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See a sample rate comparisonCPT 20805 Fee Schedule
Last Verified: October 2026
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.
Replant Forearm (Inclu Radius & Ulna To Radial Carpal Joint, Replantation Forearm (Includes Radius And Ulna To Radial Carpal Joint
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body GC - Service performed by resident under supervision RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20805 |
| Medicaid Fee Schedule | View Medicaid rates for 20805 |
National average reimbursement for CPT 20805 by major payers:
$4,451.37
$3,775.69
$3,361.53
$5,257.92
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CPT 20805
5 of 25 sample ratesHigher to lower in this preview
Texas Health Orthopedic Surgery Center Alliance, LLC, Texas Health Orthopedic Surgery Center Heritage
Texas Health Orthopedic Surgery Center Alliance LLC
$11,960.00Published rateNorthern Michigan Surgical Suites, LLC
$9,324.00Published rateAmerican Access Care Of Miami Asc LLC, Azura Surgery Center Miami
American Access Care Of Miami Asc LLC
$5,953.00Published rateNew Albany Outpatient Surgery, LLC, Surgical Center Of New Albany
$1,550.00Published rateLaser Surgery Holding Company, Ltd
Laser Surgery Holding Company Lt
$894.00Published rate
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See a sample payer proposalCPT 20805 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20805 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 20805 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 |
|---|---|---|
| 20802-CPT | High | Replant Arm (Inclu Surg Nck Humerus Through Elbow Joi, Replantation Arm (Includes Surgical Neck Of Humerus Through Elbow Joi |
| 20805-CPT | High | Replant Forearm (Inclu Radius & Ulna To Radial Carpal Joint, Replantation Forearm (Includes Radius And Ulna To Radial Carpal Joint |
| 20808-CPT | High | Replant Hand (Inclu Hand Through Metacarpophalang Joint), Replantation Hand (Includes Hand Through Metacarpophalangeal Joints) |
| 20955-CPT | High | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Fibulabone Graft With Microvascular Anastomosis Fibula |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20805. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20805 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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