CPT 20950 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 | • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 20950 by major payers:
$301.91
$339.79
$367.72
$428.91
| 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 20950 | ||||||
United | 20950 | $392.00 | 1891722609 - EYE MDS OF PUGET SOUND PLLC, NARROWS EYE SURGERY CENTER | 43700768 - (WA) EYE M.D.S OF PUGET SOUND, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $225.00 | 1891951885 - MISSISSIPPI EYE SURGERY CENTER, MISSISSIPPI EYE SURGERY CENTER FACILITY | 770619942 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $375.00 | 1578088787 - VACCO LLC | 821221738 - (OH) VACCO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $1172.00 | 1962893354 - WESTMORELAND ASC, LLC, APEX SURGICAL CENTER | 462808005 - (NY) WESTMORELAND ASC, LLC DBA APEX | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $1040.00 | 1639850415 - MEDICAL CITY SURGERY CENTER OF ALLEN, LLC | 932106228 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $592.00 | 1346596566 - SCP INDIANAPOLIS LLC | 460639908 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $341.00 | 1851845986 - WEST SHORE PAIN AND SPINE INSTITUTE, LLC | 812668532 - (PA) WEST SHORE PAIN AND SPINE INSTITUTE LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $415.00 | 1326388000 - SOUTHEASTERN ORTHOPAEDICS SURGERY CENTER | 352467951 - (GA) SOUTHEASTERN ORTHOPAEDICS SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $953.00 | 1215675111 - GRANGER SURGERY CENTER LLC, NORTHERN INDIANA SURGERY CENTER LLC | 850956968 - (IN) GRANGER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $649.00 | 1932718822 - CHARLES REGIONAL SURGICAL CENTER LLC | 833560882 - (MD) CHARLES REGIONAL SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $450.00 | 1659463669 - ARUSHA LLC, THE SURGERY CENTER OF CHESTER COUNTY | 233076222 - (PA) ARUSHA LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $250.00 | 1043205040 - ST LUKES SURGICAL CENTER INC | 592407224 - (FL) ST LUKES SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $1158.00 | 1629559208 - ORTHOARIZONA SURGERY CENTER GILBERT, LLC, ORTHOARIZONA SURGERY CENTER GILBERT | 823624585 - (AZ) ORTHOARIZONA SURGERY CENTER GILBERT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $98.00 | 1528134293 - MARYLAND AESTHETIC AND RECONSTRUCTIVE AMBULATORY SURGICAL CENTER LLC | 522277480 - (MD) MARYLAND AESTHETIC AND RECONSTRUCTIVE AMBULATORY SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20950 | $893.00 | 1376779561 - SURGICARE OF MIRAMAR LLC | 208552194 - (FL) SURGICARE OF MIRAMAR LLC | FL | 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 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 Graft Any Donor Area Minor/Small |
| 20902-CPT | Moderate | Graft Bone Any Major/Large |
| 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) |
| 20950-CPT | Moderate | 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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