21742
No office rateRepair stern/nuss w/o scope
Choose 21742 for minimally invasive pectus repair performed without thoracoscopy. Code 21740 describes open sternal reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
21740 Sternal reconstruction Medicare reimbursement rates in Guam
Open sternal reconstruction reshapes or rebuilds the sternum to correct a congenital or acquired chest-wall deformity, such as pectus deformity. Compare 21740 office and facility rates across CMS payment localities in Guam.
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 21740 in Guam?
Guam 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
$966.54
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Thoracic surgery
About 21740: Open sternal reconstruction for deformity
Open sternal reconstruction reshapes or rebuilds the sternum to correct a congenital or acquired chest-wall deformity, such as pectus deformity.
This service involves surgically reconstructing the sternum to correct a congenital or acquired deformity. It is typically performed by a thoracic surgeon in an operating room. Open reconstruction may be selected for a chest-wall deformity such as pectus excavatum or carinatum; the operative approach and extent of reconstruction distinguish it from minimally invasive repair techniques.
Report the code when the surgeon’s work reconstructs the sternum, not simply closes a separated median sternotomy. The operative report should identify the deformity, the anatomic problem addressed, and the reconstruction performed. This major surgery has a 90-day global period, including 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 others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 21740
- 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 RVU17.13 · 58%
- Practice expense (office) RVU8.19 · 28%
- Malpractice RVU4.31 · 15%
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.
21740 compared with similar codes
Office rates for Guam, from the same CMS release.
21743
No office rateRepair sternum/nuss w/scope
Choose 21743 for minimally invasive pectus repair performed with thoracoscopy. Code 21740 describes open sternal reconstruction.
No office rate
Code 21750 is for closing a separated median sternotomy. Code 21740 is for reconstructing the sternum to correct a congenital or acquired deformity.
Compare 21740 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$966.54
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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 21740 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,023
- Code
- 21740
- Physician work
- 17.13
- Practice expense
- 8.19
- Malpractice
- 4.31
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.13 | × 1.000 | 17.1300 |
| Practice expense | 8.19 | × 1.137 | 9.3120 |
| Malpractice | 4.31 | × 0.579 | 2.4955 |
| Total RVUs | 28.9375 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$966.54
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.13 | 1 |
| Practice expense | 8.19 | 1.137 |
| Malpractice | 4.31 | 0.579 |
(17.13 × 1 + 8.19 × 1.137 + 4.31 × 0.579) × $33.4009 = $966.54
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.
21740 billing questions
How does this differ from the minimally invasive pectus repair codes?
This code describes open sternal reconstruction for a deformity. The minimally invasive pectus codes distinguish repair performed without thoracoscopy from repair performed with thoracoscopy.
Should this be reported for closure of a separated median sternotomy?
No. Code 21750 describes closure of median sternotomy separation; choose based on the documented procedure and indication rather than the shared sternal anatomy.
Can modifier 50 be used for bilateral reconstruction?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting this code?
The operative report should describe the congenital or acquired sternal deformity, the reconstruction performed, and the extent of the surgical work.
How does the 90-day global period affect postoperative reporting?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those related services are included in the surgical global package.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
2,02021705,,Revision of neck muscle/rib,A,,9.67,2.65,NA,2.65,,2.48,14.80,14.80,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02121720,,Revision of neck muscle,A,,5.66,9.16,NA,9.16,,2.38,17.20,17.20,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02221725,,Revision of neck muscle,A,,7.01,6.94,NA,6.94,,1.48,15.43,15.43,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02321740,,Reconstruction of sternum,A,,17.13,8.19,NA,8.19,,4.31,29.63,29.63,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02421742,,Repair stern/nuss w/o scope,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02521743,,Repair sternum/nuss w/scope,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02621750,,Repair of sternum separation,A,,11.12,5.93,NA,5.93,,2.73,19.78,19.78,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014