Does 21812 require prior authorization?

No, 21812 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 21812?

Medicare facility rate: $655.33. Non-facility rate: $655.33. Work RVU: 12.68.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

12.68

Facility

$655.33

Non-Facility

$655.33

Internal fixation performed to stabilize rib fractures encountered during thoracotomy for other indications is an accepted indication.
Internal fixation may be used to provide stabilization and fixation for rib fusions and rib osteotomies.
Flail chest—defined as multiple consecutive ribs fractured in two or more places producing an incompetent chest-wall segment—is an indication for internal fixation to stabilize the chest wall.
Internal fixation is indicated for complex rib fractures including open rib fractures and symptomatic nonunion where surgical stabilization is needed.
Use of modular RibLoc system plates and screws (pre-contoured titanium or titanium-alloy implants with instrumentation) is described for fixation of the indicated rib fractures, fusions, and osteotomies.

A53931 — Fracture of Ribs with Internal Fixation

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