No office rate
This code concerns partial removal of a rib. Use 21620 when the operative target is sternal bone, including the xiphoid process.
On this page
CMS RVU26D · Effective 2026-10-01
21620 Sternal ostectomy Medicare reimbursement rates in Kentucky
Reports limited removal of sternal bone, including xiphoidectomy, for a focal problem such as persistent pain at the xiphoid process. Compare 21620 office and facility rates across CMS payment localities in Kentucky.
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 21620 in Kentucky?
Kentucky 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
$472.62
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 21620: Partial sternum bone excision
Reports limited removal of sternal bone, including xiphoidectomy, for a focal problem such as persistent pain at the xiphoid process.
A surgeon removes a limited portion of the sternum. A familiar use is xiphoidectomy for persistent, localized pain arising from the xiphoid process; the procedure may also address another focal sternal bony problem when partial bone removal is performed. It is generally performed in an operating room by a thoracic or general surgeon, rather than as an office procedure.
Report the code when the operative report supports partial removal of sternal bone, not simply soft-tissue work or cleaning infected tissue. Documentation should identify the sternal site, the reason for surgery, and the extent of bone removed. Distinguish limited removal from sternal debridement and from a more extensive radical resection. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21620
- 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 RVU7.10 · 47%
- Practice expense (office) RVU6.16 · 41%
- Malpractice RVU1.72 · 11%
519
Medicare services in 2024 · #3531 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.
21620 compared with similar codes
Office rates for Kentucky, from the same CMS release.
21627
No office rateSternal debridement
21627 describes sternal debridement. Choose based on whether the documented operation is debridement or limited removal of sternal bone.
No office rate
21630 is for radical sternal resection. This code is for a limited portion of the sternum rather than a radical resection.
Compare 21620 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$472.62
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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 21620 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,015
- Code
- 21620
- Physician work
- 7.10
- Practice expense
- 6.16
- Malpractice
- 1.72
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.10 | × 1.000 | 7.1000 |
| Practice expense | 6.16 | × 0.889 | 5.4762 |
| Malpractice | 1.72 | × 0.915 | 1.5738 |
| Total RVUs | 14.1500 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$472.62
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.1 | 1 |
| Practice expense | 6.16 | 0.889 |
| Malpractice | 1.72 | 0.915 |
(7.1 × 1 + 6.16 × 0.889 + 1.72 × 0.915) × $33.4009 = $472.62
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.
21620 billing questions
When is this code appropriate for xiphoidectomy?
Use it when the surgeon removes part of the sternum at the xiphoid for a focal problem such as persistent localized xiphoid pain. The operative report should establish that sternal bone was removed.
How does this differ from sternal debridement?
This code represents partial sternal bone removal. When the documented service is debridement of the sternum, compare it with 21627 rather than selecting this code based only on the fact that bone was treated.
When should a more extensive sternum resection be considered?
Compare with 21630 when the operation involves radical resection of the sternum rather than limited removal. The operative report should support the extent of resection.
Can modifier 50 be reported for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
What postoperative care is included?
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, and other procedures performed in the same session are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
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.
2,01221610,,Costotransversectomy,A,,15.51,14.38,NA,14.38,,6.54,36.43,36.43,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01321615,,Excision 1st &/cervical rib,A,,10.19,4.71,NA,4.71,,2.54,17.44,17.44,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01421616,,Exc 1st&/crv rib w/sympth,A,,12.37,4.41,NA,4.41,,3.16,19.94,19.94,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01521620,,Ostectomy sternum partial,A,,7.10,6.16,NA,6.16,,1.72,14.98,14.98,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01621627,,Sternal debridement,A,,7.12,7.81,NA,7.81,,1.70,16.63,16.63,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01721630,,Radical resection sternum,A,,18.70,12.88,NA,12.88,,3.47,35.05,35.05,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01821685,,Hyoid myotomy & suspension,A,,14.88,8.72,NA,8.72,,2.22,25.82,25.82,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631