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See a sample rate comparisonCPT 20957 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 Metatarsalbone Graft With Microvascular Anastomosis Metatarsal
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None RT - Right side of body T5 - Right foot, great toe 59 - Distinct Procedural Service LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20957 |
| Medicaid Fee Schedule | View Medicaid rates for 20957 |
National average reimbursement for CPT 20957 by major payers:
$3,634.97
$3,576.36
$3,609.71
$4,335.97
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CPT 20957
5 of 25 sample ratesHigher to lower in this preview
Summit Ambulatory Surgical Center, LLC
$6,588.00Published rateTallahassee Orthpaedic Surgery Partners Ltd
$5,920.00Published rateSouth Atlanta Ambulatory Surgical Center, LLC
South Atlanta Ambulatory Surgical Center LLC
$4,200.00Published rateSouth Jersey Endoscopy LLC, Dimarino-Kroop-Prieto Gi Assoc
South Jersey Endoscopy LLC
$2,692.00Published rateRevision Advanced Surgery Center Inc
$991.00Published rate
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See a sample payer proposalCPT 20957 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20957 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 20957 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 20957. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20957 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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