagnosis alone does not distinguish this service from partial sternum removal or debridement.

Select the code from the documented operation and structures removed, distinguishing radical resection from partial sternectomy. CMS assigns a 90-day global period, 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; 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 21630 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

21630 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,066.63
Alaska*Unavailable$1,458.92
ArizonaUnavailable$1,140.68
ArkansasUnavailable$1,053.83
AtlantaUnavailable$1,202.75
AustinUnavailable$1,183.69
BakersfieldUnavailable$1,178.55
Baltimore/Surr. CntysUnavailable$1,239.57
BeaumontUnavailable$1,123.75
BrazoriaUnavailable$1,146.33

21630 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
21630 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 21630 rate is calculated

Each of 21630’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 · 21630

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 18.70Practice expense 12.88Malpractice 3.47

35.0500 adjusted RVUs×$33.4009 conversion factor=$1,170.70

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

Payment rules and modifiers for 21630

21630 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21630

Sternum resection

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)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21630

Sternum resection

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

21630 without 51 · national facility

$1,170.70

Sternum resection

21630-51 · Second procedure: 50%

$585.35

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

21630 compared with similar codes

Compare codes

21630 vs 21620 vs 21627 vs 21601 vs 21603: national Medicare rates

Swap in your local Medicare rate.

  • 21630
    Sternum resection · 18.7 wRVU
    —
  • 21620
    Sternal ostectomy · 7.1 wRVU
    —
  • 21627
    Sternal debridement · 7.12 wRVU
    —
  • 21601
    Chest wall excision · 17.34 wRVU
    —
  • 21603
    Chest wall tumor excision · 24.54 wRVU
    —

How to choose

21620Sternal ostectomy
21620 describes partial sternum removal. Use 21630 when the documented operation is a radical resection rather than a partial sternectomy.
21627Sternal debridement
21627 is for sternal debridement. It does not describe radical removal of the sternum.
21601Chest wall excision
21601 addresses chest wall tumor excision involving ribs. Choose based on the actual structures and procedure documented, not the tumor diagnosis alone.
21603Chest wall tumor excision
21603 is a chest wall tumor excision code involving lymphadenectomy; 21630 describes radical resection of the sternum.

Codes related to 21630

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

Codes related to 21630
CodeHow it relatesNational office range
Same family
21620Sternal ostectomyPartial sternum removal; distinguish it from this radical resection by the documented extent.No office rate
Used instead
21627Sternal debridementSternal debridement is reported for debridement rather than radical sternum removal.No office rate
21601Chest wall excisionFor chest wall tumor excision involving ribs, rather than radical sternum resection.No office rate
21602Chest wall tumor excisionA chest wall tumor excision code; determine selection from the operation documented.No office rate
21603Chest wall tumor excisionA chest wall tumor excision code involving lymphadenectomy; distinguish by the procedure performed.No office rate

21630 billing questions

How does 21630 differ from 21620?

21630 is for radical sternum resection; 21620 describes partial sternum removal. Use the operative report to determine the extent of resection.

Can 21630 be reported for sternal debridement?

No. Debridement is distinct from radical resection; code 21627 describes sternal debridement.

Is modifier 50 appropriate for 21630?

No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor and anatomy.

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?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard 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

Show the CMS file lines behind this rate
RVUs for 21630PPRRVU2026_Oct_nonQPP.csv, line 2,017 (RVU26D)

Open CMS sourceHow we calculate rates

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