No office rate
21616 includes sympathectomy with the first and/or cervical rib excision. Report 21615 when the rib excision is performed without sympathectomy.
On this page
CMS RVU26D · Effective 2026-10-01
21615 Rib excision Medicare reimbursement rates in Vermont
Reports surgical removal of a first rib, cervical rib, or both, commonly to relieve compression associated with thoracic outlet syndrome. Compare 21615 office and facility rates across CMS payment localities in Vermont.
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 21615 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$539.03
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
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 21615: First or cervical rib excision
Reports surgical removal of a first rib, cervical rib, or both, commonly to relieve compression associated with thoracic outlet syndrome.
This operation removes a first rib, a cervical rib, or both. It is commonly performed to relieve neurovascular compression associated with thoracic outlet syndrome or symptoms caused by a cervical rib. Thoracic, vascular, or other surgeons experienced in thoracic outlet procedures may perform it in a hospital or surgical facility. The operative report should identify the rib or ribs removed and the clinical reason for excision.
Report 21615 for the rib excision without the sympathectomy included in 21616. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21615
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.19 · 58%
- Practice expense (office) RVU4.71 · 27%
- Malpractice RVU2.54 · 15%
123
Medicare services in 2024 · #4710 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.
21615 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
21600 describes partial removal of a rib. Use 21615 for excision of a first rib, cervical rib, or both.
No office rate
21700 describes anterior scalenotomy without cervical rib removal. Use 21615 when the operation includes removal of a first and/or cervical rib.
Compare 21615 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.
1 of 1 payment localities
Vermont →
Office / nonfacility
Unavailable
Facility
$539.03
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21615 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,013
- Code
- 21615
- Physician work
- 10.19
- Practice expense
- 4.71
- Malpractice
- 2.54
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.19 | × 1.000 | 10.1900 |
| Practice expense | 4.71 | × 0.990 | 4.6629 |
| Malpractice | 2.54 | × 0.506 | 1.2852 |
| Total RVUs | 16.1381 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$539.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.19 | 1 |
| Practice expense | 4.71 | 0.99 |
| Malpractice | 2.54 | 0.506 |
(10.19 × 1 + 4.71 × 0.99 + 2.54 × 0.506) × $33.4009 = $539.03
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
21615 billing questions
When should 21616 be reported instead?
Use 21616 when the first and/or cervical rib excision is performed with sympathectomy. Code 21615 describes the rib excision without that added procedure.
How is bilateral rib excision reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
What documentation supports 21615?
The operative report should establish the rib or ribs removed, the side or sides, and the clinical indication, such as thoracic outlet compression or symptoms related to a cervical rib.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
May 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.
2,01021602,,Exc ch wal tum w/o lymphadec,A,,21.64,18.83,NA,18.83,,5.31,45.78,45.78,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01121603,,Exc ch wal tum w/lymphadec,A,,24.54,19.34,NA,19.34,,6.18,50.06,50.06,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01221610,,Costotransversectomy,A,,15.51,14.38,NA,14.38,,6.54,36.43,36.43,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01321615,,Excision 1st &/cervical rib,A,,10.19,4.71,NA,4.71,,2.54,17.44,17.44,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01421616,,Exc 1st&/crv rib w/sympth,A,,12.37,4.41,NA,4.41,,3.16,19.94,19.94,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01521620,,Ostectomy sternum partial,A,,7.10,6.16,NA,6.16,,1.72,14.98,14.98,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01621627,,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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817