CPT 20692 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20692 |
National average reimbursement for CPT 20692 by major payers:
$1,398.24
$1,392.06
$1,535.78
$1,792.17
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 20692 | ||||||
United | 20692 | $6342.00 | 1104341254 - TEXAS HEALTH SURGERY CENTER ALLIANCE, LLC, TEXAS HEALTH SURGERY CENTER ALLIANCE | 822296081 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $1147.00 | 1306877261 - NORTHEAST ALABAMA EYE SURGERY CENTER, NORTHEAST AL EYE SURGERY | 631277373 - (AL) NORTHEAST ALABAMA EYE SURGERY CENTER | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $2585.00 | 1366137440 - SURGERY CENTER OF GEORGETOWN, LLC, GEORGETOWN SURGERY CENTER | 880604963 - (TX) SURGERY CENTER OF GEORGETOWN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $6342.00 | 1154566578 - WOMEN'S SPECIALTY SURGERY CENTER OF DALLAS, LLC | 262310072 - (TX) TEXAS HEALTH WOMEN'S SPECIALTY SURGERY CENTER OF DALLAS, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $3350.00 | 1982680492 - ROCKLAND SURGICAL PROJECT, LLC, RAMAPO VALLEY SURGICAL CENTER | 200580403 - (NJ) ROCKLAND SURGICAL PROJECT LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $1200.00 | 1114907920 - MIAMI ASC LP, THE ENDOSCOPY CENTER | 621600424 - (FL) MIAMI ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $3623.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $3570.00 | 1760491385 - ENDOSCOPY CENTER OF NORTHERN OHIO, LLC | 341966846 - (OH) ENDOSCOPY CENTER OF NORTHERN OHIO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $763.00 | 1558327445 - MERCY AMBULATORY SURGERY CENTER LTD | 631178796 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $3623.00 | 1477615284 - ROCKY MOUNTAIN ENDOSCOPY CENTERS, LLC | 841403147 - (CO) ROCKY MOUNTAIN ENDOSCOPY CENTERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $2770.00 | 1346621893 - NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | 472128570 - (NJ) NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $654.00 | 1336272657 - ARIZONA DIGESTIVE CENTER, P.C. | 201544723 - (AZ) ARIZONA DIGESTIVE CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $1300.00 | 1609803204 - AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC, AFFILIATED ENDOSCOPY SERVICES OF CLIFTON | 270064844 - (NJ) AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $5213.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20692 | $2549.00 | 1831686674 - CASTLE ROCK SURGICENTER, LLC | 825207935 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 20692 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20692 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 20692 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 20690-CPT | Moderate | Apply External Fixation System |
| 20692-CPT | High | Application Of A Multiplane (Pins Or Wires In More Than 1 Plane), Unilateral, External Fixation System (Eg, Ilizarov, Monticelli Type) |
| 20693-CPT | Moderate | Adjustment Or Revision Of External Fixation System Requiring Anesthesia (Eg, New Pin(S) Or Wire(S) And/Or New Ring(S) Or Bar(S)) |
| 20694-CPT | Moderate | Remove Under Anes Ext Fix Sys |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20692. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20692 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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