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Billing code 21811: Rib fixationMedicare rate & RVUs

Reports internal fixation of one to three fractured ribs on one side, including thoracoscopic visualization when used during operative stabilization.

CMS RVU26DEffective Oct 1, 2026109 payment localities595 Medicare services in 2024

Medicare pays $544.77 for 21811 nationally in a facility.

Medicare rate · 21811

Rib fixation

Work RVUs
10.52
Total RVUs
16.31
Global days
000

National rate · 2026

$544.77

Facility setting, before claim adjustments.

See every locality for 21811 →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 21811 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 21811 covers

The surgeon stabilizes one to three fractured ribs on one side with internal fixation, commonly when operative stabilization is selected for substantially displaced fractures or flail chest. Thoracoscopic visualization may be used and is included in the service. Thoracic or trauma surgeons typically perform the operation in an operating room, often during hospital or trauma-center care.

Select the code by the number of ribs treated with fixation on that side, and document the side, ribs stabilized, and fixation performed. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral treatment, modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 21811 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

21811 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$493.76
Alaska*Unavailable$688.39
ArizonaUnavailable$528.96
ArkansasUnavailable$487.63
AtlantaUnavailable$564.98
AustinUnavailable$541.75
BakersfieldUnavailable$527.72
Baltimore/Surr. CntysUnavailable$578.75
BeaumontUnavailable$529.01
BrazoriaUnavailable$527.52

21811 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
21811 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 21811 rate is calculated

Each of 21811’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 · 21811

RVUs × geographic indexes × conversion factor

Work10.52

10.52 RVUs× 1.000 GPCI

Practice expense3.19

3.19 RVUs× 1.000 GPCI

Malpractice2.60

2.60 RVUs× 1.000 GPCI

Adjusted RVUs

16.3100

Conversion factor

$33.4009

Medicare rate

$544.77

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

Payment rules and modifiers for 21811

The CMS indicators that decide how 21811 is paid alongside other services.

CMS payment indicators · 21811

Rib fixation

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

21811 without 50 · national facility

$544.77

Rib fixation

21811-50 · Bilateral: 150%

$817.16

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

21811 compared with similar codes

Compare codes · National

4 codes, side by side

  • 21811

    Rib fixation10.52 wRVU

    Not priced

  • 21812

    Rib fracture fixation12.68 wRVU

    Not priced

  • 21813

    Rib fracture fixation17.17 wRVU

    Not priced

  • 21825

    Sternal fracture repair7.57 wRVU

    Not priced

How to choose

21812Rib fracture fixation
Use 21812 when fixation involves four to six ribs on one side; 21811 covers one to three.
21813Rib fracture fixation
Use 21813 when fixation involves seven or more ribs on one side; 21811 is limited to one to three.
21825Sternal fracture repair
21825 describes open treatment of a sternum fracture. Code 21811 is for internal fixation of rib fractures.

Codes related to 21811

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

Codes related to 21811
CodeHow it relatesNational office range
Same family
21812Rib fracture fixationRib fixation on one side involving four to six ribs.No office rate
21813Rib fracture fixationRib fixation on one side involving seven or more ribs.No office rate
Used instead
21899Unlisted px neck/thoraxUnlisted neck or thorax procedure when no specific rib-fixation code describes the work.No office rate

21811 billing questions

How does 21811 differ from 21812?

21811 is for fixation of one to three ribs on one side. Use 21812 when four to six ribs are treated.

Is thoracoscopic visualization reported separately?

No. Thoracoscopic visualization, when used for the rib fixation, is included in this service.

How is bilateral rib fixation reported?

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

Can an assistant surgeon be reported?

CMS allows payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.

What does the 0-day global period include?

Same-day preoperative and postoperative care is included. The global period is 0 days.

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

The highest-valued procedure is paid in full, and other procedures are paid at 50% under 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 21811PPRRVU2026_Oct_nonQPP.csv, line 2,027 (RVU26D)

Open CMS sourceHow we calculate rates

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