No office rate
The key distinction is lymphadenectomy: 21603 includes it with the chest wall tumor excision, while 21602 describes the related excision without it.
On this page
CMS RVU26D · Effective 2026-10-01
21603 Chest wall tumor excision Medicare reimbursement rates in Nevada
Reports surgical removal of a chest wall tumor with lymphadenectomy, when the operative service includes both tumor excision and lymph node dissection. Compare 21603 office and facility rates across CMS payment localities in Nevada.
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 21603 in Nevada?
Nevada 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
$1638.22
1 of 1 localities have a supported rate.
Payment area: Nevada**
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 21603: Chest wall tumor excision with lymphadenectomy
Reports surgical removal of a chest wall tumor with lymphadenectomy, when the operative service includes both tumor excision and lymph node dissection.
A thoracic surgeon removes a chest wall tumor and performs lymphadenectomy during the same operation. This is a major surgical service generally performed in a hospital operating room. The operative report should establish the chest wall tumor being excised and describe the lymph node dissection performed as part of the procedure; a tumor excision alone or node sampling alone does not establish this combined service.
Select this code when the documented operation includes both components, distinguishing it from the related chest wall tumor excision code without lymphadenectomy. The 90-day global period includes 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 other procedures are subject to the standard 50% multiple-procedure 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 21603
- 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 RVU24.54 · 49%
- Practice expense (office) RVU19.34 · 39%
- Malpractice RVU6.18 · 12%
21
Medicare services in 2024 · #5885 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.
21603 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
21601 is a related chest wall tumor excision code identified with rib removal. Choose 21603 when the documented service includes lymphadenectomy.
No office rate
21600 describes partial rib removal. It is not the combined chest wall tumor excision and lymphadenectomy service reported with 21603.
Compare 21603 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
Nevada** →
Office / nonfacility
Unavailable
Facility
$1638.22
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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 21603 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
2,011
- Code
- 21603
- Physician work
- 24.54
- Practice expense
- 19.34
- Malpractice
- 6.18
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.54 | × 1.000 | 24.5400 |
| Practice expense | 19.34 | × 1.001 | 19.3593 |
| Malpractice | 6.18 | × 0.833 | 5.1479 |
| Total RVUs | 49.0473 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$1638.22
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.54 | 1 |
| Practice expense | 19.34 | 1.001 |
| Malpractice | 6.18 | 0.833 |
(24.54 × 1 + 19.34 × 1.001 + 6.18 × 0.833) × $33.4009 = $1638.22
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.
21603 billing questions
How does this differ from 21602?
Use 21603 when the chest wall tumor excision includes lymphadenectomy. Code 21602 identifies the related excision without lymphadenectomy.
Does tumor removal alone support 21603?
No. The operative report should document both chest wall tumor excision and lymphadenectomy performed during the operation.
Can modifier 50 be reported?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
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; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,00821600,,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
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
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097