$186.15
Use 21825 for open operative treatment of the sternum fracture. Use 21820 when treatment is closed and does not involve an open surgical approach.
On this page
CMS RVU26D · Effective 2026-10-01
21825 Sternal fracture repair Medicare reimbursement rates in Colorado
Open surgical treatment of a sternal fracture, with or without fixation, is reported when the fracture is managed through operative exposure. Compare 21825 office and facility rates across CMS payment localities in Colorado.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 21825 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$569.07
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Fracture treatment
About 21825: Open treatment of sternum fracture
Open surgical treatment of a sternal fracture, with or without fixation, is reported when the fracture is managed through operative exposure.
This code describes operative exposure and treatment of a fractured sternum, including restoring the fracture’s position; skeletal fixation may be used but is not required. A thoracic or orthopedic surgeon typically performs the repair in a hospital operating room, often for a fracture that requires surgical stabilization. A separate rib fracture treated during the same session is coded according to its own procedure and code.
Choose this code for open surgical treatment, not closed management of the sternum fracture. The operative report should identify the sternal fracture and document the open approach and treatment performed, including fixation when used. The service has a 90-day global period that includes the day-before preoperative visit and 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 single sternum. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21825
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.57 · 45%
- Practice expense (office) RVU7.44 · 44%
- Malpractice RVU1.87 · 11%
616
Medicare services in 2024 · #3365 by national volume
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.
21825 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
This code treats a rib fracture, not a sternal fracture. Select it only for the rib procedure performed, even when both injuries are treated in one session.
No office rate
This code is for rib-fracture treatment rather than open treatment of the sternum. The injured bone and procedure performed determine which code applies.
Compare 21825 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$569.07
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21825 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,031
- Code
- 21825
- Physician work
- 7.57
- Practice expense
- 7.44
- Malpractice
- 1.87
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.57 | × 1.012 | 7.6608 |
| Practice expense | 7.44 | × 1.064 | 7.9162 |
| Malpractice | 1.87 | × 0.781 | 1.4605 |
| Total RVUs | 17.0375 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$569.07
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.57 | 1.012 |
| Practice expense | 7.44 | 1.064 |
| Malpractice | 1.87 | 0.781 |
(7.57 × 1.012 + 7.44 × 1.064 + 1.87 × 0.781) × $33.4009 = $569.07
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
21825 billing questions
How does this differ from 21820?
21825 is for open surgical treatment of the sternal fracture. Use 21820 for closed treatment without an open operative approach.
Is fixation required to report 21825?
No. The code covers open treatment with or without skeletal fixation. Document the open treatment and specify fixation when performed.
Can a separately treated rib fracture be reported too?
Yes, when a distinct rib fracture is treated in the same session, report the applicable rib-fracture procedure separately. The multiple-procedure reduction may affect payment.
Should modifier 50 be used for a sternal fracture?
No. Modifier 50 is inappropriate for this code because the sternum is a single midline structure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,02821812,,Treatment of rib fracture,A,,12.68,3.87,NA,3.87,,3.07,19.62,19.62,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02921813,,Treatment of rib fracture,A,,17.17,4.92,NA,4.92,,4.60,26.69,26.69,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03021820,,Treat sternum fracture,A,,1.33,3.76,,3.44,,0.29,5.38,5.06,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03121825,,Treat sternum fracture,A,,7.57,7.44,NA,7.44,,1.87,16.88,16.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03221899,,Unlisted px neck/thorax,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03321920,,Biopsy soft tissue of back,A,,2.06,5.54,,1.90,,0.30,7.90,4.26,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03421925,,Biopsy soft tissue of back,A,,4.51,10.72,,5.62,,1.03,16.26,11.16,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899