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See a sample rate comparisonCPT 20962 Fee Schedule
Medicare rates as of October 2026
CPT 20962 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Bone Graft With Microvascular, Bone Graft With Microvascular Anastomosis Other Thanfibula Iliac Crest Or Metatarsal Bone Graft With Microvascular Anastomosis Other Than
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body 62Co-Surgeons |
| 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 | $2,428.25 national non-facility rate (2026)View Medicare rates for 20962 |
| Medicaid Fee Schedule | $1,928.50 median of the 8 states in the free previewView Medicaid rates for 20962 |
National average reimbursement for CPT 20962 by major payers:
$3,517.78
BCBS / Anthem
$3,492.26
UnitedHealthcare
$3,601.41
Aetna
$4,239.37
Cigna
Compare published rates across providers.
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CPT 20962
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Southwest Ohio, LLC, The Surgery Center Of Southwest Ohio
The Surgery Center Of Southwest
$11,491.00Published rateProliance Surgeons, Inc., P.S., Proliance Everett Bone And Joint Surgery Center
Proliance Surgeons, Inc., P.S.
$4,785.00Published rateMedstar Surgery Center At Brandywine, LLC
Medstar Surgery Center At Bran
$3,190.00Published rateChevy Chase Asc LLC, Chevy Chase Endoscopy Center
$2,297.00Published rateAnderson Endoscopy Center LLC
$642.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 20962 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20962. 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 20962. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20962 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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Frequently Asked Questions
What APC is CPT 20962 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20962 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 20962 in an ambulatory surgery center?
CMS lists CPT 20962 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 20962?
Hospital price transparency files list CPT 20962 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.