Billing code 21820: Sternum fracture careMedicare rate & RVUs
Reports closed management of a sternum fracture without manipulation, typically when the fracture is treated nonoperatively after chest trauma.
Medicare pays $179.70 for 21820 nationally in the office and $169.01 in a hospital or facility. Local office rates run $157.29–$235.60.
Medicare rate · 21820
Sternum fracture care
Swap in your local Medicare rate.
- Work RVUs
- 1.33
- Total RVUs
- 5.38
- Global days
- 090
National rate · 2026
$179.70
Office setting, before claim adjustments.
See every locality for 21820 → · 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
What 21820 covers
This service covers nonoperative management of a fractured sternum without manipulating the fracture. It is generally performed by a surgeon or trauma physician caring for a patient after blunt chest trauma, such as a motor vehicle collision. Management may include clinical assessment and a plan for conservative care; the fracture site and treatment approach distinguish this service from operative repair.
Report the code when the documented treatment is closed and does not involve manipulation. The note should identify the sternal fracture and support the treatment performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. Medicare does not pay an assistant at surgery for this code; 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 21820 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$157.29 to $235.60
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $159.79 | $150.44 |
| Alaska* | $205.72 | $194.34 |
| Arizona | $174.41 | $164.05 |
| Arkansas | $157.29 | $148.11 |
| Atlanta | $183.79 | $172.93 |
| Austin | $185.97 | $174.66 |
| Bakersfield | $188.81 | $177.10 |
| Baltimore/Surr. Cntys | $191.87 | $180.40 |
| Beaumont | $167.71 | $157.98 |
| Brazoria | $176.79 | $166.20 |
| Chicago | $193.18 | $182.44 |
| Chico | $188.01 | $176.30 |
| Colorado | $186.15 | $174.77 |
| Connecticut | $192.29 | $180.78 |
| Dallas | $178.22 | $167.57 |
| Dc + Md/Va Suburbs | $205.54 | $192.95 |
| Delaware | $177.43 | $166.87 |
| Detroit | $181.95 | $171.63 |
| East St. Louis | $179.47 | $169.64 |
| El Centro | $188.06 | $176.35 |
| Fort Lauderdale | $189.16 | $178.33 |
| Fort Worth | $177.09 | $166.55 |
| Fresno | $188.01 | $176.30 |
| Galveston | $177.51 | $166.89 |
| Hanford-Corcoran | $188.01 | $176.30 |
| Hawaii, Guam | $192.82 | $180.67 |
| Houston | $182.82 | $172.20 |
| Idaho | $164.55 | $154.71 |
| Indiana | $165.55 | $155.64 |
| Iowa | $163.18 | $153.40 |
| Kansas | $162.84 | $153.17 |
| Kentucky | $164.93 | $155.43 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $201.25 | $188.60 |
| Madera | $188.01 | $176.30 |
| Manhattan | $208.56 | $196.14 |
| Merced | $188.01 | $176.30 |
| Metropolitan Boston | $204.82 | $192.05 |
| Metropolitan Kansas City | $171.81 | $161.78 |
| Metropolitan Philadelphia | $187.51 | $176.39 |
| Metropolitan St. Louis | $173.69 | $163.51 |
| Miami | $199.66 | $188.53 |
| Minnesota | $176.52 | $165.52 |
| Mississippi | $159.71 | $150.51 |
| Modesto | $188.01 | $176.30 |
| Montana** | $179.68 | $168.99 |
| Napa | $217.67 | $203.58 |
| Nebraska | $164.00 | $154.14 |
| Nevada** | $178.20 | $167.51 |
| New Hampshire | $183.64 | $172.51 |
| New Mexico | $171.22 | $161.42 |
| New Orleans | $173.60 | $163.55 |
| North Carolina | $167.79 | $157.81 |
| North Dakota** | $173.94 | $163.25 |
| Northern Nj | $203.25 | $190.85 |
| Nyc Suburbs/Long Island | $214.58 | $201.87 |
| Ohio | $168.85 | $159.09 |
| Oklahoma | $164.10 | $154.55 |
| Oxnard-Thousand Oaks-Ventura | $200.15 | $187.51 |
| Portland | $191.87 | $179.99 |
| Poughkpsie/N Nyc Suburbs | $195.66 | $183.96 |
| Puerto Rico | $180.93 | $170.13 |
| Queens | $209.68 | $197.04 |
| Redding | $188.01 | $176.30 |
| Rest Of California | $188.01 | $176.30 |
| Rest Of Florida | $179.04 | $168.83 |
| Rest Of Georgia | $167.99 | $158.46 |
| Rest Of Illinois | $174.22 | $164.47 |
| Rest Of Louisiana | $164.85 | $155.39 |
| Rest Of Maine | $165.99 | $156.16 |
| Rest Of Maryland | $180.85 | $170.04 |
| Rest Of Massachusetts | $185.10 | $173.84 |
| Rest Of Michigan | $170.02 | $160.26 |
| Rest Of Missouri | $162.11 | $152.90 |
| Rest Of New Jersey | $193.97 | $182.30 |
| Rest Of New York | $170.54 | $160.39 |
| Rest Of Oregon | $176.32 | $165.67 |
| Rest Of Pennsylvania | $168.87 | $159.05 |
| Rest Of Texas | $172.35 | $162.21 |
| Rest Of Washington | $184.62 | $173.36 |
| Rhode Island | $183.64 | $172.60 |
| Riverside-San Bernardino-Ontario | $191.13 | $179.41 |
| Sacramento-Roseville-Folsom | $197.27 | $184.84 |
| Salinas | $196.55 | $184.16 |
| San Diego-Chula Vista-Carlsbad | $201.21 | $188.43 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $230.17 | $215.10 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $229.84 | $214.77 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $235.60 | $220.19 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $234.25 | $218.84 |
| San Luis Obispo-Paso Robles | $193.41 | $181.24 |
| Santa Cruz-Watsonville | $203.14 | $190.15 |
| Santa Maria-Santa Barbara | $197.29 | $184.83 |
| Santa Rosa-Petaluma | $205.17 | $192.04 |
| Seattle (King Cnty) | $208.65 | $195.54 |
| South Carolina | $168.70 | $158.82 |
| South Dakota** | $173.27 | $162.58 |
| Southern Maine | $174.99 | $164.40 |
| Stockton | $188.01 | $176.30 |
| Suburban Chicago | $190.88 | $179.90 |
| Tennessee | $163.78 | $154.07 |
| Utah | $171.17 | $161.13 |
| Vallejo | $217.19 | $203.10 |
| Vermont | $173.66 | $163.07 |
| Virgin Islands | $180.93 | $170.13 |
| Virginia | $174.71 | $164.21 |
| Visalia | $188.01 | $176.30 |
| West Virginia | $167.42 | $158.13 |
| Wisconsin | $167.72 | $157.48 |
| Wyoming** | $177.18 | $166.49 |
| Yuba City | $188.01 | $176.30 |
21820 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$157.29
$211.81
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $205.72 | 1 |
| AL | $159.79 | 1 |
| AR | $157.29 | 1 |
| AZ | $174.41 | 1 |
| CA | $188.01–$235.60 | 29 |
| CO | $186.15 | 1 |
| CT | $192.29 | 1 |
| DC | $205.54 | 1 |
| DE | $177.43 | 1 |
| FL | $179.04–$199.66 | 3 |
| GA | $167.99–$183.79 | 2 |
| GU | $192.82 | 1 |
| HI | $192.82 | 1 |
| IA | $163.18 | 1 |
| ID | $164.55 | 1 |
| IL | $174.22–$193.18 | 4 |
| IN | $165.55 | 1 |
| KS | $162.84 | 1 |
| KY | $164.93 | 1 |
| LA | $164.85–$173.60 | 2 |
| MA | $185.10–$204.82 | 2 |
| MD | $180.85–$205.54 | 3 |
| ME | $165.99–$174.99 | 2 |
| MI | $170.02–$181.95 | 2 |
| MN | $176.52 | 1 |
| MO | $162.11–$173.69 | 3 |
| MS | $159.71 | 1 |
| MT | $179.68 | 1 |
| NC | $167.79 | 1 |
| ND | $173.94 | 1 |
| NE | $164.00 | 1 |
| NH | $183.64 | 1 |
| NJ | $193.97–$203.25 | 2 |
| NM | $171.22 | 1 |
| NV | $178.20 | 1 |
| NY | $170.54–$214.58 | 5 |
| OH | $168.85 | 1 |
| OK | $164.10 | 1 |
| OR | $176.32–$191.87 | 2 |
| PA | $168.87–$187.51 | 2 |
| PR | $180.93 | 1 |
| RI | $183.64 | 1 |
| SC | $168.70 | 1 |
| SD | $173.27 | 1 |
| TN | $163.78 | 1 |
| TX | $167.71–$185.97 | 8 |
| UT | $171.17 | 1 |
| VA | $174.71–$205.54 | 2 |
| VI | $180.93 | 1 |
| VT | $173.66 | 1 |
| WA | $184.62–$208.65 | 2 |
| WI | $167.72 | 1 |
| WV | $167.42 | 1 |
| WY | $177.18 | 1 |
How the 21820 rate is calculated
Each of 21820’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 · 21820
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.33Practice expense 3.76Malpractice 0.29
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21820
21820 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21820
Sternum fracture care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21820
Sternum fracture care
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21820 without 51 · national office
$179.70
Sternum fracture care
21820-51 · Second procedure: 50%
$89.85
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%).
21820 compared with similar codes
Compare codes
21820 vs 21825 vs 21811 vs 21812 vs 21813: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21825Sternal fracture repair
- Both concern sternal fractures, but 21825 is for open treatment. Choose this code for closed treatment without manipulation.
- 21811Rib fixation
- This code concerns a sternum fracture. Code 21811 is for internal fixation of one to three rib fractures.
- 21812Rib fracture fixation
- This code concerns a sternum fracture. Code 21812 is for internal fixation of four to six rib fractures.
- 21813Rib fracture fixation
- This code concerns a sternum fracture. Code 21813 is for internal fixation of seven or more rib fractures.
21820 billing questions
When should this code be chosen over 21825?
Use this code for closed treatment without manipulation. Code 21825 describes open treatment of a sternal fracture, with or without fixation.
What documentation supports reporting this service?
Document the sternum as the fracture site and describe the closed treatment performed without manipulation.
Does the global period include related follow-up care?
Yes. 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?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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
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