No office rate
Use 21720 for release of the sternocleidomastoid in congenital muscular torticollis. Use 21725 when the neck muscle is being revised after prior treatment.
On this page
CMS RVU26D · Effective 2026-10-01
21725 Neck muscle revision Medicare reimbursement rates in Pennsylvania
Revision of the sternocleidomastoid muscle is reported for operative correction of a persistent or recurrent neck-muscle problem after prior treatment. Compare 21725 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 21725 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
$493.65–$538.63
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.
Neck surgery
About 21725: Revision of sternocleidomastoid muscle
Revision of the sternocleidomastoid muscle is reported for operative correction of a persistent or recurrent neck-muscle problem after prior treatment.
This code describes revision surgery on a neck muscle, typically the sternocleidomastoid, to address a persistent or recurrent deformity or functional problem. The surgeon works directly on the previously treated muscle; the service is distinct from an initial release or division. It is generally performed in an operating room by a surgeon treating a neck-muscle condition, such as residual or recurrent torticollis after earlier surgery.
Report the code when the operative record supports revision of the neck muscle itself, rather than a first-time release or a separate reconstruction of another structure. Documentation should identify the muscle, prior treatment, the reason revision is needed, and the work performed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur 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. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21725
- 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 RVU7.01 · 45%
- Practice expense (office) RVU6.94 · 45%
- Malpractice RVU1.48 · 10%
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.
21725 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
21700 describes open division of the sternocleidomastoid for torticollis; 21725 represents revision work rather than the initial division.
No office rate
21705 is a torticollis division procedure extending into the thoracic area. It is not the revision service described by 21725.
Compare 21725 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
$538.63
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$493.65
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21725 billing questions
How is 21725 distinguished from 21720?
21725 is for revision of a neck muscle after prior treatment. 21720 describes release of the sternocleidomastoid for congenital muscular torticollis, rather than revision surgery.
What documentation supports reporting 21725?
The operative report should identify the muscle, explain the persistent or recurrent problem and prior treatment, and describe the revision work performed.
Can modifier 50 be used for bilateral work?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the global period affect postoperative visits?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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.
2,01921700,,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
2,02321740,,Reconstruction of sternum,A,,17.13,8.19,NA,8.19,,4.31,29.63,29.63,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02421742,,Repair stern/nuss w/o scope,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,02521743,,Repair sternum/nuss w/scope,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00