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 20956 Fee Schedule
Medicare rates as of October 2026
CPT 20956 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Iliac Crestbone Graft With Microvascular Anastomosis Iliac Crest
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 59Distinct Procedural Service RTRight side of body |
| 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 | $2,355.43 national non-facility rate (2026)View Medicare rates for 20956 |
| Medicaid Fee Schedule | $1,864.97 median of the 8 states in the free previewView Medicaid rates for 20956 |
National average reimbursement for CPT 20956 by major payers:
$3,822.23
BCBS / Anthem
$3,597.11
UnitedHealthcare
$3,654.56
Aetna
$4,300.90
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20956.
CPT 20956
5 of 25 sample ratesHigher to lower in this preview
Novant Health Clemmons Outpatient Surgery, LLC
Novant Health Clemmons Outpatient Surgery LLC
$10,126.00Published rateThe Surgery Center Of Greater Nashua
Surgery Center Of Greater Nashua
$5,301.00Published ratePacific Cataract And Laser Institute Inc PC
Pacific Cataract And Laser Institute, Inc., PC
$2,788.00Published rateLaser & Cataract Center Of Shreveport LLC, Eye Surgery Center
Laser Cataract Center Of Shreveport LLC
$1,956.00Published rateSpalding Endoscopy Center, LLC
Spalding Endoscopy Center LLC
$729.00Published 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 20956 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20956. 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 20956. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20956 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 20956) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
What APC is CPT 20956 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20956 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 20956 in an ambulatory surgery center?
CMS lists CPT 20956 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 20956?
Hospital price transparency files list CPT 20956 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.