CPT 20696 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20696 |
National average reimbursement for CPT 20696 by major payers:
$1,615.29
$1,566.55
$1,619.03
$1,973.07
| 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 20696 | ||||||
United | 20696 | $619.00 | 1881684538 - MCPEAK SURGERY CENTER LLC | 611310261 - (KY) MCPEAK SURGERY CENTER LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $2307.00 | 1023036688 - BAYSIDE AMBULATORY CENTER, LLC | 510438152 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $3188.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $1989.00 | 1992702443 - THE EASTSIDE ENDOSCOPY CENTER LLC | 911665997 - (WA) THE EASTSIDE ENDOSCOPY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $950.00 | 1407095359 - PAIN CARE CENTER OF GEORGIA LLC | 814348805 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $1486.00 | 1487187076 - GREEN VALLEY SURGERY CENTER LLC | 812240255 - (NV) GREEN VALLEY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $1431.00 | 1578567954 - E. RONALD SALVITTI, M.D., INC., SOUTHWESTERN PA EYE SURGERY CENTER | 251787703 - (PA) E. RONALD SALVITTI, M.D., INC. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $2328.00 | 1811926728 - FOOTHILL SURGERY CENTER, LLC, FOOTHILL SURGERY CENTER | 510453471 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $3201.00 | 1194813840 - SURGERY CENTER OF WISCONSIN RAPIDS, LLC | 203672837 - (WI) SURGERY CENTER OF WISCONSIN RAPIDS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $2380.00 | 1487221404 - EYE SURGICAL SERVICES LLC, GATEWAY SURGERY CENTER | 834616432 - (MO) EYE SURGICAL SERVICES, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $2376.00 | 1033195912 - SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC, AVERA ENDOSCOPY/SURGICAL CENTER | 460461429 - (SD) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $2010.00 | 1639682503 - SOUTH PLAINS SURGERY CENTER LLC | 822142398 - (TX) SOUTH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $1142.00 | 1811932270 - PHILADELPHIA SURGI CENTER, INC. | 232965126 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $2169.00 | 1871608216 - COVENANT HIGH PLAINS SURGERY CENTER, LLC, COVENANT HIGH PLAINS SURGERY CENTER - 22ND STREET | 752177401 - (TX) COVENANT HIGH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20696 | $2039.00 | 1871257071 - SOUTHDALE SPECIALTY SURGERY CENTER, LLC, BHATTI GI CONSULTANTS, P.A. | 873212683 - (MN) SOUTHDALE SPECIALTY SURGERY CENTER LLC | MN | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 20696 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20696 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 20696 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 |
| 20661-CPT | Moderate | Application Of Cranial Halo Device (Stabilization Device For Skull) |
| 20692-CPT | High | Application Of A Multiplane (Pins Or Wires In More Than 1 Plane), Unilateral, External Fixation System (Eg, Ilizarov, Monticelli Type) |
| 20696-CPT | High | 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20696. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20696 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 20696) and we'll show you how you compare in 15 minutes or less.