Billing code 21610: CostotransversectomyMedicare rate & RVUs in Oregon
Reports resection at the rib–transverse process junction, commonly to reach a thoracic spinal target when that work is distinct from the definitive procedure.
CMS doesn’t publish an office rate for 21610 in Oregon.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 21610 covers
A costotransversectomy removes tissue at the junction of a rib and transverse process to provide a route to a thoracic spinal target. Spine surgeons, including orthopedic spine surgeons and neurosurgeons, may perform it in a hospital operating room when treating or accessing a lesion involving the thoracic vertebra or spinal canal. The operative report should identify the structures removed and explain the target and purpose of the resection.
Report this code when the documented costotransverse work is distinct, rather than merely an approach included in the definitive spinal procedure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. CMS treats modifier 50 as inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeon and team-surgery payment 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.
Where 21610 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,222.48 |
| Rest Of Oregon | Unavailable | $1,150.00 |
How the 21610 rate is calculated
Each of 21610’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 · 21610
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.51Practice expense 14.38Malpractice 6.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21610
21610 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21610
Costotransversectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21610
Costotransversectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21610 without 51 · national facility
$1,216.79
Costotransversectomy
21610-51 · Second procedure: 50%
$608.40
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
21610 compared with similar codes
Compare codes
21610 vs 21600 vs 63055 vs 63046: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21600Rib excision
- Use 21600 for partial rib removal without documented costotransverse resection. The operative anatomy and purpose, not rib removal alone, distinguish the services.
- 63055Spinal decompression
- Use 63055 for thoracic transpedicular decompression of the spinal cord or nerve roots, including costovertebral-joint work. Do not separately code access work already included in the definitive procedure.
- 63046Thoracic decompression
- Use 63046 for posterior thoracic decompression by laminectomy. Code 21610 concerns access through the rib–transverse process junction.
21610 billing questions
How is this different from partial rib removal?
Costotransversectomy concerns resection at the rib–transverse process junction, often to reach a thoracic spinal target. Code 21600 describes partial rib removal and is not selected solely because a rib portion was removed.
Can this be reported with a thoracic decompression code?
Report it only when the operative note supports distinct costotransverse work. Do not separately report approach work that is included in the definitive spinal procedure.
Is modifier 50 appropriate?
No. CMS identifies modifier 50 as inappropriate for this code.
What documentation supports reporting it?
Document the rib and transverse-process area addressed, the structures resected, the spinal target, and why the work was distinct from any accompanying procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. CMS does not permit co-surgeon or team-surgery payment 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 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
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