Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 20694 Fee Schedule
Medicare rates as of October 2026
CPT 20694 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Remove External Bone Hardware, Removal Of External Fixation System (Metal Hardware Placed Outside Of The Skin To Stabilize Broken Bones).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 58Staged or related procedure during postoperative period RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5112 - Level 2 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 20702 |
| Common Revenue Codes | 03600361Sign up to view all 8 |
| Medicare Fee Schedule | $461.93 national non-facility rate (2026)View Medicare rates for 20694 |
| Medicaid Fee Schedule | $367.955 median of the 8 states in the free previewView Medicaid rates for 20694 |
National average reimbursement for CPT 20694 by major payers:
$549.80
BCBS / Anthem
$573.59
UnitedHealthcare
$611.36
Aetna
$566.90
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20694.
CPT 20694
5 of 25 sample ratesHigher to lower in this preview
Peak One Surgery Center, LLC, Peak One Surgery Center
Peak One Surgery Center LLC
$4,618.00Published rateSanta Barbara Surgery Center Lp
$1,528.00Published rateJonathan Balagna
Deaconess Hospital Inc
$743.15Published rateMadison Street Surgery Center, LLC
Madison Street Surgery Center LLC
$555.00Published rateJ J Young Md, The Cataract Center Of Lawton
J J Young Md
$300.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Looking for other data?
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 20694 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20694. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 20692-CPT | Application Of A Multiplane (P, Application Of A Multiplane (Pins Or Wires In Morethan One Plane) Unilateral External Fixation Sy Stem (E.G. Ilizarov Monticelli Type) |
| 20693-CPT | Adjustment Or Revision Of Exte, Adjustment Or Revision Of External Fixation Systemrequiringanesthesia (Eg New Pin(S) Or Wire(S) An Dor New Ring(S) Or Bar(S)) |
| 20694-CPT | Remove External Bone Hardware, Removal Of External Fixation System (Metal Hardware Placed Outside Of The Skin To Stabilize Broken Bones). |
| 20696-CPT | App Mltpln Uni Xtrnl Fix 1st, Application Of Multiplane Pins Or Wires In More Than 1 Plane Unilateral External Fixation With Stereotactic Computer Assisted Adjustment Eg Spatial Frame Including Imaging Initial And Subsequent Alignment S Assessment S And Computation S Of Adjustment Schedule S |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20694. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20694 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 20694) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
What APC is CPT 20694 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20694 to APC 5112 (Level 2 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20694 in an ambulatory surgery center?
CMS lists CPT 20694 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 20694?
CMS add-on code edits list CPT 20694 as a primary code for these add-on codes: 20702.
Which revenue codes are billed with CPT 20694?
Hospital price transparency files list CPT 20694 under these revenue codes: including 0360, 0361, 0761, 0960 and 0975. A revenue code names the hospital department or charge category for the line; it does not change what the service is.