Billing code 21616: Rib excisionMedicare rate & RVUs in Florida
Reports operative removal of a first rib, cervical rib, or both with sympathectomy, typically as decompression surgery for thoracic outlet symptoms.
CMS doesn’t publish an office rate for 21616 in Florida.
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 9 sections
What 21616 covers
This open operation removes the first rib, a cervical rib, or both, and includes sympathectomy. Thoracic and vascular surgeons may perform it in an operating room for selected patients with thoracic outlet compression symptoms. The operative report should identify the rib or ribs removed and document that sympathectomy was performed; removal of a rib alone is not this service.
Report one unit for the operative service, with documentation supporting the anatomy and the included sympathectomy. The 90-day global period includes the day-before preoperative visit and 90 days of 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 multiple-procedure reduction. For bilateral reporting, 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 21616 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $753.21 |
| Miami | Unavailable | $833.43 |
| Rest Of Florida | Unavailable | $712.62 |
How the 21616 rate is calculated
Each of 21616’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 · 21616
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.37Practice expense 4.41Malpractice 3.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21616
21616 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21616
Rib excision
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 21616
Rib excision
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 50 · payment effect
With and without the modifier
21616 without 50 · national facility
$666.01
Rib excision
21616-50 · Bilateral: 150%
$999.02
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).
21616 compared with similar codes
Compare codes
21616 vs 21615 vs 21600 vs 21601: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21615Rib excision
- Choose 21616 when the rib excision includes sympathectomy; choose 21615 when it does not.
- 21600Rib excision
- 21600 describes partial rib removal generally. 21616 is specific to first and/or cervical rib excision performed with sympathectomy.
- 21601Chest wall excision
- 21601 is for chest-wall tumor excision involving ribs. It is not the code for rib removal with sympathectomy for thoracic outlet decompression.
21616 billing questions
How does this differ from 21615?
21616 includes sympathectomy with the rib excision. Use 21615 when the first and/or cervical rib is excised without sympathectomy.
Can the rib removal and sympathectomy be reported separately?
The sympathectomy is included in 21616; it is not a separately described service within this code. The operative note should support that both parts of the operation were performed.
How is bilateral surgery reported?
Report bilateral performance with modifier 50. CMS pays the bilateral procedure 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 reported?
An assistant at surgery may be paid for this procedure. CMS does not permit co-surgeons or team surgery.
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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