CPT 20693 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 58 - Staged or related procedure during postoperative period • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20693 |
National average reimbursement for CPT 20693 by major payers:
$596.11
$609.62
$640.06
$763.68
| 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 20693 | ||||||
United | 20693 | $6342.00 | 1851887863 - TEXAS HEALTH SURGERY CENTER IRVING, LLC | 831085415 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $1900.00 | 1972853810 - UNIVERSITY OF HOUSTON SYSTEM, UH COLLEGE OF OPTOMETRY SURGERY CENTER | 746001399 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $985.00 | 1407079155 - NORTHERN VIRGINIA EYE SURGERY CENTER, LLC | 204062750 - (VA) NORTHERN VIRGINIA EYE SURGERY 401(K) PROFIT SHARING PLAN AND TRUST | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $3347.00 | 1154956928 - ADVANCED SURGICAL CARE OF CLEARWATER LLC | 833698204 - (FL) ADVANCED SURGICAL CARE OF CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $1540.00 | 1073026639 - MID CITY SPECIALTY CENTER, LLC | 822996794 - (LA) MID CITY SPECIALTY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $724.00 | 1518998764 - TENNESSEE PAIN SURGERY CENTER, LLC | 621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $1335.00 | 1073621512 - DIGESTIVE DISEASE CENTER | 880291959 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $1980.00 | 1578918124 - CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | 811657416 - (ND) CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $2799.00 | 1881339133 - BSC SHEA PARK LLC | 881850069 - (AZ) BSC SHEA PARK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $4461.00 | 1699738112 - NORTH AUSTIN SURGERY CENTER, L.P. | 200648730 - (TX) NORTH AUSTIN SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $1231.00 | 1033222989 - EMPIRE SURGERY CENTER | 770581233 - (CA) EMPIRE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $2267.00 | 1285108845 - MARIETTA ADVANCED SURGERY CENTER | 832382468 - (GA) MARIETTA ADVANCED SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $1339.00 | 1982744231 - SOUTHLAND ENDOSCOPY CENTER, SOUTHLAND ENDOSCOPY CENTER | 330607952 - (CA) SOUTHLAND ENDOSCOPY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $682.00 | 1518009430 - WELLBROOK ENDOSCOPY CENTER, LLC | 582258386 - (GA) WELLBROOK ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20693 | $856.00 | 1073845087 - EYE SURGERY CENTERS OF ARIZONA, LLC, EYE SURGERY AT THE BILTMORE, LLC | 271798256 - (AZ) EYE SURGERY CENTERS OF ARIZONA 401(K) PROFIT SHARING PLAN & TRUST | AZ | 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 20693 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20693 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 20693 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 |
|---|---|---|
| 20650-CPT | Moderate | Insert Wire/Pin Skeletal Traction |
| 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)) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20693. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20693 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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