No office rate
Use 21812 when fixation involves four to six ribs on one side; 21811 covers one to three.
On this page
CMS RVU26D · Effective 2026-10-01
21811 Rib fixation Medicare reimbursement rates in Massachusetts
Reports internal fixation of one to three fractured ribs on one side, including thoracoscopic visualization when used during operative stabilization. Compare 21811 office and facility rates across CMS payment localities in Massachusetts.
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 21811 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$538.41–$570.29
2 of 2 localities have a supported rate.
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 21811: Unilateral rib fracture fixation, one to three ribs
Reports internal fixation of one to three fractured ribs on one side, including thoracoscopic visualization when used during operative stabilization.
The surgeon stabilizes one to three fractured ribs on one side with internal fixation, commonly when operative stabilization is selected for substantially displaced fractures or flail chest. Thoracoscopic visualization may be used and is included in the service. Thoracic or trauma surgeons typically perform the operation in an operating room, often during hospital or trauma-center care.
Select the code by the number of ribs treated with fixation on that side, and document the side, ribs stabilized, and fixation performed. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral treatment, 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 21811
- 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 RVU10.52 · 65%
- Practice expense (office) RVU3.19 · 20%
- Malpractice RVU2.60 · 16%
595
Medicare services in 2024 · #3400 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.
21811 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
Use 21813 when fixation involves seven or more ribs on one side; 21811 is limited to one to three.
No office rate
21825 describes open treatment of a sternum fracture. Code 21811 is for internal fixation of rib fractures.
Compare 21811 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$570.29
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$538.41
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21811 billing questions
How does 21811 differ from 21812?
21811 is for fixation of one to three ribs on one side. Use 21812 when four to six ribs are treated.
Is thoracoscopic visualization reported separately?
No. Thoracoscopic visualization, when used for the rib fixation, is included in this service.
How is bilateral rib fixation reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported?
CMS allows payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included. The global period is 0 days.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
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.
2,02421742,,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
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