No office rate
Choose 21601 when the operation is a chest-wall tumor excision involving ribs. Choose 21600 for partial rib removal that is not part of that tumor-resection service.
On this page
CMS RVU26D · Effective 2026-10-01
21600 Rib excision Medicare reimbursement rates in Hawaii
A surgeon removes a portion of a rib for a localized chest-wall problem when the operation is not a first-rib or tumor-resection service. Compare 21600 office and facility rates across CMS payment localities in Hawaii.
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 21600 in Hawaii?
Hawaii 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
$581.90
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 21600: Partial rib excision
A surgeon removes a portion of a rib for a localized chest-wall problem when the operation is not a first-rib or tumor-resection service.
This service covers surgical removal of part of a rib, rather than an entire rib or a broader chest-wall tumor resection. It may be performed by a thoracic or other surgeon for a localized rib problem, with the operative report identifying the rib and the portion removed. The procedure is generally performed in an operating room; Medicare recorded facility services for this code in 2024.
Report 21600 when the procedure is a partial rib excision and the operative work supports that extent. A first or cervical rib operation, or an operation removing a chest-wall tumor with ribs, may fit a more specific code instead. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 21600
- 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 RVU7.08 · 42%
- Practice expense (office) RVU8.24 · 48%
- Malpractice RVU1.68 · 10%
494
Medicare services in 2024 · #3576 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.
21600 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
21615 is specific to excision of the first and/or a cervical rib. Code 21600 describes partial rib removal in a different anatomic circumstance.
No office rate
21616 applies to first and/or cervical rib excision with the specified additional surgical work; 21600 is for partial rib excision without that specific service.
Compare 21600 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
$581.90
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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 21600 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,008
- Code
- 21600
- Physician work
- 7.08
- Practice expense
- 8.24
- Malpractice
- 1.68
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.08 | × 1.000 | 7.0800 |
| Practice expense | 8.24 | × 1.137 | 9.3689 |
| Malpractice | 1.68 | × 0.579 | 0.9727 |
| Total RVUs | 17.4216 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$581.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.08 | 1 |
| Practice expense | 8.24 | 1.137 |
| Malpractice | 1.68 | 0.579 |
(7.08 × 1 + 8.24 × 1.137 + 1.68 × 0.579) × $33.4009 = $581.90
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.
21600 billing questions
When should 21600 be selected instead of a chest-wall tumor code?
Use 21600 for partial rib removal when the operation is not a chest-wall tumor resection. When the procedure removes a chest-wall tumor with ribs, compare the operative work with 21601.
Can modifier 50 be used when portions of ribs on both sides are removed?
CMS identifies bilateral adjustment as inappropriate for 21600. Modifier 50 should not be used for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation, and 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.
2,00521556,,Exc neck tum deep < 5 cm,A,,7.47,5.76,NA,5.76,,1.48,14.71,14.71,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00621557,,Resect neck thorax tumor<5cm,A,,14.38,8.92,NA,8.92,,3.12,26.42,26.42,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00721558,,Resect neck tumor 5 cm/>,A,,21.04,11.03,NA,11.03,,4.50,36.57,36.57,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00821600,,Partial removal of rib,A,,7.08,8.24,NA,8.24,,1.68,17.00,17.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00921601,,Exc chest wall tumor w/ribs,A,,17.34,11.50,NA,11.50,,4.44,33.28,33.28,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01021602,,Exc ch wal tum w/o lymphadec,A,,21.64,18.83,NA,18.83,,5.31,45.78,45.78,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01121603,,Exc ch wal tum w/lymphadec,A,,24.54,19.34,NA,19.34,,6.18,50.06,50.06,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,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