Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 20955 Fee Schedule
Medicare rates as of October 2026
CPT 20955 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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 | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 62Co-Surgeons GCService performed by resident under supervision |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $2,267.92 national non-facility rate (2026)View Medicare rates for 20955 |
| Medicaid Fee Schedule | $1,938.52 median of the 8 states in the free previewView Medicaid rates for 20955 |
National average reimbursement for CPT 20955 by major payers:
$3,465.42
BCBS / Anthem
$3,387.99
UnitedHealthcare
$3,521.81
Aetna
$4,070.51
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20955.
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
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Looking for other data?
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 20955 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20955. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 20955-CPT | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Fibulabone Graft With Microvascular Anastomosis Fibula |
| 20956-CPT | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Iliac Crestbone Graft With Microvascular Anastomosis Iliac Crest |
| 20957-CPT | Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Metatarsalbone Graft With Microvascular Anastomosis Metatarsal |
| 20962-CPT | 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 20955) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
What APC is CPT 20955 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20955 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20955 in an ambulatory surgery center?
CMS lists CPT 20955 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 20955?
Hospital price transparency files list CPT 20955 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.