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CPT code 20663: Halo application, femoral fixation2026 Medicare rate & RVUs

Reports placement of the femoral fixation component of a halo-traction setup, commonly used to support gradual correction of severe spinal deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $464.94 for 20663 nationally in a facility.

Medicare rate · 20663

Halo application, femoral fixation

Office or facility?

Work RVUs
5.6
Total RVUs
13.92
Global days
090

National rate · 2026

$464.94

Facility setting, before claim adjustments.

See every locality for 20663 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 20663 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 20663 covers

This service establishes femoral fixation for halo traction, in which traction applied through a femoral attachment can help manage severe spinal deformity. An orthopedic or spine surgeon typically performs the procedure in a surgical setting. The code includes removal of the femoral halo component when the traction course is complete; it identifies the femoral application, not cranial or pelvic halo placement.

Report the code when the documented service involves femoral halo fixation, rather than another skeletal traction device or a halo applied at a different site. The record should identify the femoral fixation and its role in the traction treatment. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 20663 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

20663 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$417.72
AlaskaUnavailable$555.75
ArizonaUnavailable$451.76
ArkansasUnavailable$411.85
Atlanta, GAUnavailable$477.42
Austin, TXUnavailable$474.48
Bakersfield, CAUnavailable$475.49
Baltimore area, MDUnavailable$494.85
Beaumont, TXUnavailable$440.70
Brazoria, TXUnavailable$455.41

20663 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
20663 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 20663 rate is calculated

Each of 20663’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 20663

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.60

5.60 RVUs× 1.000 GPCI

Practice expense7.11

7.11 RVUs× 1.000 GPCI

Malpractice1.21

1.21 RVUs× 1.000 GPCI

Adjusted RVUs

13.9200

Conversion factor

$33.4009

Medicare rate

$464.94

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 20663

20663 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20663

Halo application, femoral fixation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 20663

Halo application, femoral fixation

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

20663 without 50 · national facility

$464.94

Halo application, femoral fixation

20663-50 · Bilateral: 150%

$697.41

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

20663 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 20663

    Halo application, femoral fixation5.6 wRVU

    Not priced

  • 20660

    Cranial traction, tongs or calipers3.9 wRVU

    Not priced

  • 20661

    Cranial halo, four-pin application5.13 wRVU

    Not priced

  • 20662

    Halo application, pelvic fixation6.22 wRVU

    Not priced

  • 20665

    Cranial device removal, tongs or halo1.33 wRVU

    $117.91

How to choose

20660Cranial tractionTongs or calipers
20660 describes another form of skeletal traction-device application. Choose 20663 when the documented fixation is femoral halo traction.
20661Cranial haloFour-pin application
20661 is for cranial halo application; 20663 identifies the femoral site.
20662Halo applicationPelvic fixation
20662 identifies pelvic halo application, not femoral fixation.
20665Cranial device removalTongs or halo
20665 describes removal of tongs or a halo other than from the femur. Femoral halo removal is included in 20663.

Codes related to 20663

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 20663
CodeHow it relatesNational office range
Used instead
20660Cranial traction, tongs or calipersUse for a different skeletal traction device rather than femoral halo fixation.No office rate
Same family
20661Cranial halo, four-pin applicationHalo application at the cranial site.No office rate
20662Halo application, pelvic fixationHalo application at the pelvic site.No office rate
20664Cranial halo, six or more pinsCranial halo application distinguished by use of six or more pins.No office rate

20663 billing questions

How does this differ from cranial or pelvic halo application?

This code identifies femoral fixation for halo traction. Use the cranial or pelvic sibling code when the halo is applied at that site.

Is removal of the femoral halo reported separately?

No. Removal of the femoral halo component is included in this service.

Can this be reported with a cranial halo code?

A cranial halo may be part of the same traction treatment, but report each service only when the corresponding site-specific application is performed and documented.

When is modifier 50 used?

For a bilateral procedure, modifier 50 applies under the CMS bilateral payment rule; payment is 150%.

What supports assistant-at-surgery payment?

The record must document medical necessity for the assistant. CMS does not permit co-surgeon or team-surgery payment for this code.

Does the global period include postoperative care?

Yes. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 20663PPRRVU2026_Oct_nonQPP.csv, line 1,779 (RVU26D)

Open CMS sourceHow we calculate rates

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