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See a sample rate comparisonCPT 20955 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Fibulabone Graft With Microvascular Anastomosis Fibula
| 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 62 - Co-Surgeons GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20955 |
| Medicaid Fee Schedule | View Medicaid rates for 20955 |
National average reimbursement for CPT 20955 by major payers:
$3,465.42
$3,387.99
$3,521.81
$4,070.51
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CPT 20955
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Memorial City LLC, Memorial Hermann Memorial Village Surgery Center
$8,825.00Published rateSummit Ambulatory Surgical Center, LLC
$6,506.00Published rateBaptist Health Surgery Center LLC, Baptist Health Surgery Center At Kendall
Baptist Health Surgery Center LLC
$3,320.00Published rateEnglewood Surgery Center, LLC
Englewood Surgery Center LLC
$2,300.00Published rateLancaster Surgery Center, Inc.
Lancaster Surgery Center Inc
$1,250.00Published rate
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See a sample payer proposalCPT 20955 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20955 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 20955 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 |
|---|---|---|
| 20955-CPT | High | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Fibulabone Graft With Microvascular Anastomosis Fibula |
| 20956-CPT | High | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Iliac Crestbone Graft With Microvascular Anastomosis Iliac Crest |
| 20957-CPT | High | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Metatarsalbone Graft With Microvascular Anastomosis Metatarsal |
| 20962-CPT | High | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Other Thanfibula Iliac Crest Or Metatarsal Bone Graft With Microvascular Anastomosis Other Than |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20955. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20955 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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