No office rate
CPT 41512 describes suture-based tongue-base suspension. Use 21685 for hyoid myotomy and suspension, not for the tongue-base technique alone.
On this page
CMS RVU26D · Effective 2026-10-01
21685 Hyoid suspension Medicare reimbursement rates in Oklahoma
Reports hyoid release and anterior suspension to address hypopharyngeal airway obstruction, commonly as part of surgical treatment for obstructive sleep apnea. Compare 21685 office and facility rates across CMS payment localities in Oklahoma.
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 21685 in Oklahoma?
Oklahoma 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
$814.71
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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.
ENT surgery
About 21685: Hyoid myotomy and suspension
Reports hyoid release and anterior suspension to address hypopharyngeal airway obstruction, commonly as part of surgical treatment for obstructive sleep apnea.
An otolaryngologist performs this operation in the operating room, typically for obstructive sleep apnea associated with obstruction behind the tongue. The surgeon releases the hyoid through myotomy and suspends it forward, commonly securing it to the thyroid cartilage to enlarge the hypopharyngeal airway. It may be one part of multilevel airway surgery, including a palate procedure, when the operative plan addresses obstruction at more than one level.
Report the service when the operative documentation supports both the hyoid myotomy and suspension; document the indication, airway findings, and steps performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care through day 90. 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% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21685
- 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 RVU14.88 · 58%
- Practice expense (office) RVU8.72 · 34%
- Malpractice RVU2.22 · 9%
173
Medicare services in 2024 · #4454 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.
21685 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
CPT 42145 addresses palatal surgery. It may accompany hyoid suspension when the surgeon treats a separate level of airway obstruction.
No office rate
CPT 64582 reports hypoglossal nerve stimulator implantation, a distinct device-based treatment rather than hyoid release and suspension.
Compare 21685 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$814.71
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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 21685 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
2,018
- Code
- 21685
- Physician work
- 14.88
- Practice expense
- 8.72
- Malpractice
- 2.22
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.88 | × 1.000 | 14.8800 |
| Practice expense | 8.72 | × 0.893 | 7.7870 |
| Malpractice | 2.22 | × 0.777 | 1.7249 |
| Total RVUs | 24.3919 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$814.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.88 | 1 |
| Practice expense | 8.72 | 0.893 |
| Malpractice | 2.22 | 0.777 |
(14.88 × 1 + 8.72 × 0.893 + 2.22 × 0.777) × $33.4009 = $814.71
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.
21685 billing questions
How is this different from tongue-base suspension?
This code represents release and anterior suspension of the hyoid. CPT 41512 describes a separate suture-based tongue-base suspension technique.
Can it be reported with a palate procedure?
It may be performed in the same session as palatopharyngoplasty when the surgeon treats obstruction at multiple airway levels. The operative report should support each distinct procedure.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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.
2,01521620,,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
2,01921700,,Revision of neck muscle,A,,6.15,2.23,NA,2.23,,1.57,9.95,9.95,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02021705,,Revision of neck muscle/rib,A,,9.67,2.65,NA,2.65,,2.48,14.80,14.80,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02121720,,Revision of neck muscle,A,,5.66,9.16,NA,9.16,,2.38,17.20,17.20,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193