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See a sample rate comparisonCPT 20969 Fee Schedule
Last Verified: October 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.
Free Osteocutaneous Flap With, Free Osteocutaneous Flap With Microvascular Anastomosisother Than Iliac Crest Metatarsal Or Greattoe Free Osteocutaneous Flap With Microvascular Anastomosis
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20969 |
| Medicaid Fee Schedule | View Medicaid rates for 20969 |
National average reimbursement for CPT 20969 by major payers:
$3,740.55
$3,751.24
$4,062.69
$4,498.15
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CPT 20969
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Southwest Fort Worth
$16,929.00Published rateRsc Illinois LLC, Regional Surgicenter
$5,433.00Published rateChelmsford Surgery Center LLC
$2,602.00Published rateSouthwest Endoscopy Ltd
$1,936.00Published rateKleinert Kutz Surgery Center, LLC
Kleinert Kutz Surgery Center LLC
$643.38Published rate
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See a sample payer proposalCPT 20969 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20969 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 20969 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 |
|---|---|---|
| 20950-CPT | Moderate | Mntr Intrstitial Fluid Press, Monitoring Of Interstitial Fluid Pressure (Includes Insertion Of Device Eg Wick Catheter Technique Needle Manometer Technique) In Detection Of Muscle Compartment Syndrome |
| 20969-CPT | High | Free Osteocutaneous Flap With, Free Osteocutaneous Flap With Microvascular Anastomosisother Than Iliac Crest Metatarsal Or Greattoe Free Osteocutaneous Flap With Microvascular Anastomosis |
| 20970-CPT | High | Free Osteocutaneous Flap With, Free Osteocutaneous Flap With Microvascular Anastomosisiliac Crest Free Osteocutaneous Flap With Microvascular Anastomosis |
| 20972-CPT | High | Free Osteocutaneous Flap With, Free Osteocutaneous Flap With Microvascular Anastomosismetatarsal Free Osteocutaneous Flap With Microvascular Anastomosis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20969. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20969 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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