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See a sample rate comparisonCPT 20934 Fee Schedule
Last Verified: October 2026
Healthcare 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.
Intercalary Algrft Compl, Allograft Includes Templating Cutting Placement And Internal Fixation When Performed Intercalary Complete Ie Cylindrical 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 | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20934 |
| Medicaid Fee Schedule | View Medicaid rates for 20934 |
National average reimbursement for CPT 20934 by major payers:
$925.92
$993.74
$1,000.80
$1,200.54
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CPT 20934
5 of 25 sample ratesHigher to lower in this preview
Lexington Health Inc, Lmc Northeast Asc
Lexington Health Inc
$1,901.00Published rateSurgcenter Of Silver Spring, LLC
Surgcenter Of Silver Spring LLC
$506.00Published rateAkdhc Surgery Center, LLC
$245.00Published rateCheckerspot Surgery Centers, LLC
Checkerspot Surgery Centers LLC
$137.00Published rateHattiesburg Surgery Center, LLC
Hattiesburg Surgery Center LLC
$79.00Published rate
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See a sample payer proposalCPT 20934 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20934 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 20934 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 |
|---|---|---|
| 20930-CPT | Low | 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 | Low | Sp Bone Algrft Struct Add On, Allograft Structural For Spine Surgery Only List Separately In Addition To Code For Primary Procedure |
| 20932-CPT | Moderate | 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 |
| 20934-CPT | Moderate | Intercalary Algrft Compl, Allograft Includes Templating Cutting Placement And Internal Fixation When Performed Intercalary Complete Ie Cylindrical 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 20934. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20934 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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