{"id":176241,"date":"2026-08-12T11:35:01","date_gmt":"2026-08-12T11:35:01","guid":{"rendered":"https:\/\/pabau.com\/?p=176241"},"modified":"2026-08-12T12:12:47","modified_gmt":"2026-08-12T12:12:47","slug":"cpt-code-21720","status":"publish","type":"post","link":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21720\/","title":{"rendered":"CPT code 21720: Division of sternocleidomastoid for torticollis"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT code 21720: Division of sternocleidomastoid for torticollis\",\"description\":\"CPT code 21720 covers division of sternocleidomastoid for torticollis, open operation, without cast application. Learn modifiers, Medicare reimbursement, RVU values, ICD-10 pairings, and billing tips.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21720\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-12\",\"dateModified\":\"2026-08-12\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 21720 covers open division of the sternocleidomastoid for torticollis, with no cast applied in the same session<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The code sits in the Neck (Soft Tissue) and Thorax subsection of the CPT Musculoskeletal System section<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>21720 carries a 90-day global surgery period, so routine post-op visits inside that window are bundled into the base payment<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Modifier -50 covers a bilateral release, and -LT or -RT identifies the side when only one muscle is divided<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau validates modifiers and scrubs claims before a surgical code like 21720 goes out<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 21720 is the billable code for open division of the sternocleidomastoid muscle to correct torticollis, without cast application. Its official descriptor reads: Division of sternocleidomastoid for torticollis, open operation, without cast application. The code sits in the Musculoskeletal System section of <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">AMA&#8217;s CPT code set<\/a>, under the Neck (Soft Tissue) and Thorax subsection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That subsection covers 21501 through 21899, the same range as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21552\/\">CPT 21552<\/a> and <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21750\/\">CPT 21750<\/a>. Coders working from the neck heading rather than the head codes land on the right family first, as <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes\/21720\" target=\"_blank\" rel=\"nofollow noopener\">AAPC&#8217;s listing for 21720<\/a> confirms. Prior authorization is also common on this code, so check the payer&#8217;s list before the case is booked.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The code belongs to a two-code family, and one phrase separates them. &#8220;Without cast application&#8221; is what distinguishes 21720 from CPT 21725. That code covers the identical open division, with a cast applied during the same session. Pick the wrong one and the claim stops matching the operative report, which is what invites payer scrutiny.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Details<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21720<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official description<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Division of sternocleidomastoid for torticollis, open operation, without cast application<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Musculoskeletal System<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Subsection<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Neck (Soft Tissue) and Thorax<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Procedure type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open surgical, not endoscopic<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Global period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">90 days<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Sibling code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21725, with cast application<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-procedure-description-the-sternocleidomastoid-release\" class=\"wp-block-heading\">Procedure description: The sternocleidomastoid release<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The sternocleidomastoid (SCM) muscle runs from the mastoid process of the skull down to the clavicle and sternum. In muscular torticollis, fibrosis or contracture inside the muscle tilts the head toward the affected side and rotates it away. Surgical division is indicated when physical therapy and stretching fail to resolve the deformity.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">During the open procedure, the surgeon incises over the SCM and identifies the affected muscle heads. One or both heads are divided at the clavicular or sternal insertion, then the wound is closed. No cast is applied in that session, which is what makes 21720 the correct code. If a cast goes on before the patient leaves the operating room, bill 21725 instead.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Approach:<\/strong> Open incision, not endoscopic or percutaneous<\/li>\n\n\n\n<li><strong>Target structure:<\/strong> Sternocleidomastoid muscle, usually at the clavicular or sternal origin<\/li>\n\n\n\n<li><strong>Primary performers:<\/strong> Orthopedic surgeons and pediatric surgeons<\/li>\n\n\n\n<li><strong>Setting:<\/strong> Hospital inpatient or outpatient surgical center<\/li>\n\n\n\n<li><strong>Cast application:<\/strong> None during the operative session, which is the dividing line with 21725<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-clinical-indications-for-cpt-code-21720\" class=\"wp-block-heading\">Clinical indications for CPT code 21720<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medical necessity is the gating criterion for every surgical claim. For teams billing SCM procedures inside a <a href=\"https:\/\/pabau.com\/industry\/plastic-surgery-emr\/\">plastic surgery EMR<\/a>, the documentation has to link the diagnosis to a recognized indication. Payers adjudicate these claims against LCD policies, not general clinical opinion.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Congenital muscular torticollis (CMT):<\/strong> The most common indication, usually present at birth or in infancy from SCM fibrosis or a pseudotumor. Surgery comes into view when stretching programs over 6-12 months fail to correct the deformity.<\/li>\n\n\n\n<li><strong>Residual or recurrent torticollis:<\/strong> Cases where earlier conservative management achieved partial correction but functional limitation persists.<\/li>\n\n\n\n<li><strong>Fixed bony or muscular torticollis:<\/strong> Cases unresponsive to other interventions, including SCM shortening after an earlier injury or fibrosis.<\/li>\n\n\n\n<li><strong>Cervical dystonia with significant SCM involvement:<\/strong> Less common, and it needs documentation of failed drug management before surgical approval.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Documentation should specify the duration of conservative treatment attempted, the functional limitations the deformity causes, and the operative plan. Much of that history sits with the referring therapy team, so request it from their <a href=\"https:\/\/pabau.com\/industry\/physical-therapy-emr\/\">physical therapy EMR<\/a> before submitting. Vague clinical notes are the leading cause of medical necessity denials on this code.<\/p>\n\n\n\n<h2 id=\"h-icd-10-codes-used-with-cpt-21720\" class=\"wp-block-heading\">ICD-10 codes used with CPT 21720<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 21720 pairs with specific ICD-10-CM diagnosis codes on the claim, and the primary diagnosis must justify the surgical approach. An unspecified or loosely mapped code can trigger an automatic downcode or a denial.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M43.6<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Torticollis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Primary code, covering acquired and muscular torticollis broadly<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q68.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Congenital deformity of sternocleidomastoid muscle<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Preferred for congenital muscular torticollis in pediatric cases<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G24.3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Spasmodic torticollis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use only when a spasmodic or dystonic component is documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q67.3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Plagiocephaly<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Secondary code when head shape asymmetry accompanies congenital torticollis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m436\/\">M43.6<\/a> is the most frequently used primary diagnosis with 21720. Q68.0 is the more precise code for congenital cases, and pediatric payers increasingly prefer it. Plagiocephaly is common alongside congenital muscular torticollis, so Q67.3 often appears as a secondary diagnosis. Check payer LCD policies before defaulting to M43.6 everywhere, because some require Q68.0 to confirm congenital etiology.<\/p>\n\n\n\n<h2 id=\"h-cpt-code-21720-vs-cpt-code-21725\" class=\"wp-block-heading\">CPT code 21720 vs CPT code 21725<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The distinction is simple in theory and frequently wrong in practice. Both codes describe the same open division of the sternocleidomastoid for torticollis. The single differentiating factor is whether a cast is applied during the same operative session.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Element<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 21720<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 21725<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Division of SCM, open<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Division of SCM, open<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Cast application<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No cast applied<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cast applied in same session<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Documentation trigger<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Op note confirms no cast<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Op note confirms cast placed<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Relative frequency<\/td>\n<td style=\"padding:12px 16px;color:#374151\">More common<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Less common<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The practical rule is to read the operative note before selecting the code. If the surgeon applied a cast before closing, use 21725. If the patient went to recovery without one, use 21720, even when a cast is planned for a later date. Billing 21725 with no cast in the session inflates the claim and creates audit risk.<\/p>\n\n\n\n<h2 id=\"h-applicable-modifiers-for-cpt-code-21720\" class=\"wp-block-heading\">Applicable modifiers for CPT code 21720<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection for 21720 depends on whether the release is bilateral, who performed it, and whether anything unusual happened in the case. Those rules follow National Correct Coding Initiative (NCCI) edits and payer policy, which sometimes diverges from CMS guidance.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to apply<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Reimbursement impact<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-50 (Bilateral)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Both SCM muscles divided in a single operative session<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Typically 150% of the unilateral rate, but confirm payer policy<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-LT \/ -RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unilateral procedure on one specified side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No payment adjustment, but it clarifies laterality for the audit trail<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-62 (Co-surgery)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Two surgeons of different specialties each performing a distinct part of the procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Each surgeon typically receives 62.5% of the allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-80 (Assistant surgeon)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Second surgeon assisting, not independently performing a distinct component<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Typically 16% of the primary surgeon&#8217;s allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-22 (Unusual complexity)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Substantially increased work from patient comorbidities or anatomic difficulty<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Requires written justification, and the payer may raise payment or request review<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h3 id=\"h-modifier-50-and-bilateral-procedures\" class=\"wp-block-heading\">Modifier -50 and bilateral procedures<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Bilateral SCM division happens less often than unilateral release. When it does, modifier -50 appends to 21720 on a single line item. Medicare typically reimburses bilateral procedures at 150% of the unilateral allowed amount, though commercial contracts vary.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some payers want the code listed twice instead, once with -LT and once with -RT. Confirm the payer&#8217;s billing manual first, because the wrong format denies regardless of clinical appropriateness.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Before billing modifier -50, pull the payer&#8217;s surgical billing manual. Medicare pays 150% for bilateral procedures, but several commercial payers require two separate line items with -LT and -RT. Submitting in the wrong format delays payment by weeks and starts a second denial cycle.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-medicare-reimbursement-for-cpt-code-21720\" class=\"wp-block-heading\">Medicare reimbursement for CPT code 21720<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare payment rates for CPT code 21720 vary by locality and update annually through the Medicare Physician Fee Schedule (MPFS). The rates below reflect national average estimates from publicly available CMS data. Verify your own locality&#8217;s figures with the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS fee schedule lookup<\/a> before billing. Rates also shift with budget neutrality adjustments.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Setting<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Estimated national average payment<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Facility (hospital or ASC)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Verify via CMS MPFS lookup<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Lower physician payment, and the facility bills separately for overhead<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Non-facility<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Verify via CMS MPFS lookup<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Higher physician payment, and the practice absorbs overhead costs<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Because this is an open surgical procedure, CPT code 21720 is almost always performed in a facility setting. The hospital or ambulatory surgical center bills separately for facility fees. Use the <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU lookup<\/a> to pull current work, practice expense, and malpractice RVU components for locality-adjusted math.<\/p>\n\n\n\n<h3 id=\"h-rvu-breakdown-for-cpt-21720\" class=\"wp-block-heading\">RVU breakdown for CPT 21720<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare pays the summed work, practice expense, and malpractice RVUs, adjusted by the Geographic Practice Cost Index (GPCI) and the annual conversion factor. For surgical codes, the work RVU component dominates. Verify current values against the CMS MPFS data files, because RVUs are adjusted every year.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">RVU component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CMS source<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician time, skill, and intensity<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS MPFS data file, published annually<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice expense RVU (facility)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Clinical staff, supplies, and equipment at the facility rate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS MPFS data file, published annually<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice expense RVU (non-facility)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Clinical staff, supplies, and equipment at the non-facility rate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS MPFS data file, published annually<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Malpractice RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Professional liability insurance component<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS MPFS data file, published annually<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-global-surgery-period-for-cpt-21720\" class=\"wp-block-heading\">Global surgery period for CPT 21720<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 21720 carries a 90-day global surgery period under CMS rules. The surgical payment covers all related post-operative care from the day before surgery through day 90. Billing a routine post-op visit inside that window generates an automatic denial. The clock starts on the day of surgery, not the discharge date.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Included in the global payment:<\/strong> The pre-operative visit the day before surgery, the procedure itself, and intraoperative services. Routine post-operative care through day 90 is bundled too.<\/li>\n\n\n\n<li><strong>Separately billable during the global period:<\/strong> Care for a completely unrelated diagnosis, and staged procedures not anticipated at the original surgery. Complications that need a return to the operating room also bill separately.<\/li>\n\n\n\n<li><strong>Modifier -24:<\/strong> Appended to an E&amp;M visit during the global period when treating an unrelated condition. It documents that the visit falls outside the bundle.<\/li>\n\n\n\n<li><strong>Modifier -79:<\/strong> Used when an unrelated surgical procedure happens during the global period of CPT code 21720.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">A common error looks like this. A practice schedules a 6-week post-op check and bills it as an office visit. Without modifier -24 and documentation of an unrelated diagnosis, the claim will deny. The same trap catches bundled add-on services, so confirm the global status of a code like <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-15851\/\">CPT 15851<\/a> before you bill it separately.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Documentation for any global-period visit must state the purpose of the encounter. If you bill separately, it must also confirm the visit is unrelated to the torticollis surgery.<\/p>\n\n\n\n<h2 id=\"h-billing-and-coding-tips-for-cpt-21720\" class=\"wp-block-heading\">Billing and coding tips for CPT 21720<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Orthopedic and pediatric surgical billing teams see a short list of predictable errors on this code. Catching them before submission saves denial management time and protects cash flow.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-for-medical-offices\/\">HIPAA compliance<\/a> rules apply to the paper trail as well. The operative note and post-op records must stay accessible for payer audit requests within the required timeframe.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Read the operative note first.<\/strong> Confirm whether a cast was applied, and switch to 21725 if it was. This is the single most important pre-submission check for the family.<\/li>\n\n\n\n<li><strong>Confirm laterality.<\/strong> Append -LT or -RT for a unilateral procedure. For bilateral work in one session, use -50, or two line items with -LT and -RT where the payer prefers that.<\/li>\n\n\n\n<li><strong>Verify the primary diagnosis code.<\/strong> M43.6 covers most adult cases, while Q68.0 is preferred for congenital pediatric cases.<\/li>\n\n\n\n<li><strong>Check prior authorization requirements.<\/strong> Many commercial payers require pre-authorization for elective musculoskeletal surgery, and submitting without an authorization number is a preventable denial.<\/li>\n\n\n\n<li><strong>Track the 90-day global window.<\/strong> Flag every post-op appointment in the practice management system, so billing staff know which encounters fall inside the global period.<\/li>\n\n\n\n<li><strong>Do not bill anesthesia from the surgeon&#8217;s claim.<\/strong> The anesthesiologist or nurse anesthetist bills it separately, using the appropriate anesthesia base code.<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-how-practice-management-software-streamlines-cpt-21720-billing\" class=\"wp-block-heading\">How practice management software streamlines CPT 21720 billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Surgical code billing fails at three predictable points.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The wrong modifier for the payer&#8217;s bilateral format<\/li>\n\n\n\n<li>A diagnosis code that does not support the surgical approach<\/li>\n\n\n\n<li>A post-op visit billed inside the global window without -24<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Each one sends the claim back for rework and pushes payment out by weeks. <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">Claims management software<\/a> that validates modifiers inside the billing workflow catches all three before the claim leaves the practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau connects clinical documentation to the billing queue. When a surgeon closes an encounter note, the procedure and diagnosis codes flow straight into the claim draft.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21720\/automate-claims-through-healthcode.webp\" alt=\"Pabau claims management screen showing a submitted surgical claim\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s claims tools send a surgical claim from the treatment note, so a 21720 line item leaves with its modifier already checked.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The system flags modifier combinations that conflict with NCCI edits. It also surfaces the global period end date on every surgical claim. Billing staff resolve both inside one workflow, instead of switching between a code lookup tool and a separate billing system.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For practices using <a href=\"https:\/\/pabau.com\/features\/automated-workflows-software\/\">automated billing workflows<\/a>, the global period tracking does the calendar math. The system marks post-op encounters against the open global period and alerts staff before a routine visit becomes an erroneous claim.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21720\/automated-communication-in-pabau.webp\" alt=\"Automated communication in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s automated messages handle post-op follow-up, so nobody phones round every torticollis patient during the 90-day global window.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/blog\/practice-management-software\/\">Practice management software<\/a> that holds the chart, the code, and the claim removes one copy step. Nobody retypes a code from a lookup tool into a separate billing screen.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Set up a global period alert for every surgical claim. For CPT 21720, flag the 91st day after the procedure date as the point where the global window closes. That stops billing staff generating claims for routine post-op encounters without the -24 modifier.<\/p>\n            <\/div>\n        <\/div>\n    \n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Reduce surgical claim denials with smarter workflows                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims tools track modifier requirements and global periods for surgical codes like CPT 21720. See how it fits your practice&#8217;s billing workflow.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The whole billing risk on this code sits in three places. Read the operative note for the cast, watch the 90-day global window, and match the modifier to your payer&#8217;s bilateral format. Get those right and 21720 pays on first submission.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices that leave the checks to memory pay for it later in denial work. That stings most on a code that comes through the door a few times a year. Building the checks into the billing workflow is the cheaper habit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s claims management software keeps modifier logic, global period dates, and diagnosis pairing on the same screen as the claim. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how it handles surgical coding for your practice.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing another code in the same neck and thorax range?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21925\/\">CPT 21925<\/a> walks through deep soft tissue biopsy of the back or flank, with the same modifier and documentation checks.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need the modifier and reimbursement rules for a neighboring code?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21497\/\">CPT 21497<\/a> covers interdental wiring, including how payers handle unusual complexity.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Working out how to sequence a secondary diagnosis?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s338xxs\/\">S33.8XXS<\/a> sets out sequencing order and the denial patterns that follow a weak primary code.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Chasing pre-authorization before an elective surgery?<\/strong> Our <a href=\"https:\/\/pabau.com\/templates\/medical-prior-authorization-form\/\">prior authorization form<\/a> gives you the fields payers ask for, ready to send with the clinical notes.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding the same surgery for a UK payer?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/bupa-ccsd-codes\/\">Bupa CCSD codes<\/a> explains the procedure coding and billing rules that replace CPT outside the US.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786522309295\"><h3 class=\"schema-faq-question\">What is CPT code 21720 used for?<\/h3> <p class=\"schema-faq-answer\">CPT code 21720 bills the open division of the sternocleidomastoid muscle to treat torticollis, with no cast applied in the same session. It sits in the Neck (Soft Tissue) and Thorax subsection of the CPT Musculoskeletal System section. Orthopedic and pediatric surgeons perform it most often, usually on children whose congenital muscular torticollis has not responded to stretching.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786522309296\"><h3 class=\"schema-faq-question\">What is the difference between CPT 21720 and CPT 21725?<\/h3> <p class=\"schema-faq-answer\">The only difference is whether a cast is applied during the same operative session. Use 21720 when no cast is placed. Use 21725 when a cast goes on before the patient leaves the operating room. Both codes describe an open division of the sternocleidomastoid for torticollis. Your selection must match the operative report, because billing 21725 with no cast inflates the claim.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786522309297\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 21720?<\/h3> <p class=\"schema-faq-answer\">Modifier -50 covers a bilateral release, where both sternocleidomastoid muscles are divided in the same session. Modifiers -LT and -RT document laterality on a unilateral case. Modifier -62 applies when two surgeons of different specialties each perform a distinct part of the procedure. Modifier -22 covers substantially increased operative complexity. Check your payer&#8217;s billing manual before applying -50, because some commercial payers want two line items instead.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786522309298\"><h3 class=\"schema-faq-question\">What is the global period for CPT code 21720?<\/h3> <p class=\"schema-faq-answer\">CPT code 21720 carries a 90-day global surgery period. The global window begins on the day of surgery and covers all routine pre-operative and post-operative care through day 90. Routine post-op visits billed inside the global period without modifier -24 will deny. Care for a completely unrelated diagnosis, an unplanned return to the operating room, and treatment of major complications can all be billed separately.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786522309299\"><h3 class=\"schema-faq-question\">What ICD-10 codes pair with CPT 21720?<\/h3> <p class=\"schema-faq-answer\">The primary ICD-10 diagnosis code is M43.6, which covers acquired and muscular torticollis broadly. For congenital muscular torticollis in pediatric patients, Q68.0 is the more precise and increasingly preferred code. G24.3 applies only when a dystonic component is clinically documented. Plagiocephaly often accompanies congenital cases, so Q67.3 can be reported as a secondary diagnosis. Always verify against the payer&#8217;s LCD policy first.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786522309300\"><h3 class=\"schema-faq-question\">Is CPT 21720 a bilateral procedure?<\/h3> <p class=\"schema-faq-answer\">CPT 21720 can be performed bilaterally when both sternocleidomastoid muscles need dividing in the same session, though unilateral release is more common. Bilateral cases carry modifier -50, or two line items with -LT and -RT where the payer prefers that format. Medicare typically reimburses a bilateral procedure at about 150% of the unilateral rate. Confirm the policy with each payer first, because commercial rules vary.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>CPT code 21720 is the billable code for open division of the sternocleidomastoid muscle to correct torticollis, without cast application. Its official descriptor reads: Division of sternocleidomastoid for torticollis, open operation, without cast application. The code sits in the Musculoskeletal System section of AMA&#8217;s CPT code set, under the Neck (Soft Tissue) and Thorax subsection. [&hellip;]<\/p>\n","protected":false},"author":82,"featured_media":176240,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"83","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[],"class_list":["post-176241","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT code 21720 or 21725? Modifiers, global period, and RVUs<\/title>\n<meta name=\"description\" content=\"CPT code 21720 covers open sternocleidomastoid division for torticollis with no cast. Use 21725 when a cast goes on in the same session.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21720\/\" \/>\n<meta property=\"og:locale\" content=\"nl_NL\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 21720 or 21725? Modifiers, global period, and RVUs\" \/>\n<meta property=\"og:description\" content=\"CPT code 21720 covers open sternocleidomastoid division for torticollis with no cast. Use 21725 when a cast goes on in the same session.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21720\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-12T11:35:01+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-12T12:12:47+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-21720.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Maja Popovska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Geschreven door\" \/>\n\t<meta name=\"twitter:data1\" content=\"Maja Popovska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Geschatte leestijd\" \/>\n\t<meta name=\"twitter:data2\" content=\"13 minuten\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/\"},\"author\":{\"name\":\"Maja Popovska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#\\\/schema\\\/person\\\/b00aec1dd379f0ddcf6137d78e2a21db\"},\"headline\":\"CPT code 21720: Division of sternocleidomastoid for torticollis\",\"datePublished\":\"2026-08-12T11:35:01+00:00\",\"dateModified\":\"2026-08-12T12:12:47+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/\"},\"wordCount\":2564,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21720.webp\",\"articleSection\":[\"Billing Codes\",\"CPT Codes\"],\"inLanguage\":\"nl-NL\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/\",\"name\":\"CPT code 21720 or 21725? Modifiers, global period, and RVUs\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21720\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21720.webp\",\"datePublished\":\"2026-08-12T11:35:01+00:00\",\"dateModified\":\"2026-08-12T12:12:47+00:00\",\"description\":\"CPT code 21720 covers open sternocleidomastoid division for torticollis with no cast. 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Always verify against the payer's LCD policy first.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21720\/#faq-question-1786522309300","position":6,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21720\/#faq-question-1786522309300","name":"Is CPT 21720 a bilateral procedure?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 21720 can be performed bilaterally when both sternocleidomastoid muscles need dividing in the same session, though unilateral release is more common. Bilateral cases carry modifier -50, or two line items with -LT and -RT where the payer prefers that format. Medicare typically reimburses a bilateral procedure at about 150% of the unilateral rate. Confirm the policy with each payer first, because commercial rules vary.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"}]}},"yoast":{"focus_keyword":"CPT code 21720","seo_title":"CPT code 21720 or 21725? Modifiers, global period, and RVUs","meta_description":"CPT code 21720 covers open sternocleidomastoid division for torticollis with no cast. Use 21725 when a cast goes on in the same session.","content_score":"30","is_cornerstone":"","related_keyphrases":[{"keyword":"sternocleidomastoid release procedure","score":61},{"keyword":"modifier 50 bilateral surgery","score":61},{"keyword":"global surgery period cpt","score":61},{"keyword":"rvu values surgical codes","score":61},{"keyword":"torticollis icd-10 code","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/176241","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/users\/82"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/comments?post=176241"}],"version-history":[{"count":3,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/176241\/revisions"}],"predecessor-version":[{"id":176719,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/176241\/revisions\/176719"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/media\/176240"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/media?parent=176241"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/categories?post=176241"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/tags?post=176241"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}