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Billing code 21700: Scalene divisionMedicare rate & RVUs

Reports surgical division of scalene muscles, commonly for thoracic outlet decompression, when the operation does not include cervical rib resection.

CMS RVU26DEffective Oct 1, 2026109 payment localities25 Medicare services in 2024

Medicare pays $332.34 for 21700 nationally in a facility.

Medicare rate · 21700

Scalene division

Swap in your local Medicare rate.

Work RVUs
6.15
Total RVUs
9.95
Global days
090

National rate · 2026

$332.34

Facility setting, before claim adjustments.

See every locality for 21700 → · 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 21700 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 21700 covers

The surgeon divides scalene muscle fibers in the neck to relieve compression associated with thoracic outlet syndrome, such as pressure affecting the brachial plexus or subclavian vessels. The operation is performed by a surgeon, commonly in a hospital operating room. This code describes the scalene release without removal of a cervical rib; a rib-resection operation falls under a different code in the same family.

Choose the code from the operation performed, documenting the indication, side, scalene muscles addressed, and whether a cervical rib was removed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 21700 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

21700 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$300.27
Alaska*Unavailable$416.34
ArizonaUnavailable$322.48
ArkansasUnavailable$296.40
AtlantaUnavailable$344.69
AustinUnavailable$331.09
BakersfieldUnavailable$322.89
Baltimore/Surr. CntysUnavailable$353.49
BeaumontUnavailable$321.91
BrazoriaUnavailable$321.78

21700 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
21700 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 21700 rate is calculated

Each of 21700’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 · 21700

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.15Practice expense 2.23Malpractice 1.57

9.9500 adjusted RVUs×$33.4009 conversion factor=$332.34

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

Payment rules and modifiers for 21700

21700 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21700

Scalene division

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)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 · 21700

Scalene division

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 50 · payment effect

With and without the modifier

21700 without 50 · national facility

$332.34

Scalene division

21700-50 · Bilateral: 150%

$498.51

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

21700 compared with similar codes

Compare codes

21700 vs 21705 vs 21615 vs 21725: national Medicare rates

Swap in your local Medicare rate.

  • 21700
    Scalene division · 6.15 wRVU
    —
  • 21705
    Neck muscle surgery · 9.67 wRVU
    —
  • 21615
    Rib excision · 10.19 wRVU
    —
  • 21725
    Neck muscle revision · 7.01 wRVU
    —

How to choose

21705Neck muscle surgery
21700 covers scalene division without cervical rib removal. Choose 21705 when cervical rib resection is part of the operation.
21615Rib excision
21615 reports first-rib resection. It represents a rib-removal operation, while 21700 reports scalene muscle division without cervical rib resection.
21725Neck muscle revision
21725 is an open sternocleidomastoid tenotomy, generally for a different neck-muscle condition; 21700 addresses scalene division for thoracic outlet decompression.

Codes related to 21700

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

Codes related to 21700
CodeHow it relatesNational office range
Same family
21705Neck muscle surgeryScalene division in the same code family when cervical rib resection is also performed.No office rate
Used instead
21615Rib excisionFirst-rib resection is a rib-directed thoracic outlet decompression approach.No office rate
21600Rib excisionPartial rib excision is a rib-directed operation, rather than scalene division alone.No office rate

21700 billing questions

How does 21700 differ from 21705?

Use 21700 when scalene division is performed without cervical rib resection. When the operation includes cervical rib resection, use 21705.

Can 21700 be reported bilaterally?

CMS identifies this as a bilateral procedure. Modifier 50 is paid at 150%.

What postoperative care is included?

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

Can an assistant surgeon be paid for this operation?

CMS indicates that assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.

What documentation supports reporting 21700?

Document the thoracic outlet or other operative indication, laterality, scalene muscle work, and whether a cervical rib was removed. The operative note should support selection of 21700 rather than the rib-resection code.

How are multiple procedures handled in the same session?

CMS pays the highest-valued procedure in full and other procedures at 50% when performed in the same session.

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 21700PPRRVU2026_Oct_nonQPP.csv, line 2,019 (RVU26D)

Open CMS sourceHow we calculate rates

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