Billing code 21811: Rib fixationMedicare rate & RVUs in Oklahoma

Reports internal fixation of one to three fractured ribs on one side, including thoracoscopic visualization when used during operative stabilization.

CMS RVU26DEffective Oct 1, 20261 payment locality595 Medicare services in 2024

CMS doesn’t publish an office rate for 21811 in Oklahoma.

—Office (non-facility)
$514.00Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21811 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Oklahoma
  2. What 21811 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 21811 covers

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.

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 in Oklahoma

21811 office and facility rates by payment locality
Payment localityOfficeFacility
OklahomaUnavailable$514.00

How the 21811 rate is calculated

Each of 21811’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 21811

RVUs × geographic indexes × conversion factor

Work10.52

10.52 RVUs× 1.000 GPCI

Practice expense3.19

3.19 RVUs× 1.000 GPCI

Malpractice2.60

2.60 RVUs× 1.000 GPCI

Adjusted RVUs

16.3100

Conversion factor

$33.4009

Medicare rate

$544.77

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 21811

The CMS indicators that decide how 21811 is paid alongside other services.

CMS payment indicators · 21811

Rib fixation

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

21811 without 50 · national facility

$544.77

Rib fixation

21811-50 · Bilateral: 150%

$817.16

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

21811 compared with similar codes

Compare codes · National

4 codes, side by side

  • 21811

    Rib fixation10.52 wRVU

    Not priced

  • 21812

    Rib fracture fixation12.68 wRVU

    Not priced

  • 21813

    Rib fracture fixation17.17 wRVU

    Not priced

  • 21825

    Sternal fracture repair7.57 wRVU

    Not priced

How to choose

21812Rib fracture fixation
Use 21812 when fixation involves four to six ribs on one side; 21811 covers one to three.
21813Rib fracture fixation
Use 21813 when fixation involves seven or more ribs on one side; 21811 is limited to one to three.
21825Sternal fracture repair
21825 describes open treatment of a sternum fracture. Code 21811 is for internal fixation of rib fractures.

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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 21811PPRRVU2026_Oct_nonQPP.csv, line 2,027 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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