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Billing code 21725: Neck muscle revisionMedicare rate & RVUs

Revision of the sternocleidomastoid muscle is reported for operative correction of a persistent or recurrent neck-muscle problem after prior treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $515.38 for 21725 nationally in a facility.

Medicare rate · 21725

Neck muscle revision

Swap in your local Medicare rate.

Work RVUs
7.01
Total RVUs
15.43
Global days
090

National rate · 2026

$515.38

Facility setting, before claim adjustments.

See every locality for 21725 → · 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 21725 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 21725 covers

This code describes revision surgery on a neck muscle, typically the sternocleidomastoid, to address a persistent or recurrent deformity or functional problem. The surgeon works directly on the previously treated muscle; the service is distinct from an initial release or division. It is generally performed in an operating room by a surgeon treating a neck-muscle condition, such as residual or recurrent torticollis after earlier surgery.

Report the code when the operative record supports revision of the neck muscle itself, rather than a first-time release or a separate reconstruction of another structure. Documentation should identify the muscle, prior treatment, the reason revision is needed, and the work performed. The service has a 90-day global period, including the day-before preoperative visit and 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 21725 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

21725 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$464.95
Alaska*Unavailable$625.32
ArizonaUnavailable$501.07
ArkansasUnavailable$458.72
AtlantaUnavailable$529.72
AustinUnavailable$523.65
BakersfieldUnavailable$522.75
Baltimore/Surr. CntysUnavailable$547.76
BeaumontUnavailable$491.00
BrazoriaUnavailable$504.29

21725 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.

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View every state and territory as a table
21725 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 21725 rate is calculated

Each of 21725’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 · 21725

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.01Practice expense 6.94Malpractice 1.48

15.4300 adjusted RVUs×$33.4009 conversion factor=$515.38

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

Payment rules and modifiers for 21725

21725 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21725

Neck muscle revision

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 · 21725

Neck muscle revision

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

21725 without 51 · national facility

$515.38

Neck muscle revision

21725-51 · Second procedure: 50%

$257.69

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

21725 compared with similar codes

Compare codes

21725 vs 21720 vs 21700 vs 21705: national Medicare rates

Swap in your local Medicare rate.

  • 21725
    Neck muscle revision · 7.01 wRVU
    —
  • 21720
    Neck muscle repair · 5.66 wRVU
    —
  • 21700
    Scalene division · 6.15 wRVU
    —
  • 21705
    Neck muscle surgery · 9.67 wRVU
    —

How to choose

21720Neck muscle repair
Use 21720 for release of the sternocleidomastoid in congenital muscular torticollis. Use 21725 when the neck muscle is being revised after prior treatment.
21700Scalene division
21700 describes open division of the sternocleidomastoid for torticollis; 21725 represents revision work rather than the initial division.
21705Neck muscle surgery
21705 is a torticollis division procedure extending into the thoracic area. It is not the revision service described by 21725.

Codes related to 21725

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

Codes related to 21725
CodeHow it relatesNational office range
Same family
21720Neck muscle repairRelease of the sternocleidomastoid for congenital muscular torticollis.No office rate
21700Scalene divisionInitial open division of the sternocleidomastoid for torticollis.No office rate
21705Neck muscle surgeryTorticollis muscle division with extension into the thoracic area.No office rate

21725 billing questions

How is 21725 distinguished from 21720?

21725 is for revision of a neck muscle after prior treatment. 21720 describes release of the sternocleidomastoid for congenital muscular torticollis, rather than revision surgery.

What documentation supports reporting 21725?

The operative report should identify the muscle, explain the persistent or recurrent problem and prior treatment, and describe the revision work performed.

Can modifier 50 be used for bilateral work?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

How does the global period affect postoperative visits?

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

Can 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 21725PPRRVU2026_Oct_nonQPP.csv, line 2,022 (RVU26D)

Open CMS sourceHow we calculate rates

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