CPT 20939 Fee Schedule
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.
| 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 | Low |
National average reimbursement for CPT 20939 by major payers:
$100.57
$95.59
$96.96
$123.08
| 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 20939 | ||||||
United | 20939 | $344.00 | 1003110792 - CREVE COEUR SURGERY CENTER, LLC, CITY PLACE SURGERY CENTER | 273332421 - (MO) CREVE COEUR SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $1446.00 | 1073694550 - ROCKWALL AMBULATORY SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - ROCKWALL | 205506447 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $1446.00 | 1780683490 - METROCREST SURGERY CENTER LP, BAYLOR SURGICARE AT CARROLLTON | 30380493 - (TX) METROCREST SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $550.00 | 1811052749 - GDC ENDOSCOPY CENTER LLC | 651240653 - (GA) GDC ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $115.00 | 1518998764 - TENNESSEE PAIN SURGERY CENTER, LLC | 621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $85.00 | 1124559679 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER III | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $1029.00 | 1902844426 - SOUTH ARLINGTON SURGICAL PROVIDERS, LLC, SAME DAY SURGICARE | 752723958 - (TX) SOUTH ARLINGTON SURGICAL PROVIDERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $85.00 | 1487627642 - SURGERY CENTER OF CORAL GABLES LLC, SURGERY CENTER OF CORAL GABLES LLC | 621827649 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $6623.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $150.00 | 1497706626 - CHICAGO PROSTATE CANCER SURGERY CENTER, LLC, DUPAGE MEDICAL GROUP SURGERY CENTER, WESTMONT | 204403852 - (IL) CHICAGO PROSTATE CANCER SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $128.00 | 1164697009 - BOX HILL SURGERY CENTER LLC | 262454678 - (MD) BOX HILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $124.00 | 1134777832 - PETERS ENDOSCOPY CENTER, LLC | 842583326 - (NC) PETERS ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $572.00 | 1508863242 - BUFFALO SURGERY CENTER LLC | 161574540 - (NY) BUFFALO SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $357.00 | 1740288679 - GULF COAST SURGICAL PARTNERS LLC | 631285913 - (AL) GULF COAST SURGICAL PARTNERS LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20939 | $574.00 | 1063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER | 371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLC | IL | 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 |
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CPT 20939 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20939 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 20939 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 | Allograft, Morselized, Or Placement Of Osteopromotive Material, For Spine Surgery Only; (List Separately In Addition To Code For Primary Procedure) |
| 20931-CPT | Low | Allograft, Structural, For Spine Surgery Only; (List Separately In Addition To Code For Primary Procedure) |
| 20936-CPT | Low | 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) |
| 20939-CPT | Low | Bone Marrow Aspiration For Bone Grafting Spine Surgery Only Through Separate Skin Or Fascial 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 20939. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20939 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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