No office rate
Use 21811 when internal fixation treats one to three ribs; use 21812 for four to six.
On this page
CMS RVU26D · Effective 2026-10-01
21812 Rib fracture fixation Medicare reimbursement rates in Kentucky
Reports open stabilization with internal fixation of four to six fractured ribs, commonly performed for multiple displaced fractures or flail chest. Compare 21812 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 21812 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
$632.26
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 21812: Rib fracture fixation, four to six ribs
Reports open stabilization with internal fixation of four to six fractured ribs, commonly performed for multiple displaced fractures or flail chest.
This service involves surgically exposing fractured ribs and stabilizing four to six ribs with internal fixation, such as plates. Thoracic or trauma surgeons commonly perform it in a hospital setting for selected patients with multiple displaced rib fractures or flail chest. Thoracoscopy performed as part of the stabilization is included. The code level is based on the number of ribs treated, not simply the total number of fractures identified.
The operative report should identify the ribs stabilized, confirm internal fixation, and describe the approach and any thoracoscopic assistance. Choose the sibling code for one to three ribs or seven or more ribs when the treated-rib count falls in those ranges. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21812
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.68 · 65%
- Practice expense (office) RVU3.87 · 20%
- Malpractice RVU3.07 · 16%
668
Medicare services in 2024 · #3301 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.
21812 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
Use 21813 when seven or more ribs receive internal fixation; 21812 covers four to six.
Compare 21812 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
$632.26
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 21812 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,028
- Code
- 21812
- Physician work
- 12.68
- Practice expense
- 3.87
- Malpractice
- 3.07
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.68 | × 1.000 | 12.6800 |
| Practice expense | 3.87 | × 0.889 | 3.4404 |
| Malpractice | 3.07 | × 0.915 | 2.8091 |
| Total RVUs | 18.9295 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$632.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.68 | 1 |
| Practice expense | 3.87 | 0.889 |
| Malpractice | 3.07 | 0.915 |
(12.68 × 1 + 3.87 × 0.889 + 3.07 × 0.915) × $33.4009 = $632.26
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.
21812 billing questions
How is this code distinguished from 21811 and 21813?
Select this level when internal fixation is performed on four to six ribs. Code 21811 is the one-to-three-rib level, and 21813 is for seven or more ribs.
Does the rib count refer to fractures or ribs stabilized?
Count the ribs treated with internal fixation. Document the rib levels and number stabilized in the operative report.
Is thoracoscopy separately reported when used during fixation?
Thoracoscopy performed as part of the rib stabilization is included in this service.
When is modifier 50 used?
For bilateral performance, report modifier 50; CMS pays this bilateral procedure at 150%.
How does the multiple procedure reduction affect payment?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
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.
2,02521743,,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
2,02721811,,Optx of rib fx w/fixj scope,A,,10.52,3.19,NA,3.19,,2.60,16.31,16.31,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02821812,,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
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