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See a sample rate comparisonCPT 20931 Fee Schedule
Medicare rates as of October 2026
CPT 20931 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Sp Bone Algrft Struct Add On, Allograft Structural For Spine Surgery Only List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | ASPA/NP/CNS assistant at surgery 59Distinct Procedural Service |
| Surgery Center Payment (ASC) | N1 - Packaged; no separate payment |
| Add-on Code For | 2231922532Sign up to view all 23 |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $98.20 national non-facility rate (2026)View Medicare rates for 20931 |
| Medicaid Fee Schedule | $81.705 median of the 8 states in the free previewView Medicaid rates for 20931 |
National average reimbursement for CPT 20931 by major payers:
$151.02
BCBS / Anthem
$153.62
UnitedHealthcare
$162.74
Aetna
$179.94
Cigna
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CPT 20931
5 of 25 sample ratesHigher to lower in this preview
Los Gatos Surgical Center, A California Limited Partnership
$2,830.00Published rateTallahassee Orthpaedic Surgery Partners Ltd
$555.00Published rateBerks Center For Digestive Health, Lp
$235.00Published rateColonial Outpatient Surgery Center, LLC
Colonial Outpatient Surgery Center LLC
$115.00Published rateChildrens Surgery Center Of Malvern, LLC
Childrens Surgery Center Of Malvern LLC
$65.00Published rate
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See a sample payer proposalCPT 20931 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20931. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 20930-CPT | Sp Bone Algrft Morsel Add On, Allograft Morselized Or Placement Of Osteopromotive Material For Spine Surgery Only List Separately In Addition To Code For Primary Procedure |
| 20931-CPT | Sp Bone Algrft Struct Add On, Allograft Structural For Spine Surgery Only List Separately In Addition To Code For Primary Procedure |
| 20932-CPT | Osteoart Algrft W Surf B1, Allograft Includes Templating Cutting Placement And Internal Fixation When Performed Osteoarticular Including Articular Surface And Contiguous Bone List Separately In Addition To Code For Primary Procedure |
| 20936-CPT | Sp Bone Agrft Local Add On, Autograft For Spine Surgery Only Includes Harvesting The Graft Local Eg Ribs Spinous Process Or Laminar Fragments Obtained From Same Incision List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20931. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20931 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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Frequently Asked Questions
How does Medicare pay for CPT 20931 in an ambulatory surgery center?
CMS lists CPT 20931 with ASC payment indicator N1: Packaged; no separate payment.
Is CPT 20931 an add-on code?
Yes. CMS add-on code edits list CPT 20931 as an add-on code, billed with a primary code. Its primary codes: including 22319, 22532, 22533, 22548 and 22551.
Which revenue codes are billed with CPT 20931?
Hospital price transparency files list CPT 20931 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.