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See a sample rate comparisonHealthcare 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 | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20900 |
| Medicaid Fee Schedule | View Medicaid rates for 20900 |
National average reimbursement for CPT 20900 by major payers:

$500.11

$576.40

$579.16

$362.89
Choose a payer to see a sample of rates for CPT 20900.
Bay Surgery Centers
The Plastic Surgicentre, Inc.
Deaconess Hospital Inc
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 20900 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20900 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 20900 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 |
|---|---|---|
| 20900-CPT | Moderate | Bone Grft Any Donor Area; Minor Or Small (Eg Dowel Or Button), Bone Graft Any Donor Area; Minor Or Small (Eg Dowel Or Button) |
| 20902-CPT | Moderate | Collect Bone For Graft, Surgery To Take Healthy Bone From Rib Hip Leg Or Other Site To Use In Repairing A Skeletal Problem. |
| 20910-CPT | Moderate | Collect Cartilage For Graft, Surgery To Take Healthy Cartilage From Nasal Septum Or Rib For Reconstruction Of Another Area. |
| 20912-CPT | Moderate | Collect Cartilage For Graft, Surgery To Take Healthy Cartilage From Nasal Septum Or Rib For Reconstruction Of Another Area. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20900 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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