No office rate
The key distinction is mediastinal lymphadenectomy: this code is for tumor excision without it; 21603 includes it.
On this page
CMS RVU26D · Effective 2026-10-01
21602 Chest wall tumor excision Medicare reimbursement rates in Wyoming
Reports surgical removal of a chest wall tumor, including involved ribs, when the operation does not include mediastinal lymphadenectomy. Compare 21602 office and facility rates across CMS payment localities in Wyoming.
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 21602 in Wyoming?
Wyoming 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
$1482.98
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 21602: Chest wall tumor excision without lymphadenectomy
Reports surgical removal of a chest wall tumor, including involved ribs, when the operation does not include mediastinal lymphadenectomy.
A thoracic surgeon or surgical oncologist reports this service for removal of a chest wall tumor that involves the ribs, without mediastinal lymphadenectomy. A typical setting is an operating room, with the operative report describing the tumor’s site and extent, the chest wall structures removed, and the absence of mediastinal node dissection. Rib removal performed as part of the tumor resection is included in the service; this is not a code for an isolated rib resection.
Select this code based on the operation actually performed, distinguishing it from the related tumor-excision service that includes mediastinal lymphadenectomy. The operative report should support the tumor excision and its extent, including any rib resection. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of 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. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Modifier 50 is inappropriate, and team surgery is not permitted.
CMS billing rules for 21602
- 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 RVU21.64 · 47%
- Practice expense (office) RVU18.83 · 41%
- Malpractice RVU5.31 · 12%
152
Medicare services in 2024 · #4552 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.
21602 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
21600 describes costochondral resection. Use this code for chest wall tumor excision, not isolated removal of a costochondral segment.
No office rate
21630 is for radical resection of the sternum. This code is for chest wall tumor excision without mediastinal lymphadenectomy.
Compare 21602 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$1482.98
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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 21602 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,010
- Code
- 21602
- Physician work
- 21.64
- Practice expense
- 18.83
- Malpractice
- 5.31
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.64 | × 1.000 | 21.6400 |
| Practice expense | 18.83 | × 1.000 | 18.8300 |
| Malpractice | 5.31 | × 0.740 | 3.9294 |
| Total RVUs | 44.3994 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1482.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.64 | 1 |
| Practice expense | 18.83 | 1 |
| Malpractice | 5.31 | 0.74 |
(21.64 × 1 + 18.83 × 1 + 5.31 × 0.74) × $33.4009 = $1482.98
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.
21602 billing questions
How does this code differ from 21603?
This code describes chest wall tumor excision without mediastinal lymphadenectomy. Use 21603 when the operation also includes mediastinal lymphadenectomy.
Can the rib resection be reported separately?
When rib removal is part of the chest wall tumor resection, it is included in this service. This code is not for an isolated rib resection.
What documentation supports reporting this code?
The operative report should identify the chest wall tumor, the structures removed, any involved ribs resected, and whether mediastinal lymphadenectomy was performed.
Should modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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.
2,00721558,,Resect neck tumor 5 cm/>,A,,21.04,11.03,NA,11.03,,4.50,36.57,36.57,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00821600,,Partial removal of rib,A,,7.08,8.24,NA,8.24,,1.68,17.00,17.00,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,00921601,,Exc chest wall tumor w/ribs,A,,17.34,11.50,NA,11.50,,4.44,33.28,33.28,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,01021602,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,