Billing code 21630: Sternum resectionMedicare rate & RVUs in Oregon
Report radical sternum resection for an extensive operation removing the sternum, such as for a tumor involving the bone, rather than partial removal or debridement.
CMS doesn’t publish an office rate for 21630 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 21630 covers
billing code 21630 describes a radical operation to remove the sternum. It is typically performed by a thoracic or surgical oncologist in an operating room when disease, such as a tumor involving the sternum, requires extensive resection. The operative report should establish the resection’s radical extent; the diagnosis alone does not distinguish this service from partial sternum removal or debridement.
Select the code from the documented operation and structures removed, distinguishing radical resection from partial sternectomy. CMS assigns a 90-day global period, including 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 for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 21630 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,198.78 |
| Rest Of Oregon | Unavailable | $1,134.56 |
How the 21630 rate is calculated
Each of 21630’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 · 21630
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 18.70Practice expense 12.88Malpractice 3.47
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21630
21630 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21630
Sternum resection
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 21630
Sternum resection
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
21630 without 51 · national facility
$1,170.70
Sternum resection
21630-51 · Second procedure: 50%
$585.35
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%).
21630 compared with similar codes
Compare codes
21630 vs 21620 vs 21627 vs 21601 vs 21603: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21620Sternal ostectomy
- 21620 describes partial sternum removal. Use 21630 when the documented operation is a radical resection rather than a partial sternectomy.
- 21627Sternal debridement
- 21627 is for sternal debridement. It does not describe radical removal of the sternum.
- 21601Chest wall excision
- 21601 addresses chest wall tumor excision involving ribs. Choose based on the actual structures and procedure documented, not the tumor diagnosis alone.
- 21603Chest wall tumor excision
- 21603 is a chest wall tumor excision code involving lymphadenectomy; 21630 describes radical resection of the sternum.
21630 billing questions
How does 21630 differ from 21620?
21630 is for radical sternum resection; 21620 describes partial sternum removal. Use the operative report to determine the extent of resection.
Can 21630 be reported for sternal debridement?
No. Debridement is distinct from radical resection; code 21627 describes sternal debridement.
Is modifier 50 appropriate for 21630?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor and anatomy.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to 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
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