No office rate
Choose 21616 when the rib excision includes sympathectomy; choose 21615 when it does not.
On this page
CMS RVU26D · Effective 2026-10-01
21616 Rib excision Medicare reimbursement rates in Virginia
Reports operative removal of a first rib, cervical rib, or both with sympathectomy, typically as decompression surgery for thoracic outlet symptoms. Compare 21616 office and facility rates across CMS payment localities in Virginia.
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 21616 in Virginia?
Virginia 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
$632.48–$726.47
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 21616: First or cervical rib excision with sympathectomy
Reports operative removal of a first rib, cervical rib, or both with sympathectomy, typically as decompression surgery for thoracic outlet symptoms.
This open operation removes the first rib, a cervical rib, or both, and includes sympathectomy. Thoracic and vascular surgeons may perform it in an operating room for selected patients with thoracic outlet compression symptoms. The operative report should identify the rib or ribs removed and document that sympathectomy was performed; removal of a rib alone is not this service.
Report one unit for the operative service, with documentation supporting the anatomy and the included sympathectomy. The 90-day global period includes 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 multiple-procedure reduction. For bilateral reporting, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21616
- 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 RVU12.37 · 62%
- Practice expense (office) RVU4.41 · 22%
- Malpractice RVU3.16 · 16%
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.
21616 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
21600 describes partial rib removal generally. 21616 is specific to first and/or cervical rib excision performed with sympathectomy.
No office rate
21601 is for chest-wall tumor excision involving ribs. It is not the code for rib removal with sympathectomy for thoracic outlet decompression.
Compare 21616 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$726.47
Virginia →
Office / nonfacility
Unavailable
Facility
$632.48
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21616 billing questions
How does this differ from 21615?
21616 includes sympathectomy with the rib excision. Use 21615 when the first and/or cervical rib is excised without sympathectomy.
Can the rib removal and sympathectomy be reported separately?
The sympathectomy is included in 21616; it is not a separately described service within this code. The operative note should support that both parts of the operation were performed.
How is bilateral surgery reported?
Report bilateral performance with modifier 50. CMS pays the bilateral procedure 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 reported?
An assistant at surgery may be paid for this procedure. CMS does not permit co-surgeons or team surgery.
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.
2,01121603,,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
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