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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 | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20950 |
| Medicaid Fee Schedule | View Medicaid rates for 20950 |
National average reimbursement for CPT 20950 by major payers:

$301.91

$339.79

$367.72

$413.27
Choose a payer to see a sample of rates for CPT 20950.
Silicon Valley Surgery Center, L.P.
Chattanooga Endoscopy, Asc, LLC
Joint Replacement Center Of Lous
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 20950 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20950 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 20950 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. |
| 20936-CPT | Low | 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 |
| 20950-CPT | Moderate | Mntr Intrstitial Fluid Press, Monitoring Of Interstitial Fluid Pressure (Includes Insertion Of Device Eg Wick Catheter Technique Needle Manometer Technique) In Detection Of Muscle Compartment Syndrome |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20950. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20950 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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