CPT 20973 Fee Schedule
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.
| 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 |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 20973 by major payers:
$4,030.28
$3,916.43
$3,973.40
$4,860.36
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 20973 | ||||||
United | 20973 | $1472.00 | 1760445928 - ARIZONA ENDOSCOPY CENTER, LLC | 860908400 - (AZ) ARIZONA ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $1610.00 | 1346270428 - BALTIMORE AMBULATORY CENTER FOR ENDOSCOPY | 521913193 - (MD) BALTIMORE AMBULATORY CENTER FO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $6365.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $5846.00 | 1154911592 - BCC WEST VALLEY LLC | 854264663 - (AZ) BCC WEST VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $1500.00 | 1669181822 - ALLIANCE SURGERY CENTER AT CUMMING | 881953675 - (GA) ALLIANCE SURGERY CENTER AT CUMMING | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $2860.00 | 1659505857 - HASBROUCK HEIGHTS SURGERY CENTER, LLC | 264379508 - (NJ) HASBROUCK HEIGHTS SURGERY CENT | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $4523.00 | 1013298926 - MATTHEWS SURGERY CENTER, LLC | 273634811 - (NC) MATTHEWS SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $5751.00 | 1386119253 - CHRISTUS AMBULATORY SURGERY CENTER AT OLYMPIA HILLS LLC, CHRISTUS SURGERY CENTER OLYMPIA HILLS | 384092858 - (TX) CHRISTUS AMBULATORY SURGERY CENTER AT OLYMPIA HILLS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $4704.00 | 1508871211 - TEXAS DIGESTIVE DISEASE CENTER, LTD | 273578014 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $1521.00 | 1366799033 - UPSTATE GASTROENTEROLOGY, LLC | 270998899 - (NY) UPSTATE GASTROENTEROLOGY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $1957.00 | 1801822739 - SYLVAN SURGERY CENTER, INC. | 200500901 - (CA) SYLVAN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $9742.00 | 1871720540 - BALL OUTPATIENT SURGERY CENTER, LLC, BALL OUTPATIENT SURGERY CENTER | 270275794 - (IN) BALL OUTPATIENT SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $2657.00 | 1184635955 - SAN RAMON ENDOSCOPY CENTER INC | 680466508 - (CA) SAN RAMON ENDOSCOPY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $2902.00 | 1649921065 - JOINT REPLACEMENT CENTER OF LOUISIANA | 874022126 - (LA) JOINT REPLACEMENT CENTER OF LOUS | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20973 | $6365.00 | 1659748184 - SURGCENTER OF THE POTOMAC, LLC | 472311914 - (MD) SURGCENTER OF THE POTOMAC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 20973 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20973 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 20973 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 | Monitoring Of Interstitial Fluid Pressure (Includes Insertion Of Device, Eg, Wick Catheter Technique, Needle Manometer Technique) In Detection Of Muscle Compartment Syndrome |
| 20962-CPT | High | Graft Bone Microvasc Anastomosis |
| 20973-CPT | High | Free Osteo Flap W/Microvasc Great Toe W/ |
| 20974-CPT | Low | Stimulate Bone Electric Noninvasive |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20973. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20973 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 20973) and we'll show you how you compare in 15 minutes or less.