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See a sample rate comparisonCPT 20970 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 Anastomosisiliac Crest 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 |
| Common Modifiers | None RT - Right side of body 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20970 |
| Medicaid Fee Schedule | View Medicaid rates for 20970 |
National average reimbursement for CPT 20970 by major payers:
$3,966.42
$3,866.37
$3,917.81
$4,632.30
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CPT 20970
5 of 25 sample ratesHigher to lower in this preview
Santa Monica Surgical Partners LLC, Surgery Center Of The Pacific
Santa Monica Surgical Partners LLC
$5,630.00Published rateSurgcenter Northern Phoenix LLC
$3,393.00Published rateEast Cobb Podiatry Surgery Center, LLC
East Cobb Podiatry Surgery Center LLC
$2,946.00Published rateBay Area Endoscopy Center Limited Partnership
$1,594.00Published rateZitelli & Brodland PC, Zitelli & Brodland Asf Central
John A. Zitelli, Md, PC
$1,202.00Published rate
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See a sample payer proposalCPT 20970 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20970 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 20970 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 |
| 20970-CPT | High | Free Osteocutaneous Flap With, Free Osteocutaneous Flap With Microvascular Anastomosisiliac Crest 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 20970. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20970 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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