No office rate
21700 covers scalene division without cervical rib removal. Choose 21705 when cervical rib resection is part of the operation.
On this page
CMS RVU26D · Effective 2026-10-01
21700 Scalene division Medicare reimbursement rates in Pennsylvania
Reports surgical division of scalene muscles, commonly for thoracic outlet decompression, when the operation does not include cervical rib resection. Compare 21700 office and facility rates across CMS payment localities in Pennsylvania.
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 21700 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$323.35–$349.21
2 of 2 localities have a supported rate.
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 21700: Scalene muscle division without rib resection
Reports surgical division of scalene muscles, commonly for thoracic outlet decompression, when the operation does not include cervical rib resection.
The surgeon divides scalene muscle fibers in the neck to relieve compression associated with thoracic outlet syndrome, such as pressure affecting the brachial plexus or subclavian vessels. The operation is performed by a surgeon, commonly in a hospital operating room. This code describes the scalene release without removal of a cervical rib; a rib-resection operation falls under a different code in the same family.
Choose the code from the operation performed, documenting the indication, side, scalene muscles addressed, and whether a cervical rib was removed. 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 21700
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.15 · 62%
- Practice expense (office) RVU2.23 · 22%
- Malpractice RVU1.57 · 16%
25
Medicare services in 2024 · #5776 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.
21700 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
21615 reports first-rib resection. It represents a rib-removal operation, while 21700 reports scalene muscle division without cervical rib resection.
No office rate
21725 is an open sternocleidomastoid tenotomy, generally for a different neck-muscle condition; 21700 addresses scalene division for thoracic outlet decompression.
Compare 21700 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$349.21
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$323.35
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21700 billing questions
How does 21700 differ from 21705?
Use 21700 when scalene division is performed without cervical rib resection. When the operation includes cervical rib resection, use 21705.
Can 21700 be reported bilaterally?
CMS identifies this as a bilateral procedure. Modifier 50 is paid at 150%.
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 surgeon be paid for this operation?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 21700?
Document the thoracic outlet or other operative indication, laterality, scalene muscle work, and whether a cervical rib was removed. The operative note should support selection of 21700 rather than the rib-resection code.
How are multiple procedures handled in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% when performed in the same session.
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.
2,01621627,,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
2,02221725,,Revision of neck muscle,A,,7.01,6.94,NA,6.94,,1.48,15.43,15.43,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00