CPT code 20663: Halo application, femoral fixation2026 Medicare rate & RVUs in King County, WA
Reports placement of the femoral fixation component of a halo-traction setup, commonly used to support gradual correction of severe spinal deformity.
In King County, WA, Medicare pays $520.80 for 20663 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 20663 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How King County, WA compares for 20663
Across 109 of 109 payment localities, the facility rate for 20663 runs from $411.85 in Arkansas to $571.73 in San Benito County, CA. King County, WA pays $520.80. The RVUs are the same everywhere; the geographic indexes change the dollars.
- King County, WA · this page$520.80
- Rest of Washington · Washington$470.30−$50.50
- Los Angeles, CA · California$502.49−$18.31
- Washington, DC area · District of Columbia$521.88+$1.08
- Miami, FL · Florida$536.47+$15.67
- Chicago, IL · Illinois$519.77−$1.03
- Manhattan, NY · New York$539.07+$18.27
Other areas in Washington first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | — | $555.75 |
| AlabamaAlabama | — | $417.72 |
| ArkansasArkansas | — | $411.85 |
| ArizonaArizona | — | $451.76 |
| Bakersfield, CACalifornia | — | $475.49 |
| Chico, CACalifornia | — | $472.17 |
| El Centro, CACalifornia | — | $472.37 |
| Fresno, CACalifornia | — | $472.17 |
| Hanford, CACalifornia | — | $472.17 |
| Madera, CACalifornia | — | $472.17 |
| Merced, CACalifornia | — | $472.17 |
| Modesto, CACalifornia | — | $472.17 |
| Napa, CACalifornia | — | $532.36 |
| Oxnard, CACalifornia | — | $498.16 |
| Redding, CACalifornia | — | $472.17 |
| Rest of CaliforniaCalifornia | — | $472.17 |
| Riverside, CACalifornia | — | $485.16 |
| Sacramento, CACalifornia | — | $491.63 |
| Salinas, CACalifornia | — | $489.75 |
| San Diego, CACalifornia | — | $498.59 |
| Marin County, CACalifornia | — | $558.21 |
| San Francisco, CACalifornia | — | $556.84 |
| San Benito County, CACalifornia | — | $571.73 |
| Santa Clara County, CACalifornia | — | $566.11 |
| San Luis Obispo, CACalifornia | — | $482.38 |
| Santa Cruz, CACalifornia | — | $501.17 |
| Santa Maria, CACalifornia | — | $490.85 |
| Santa Rosa, CACalifornia | — | $505.94 |
| Stockton, CACalifornia | — | $472.17 |
| Vallejo, CACalifornia | — | $530.38 |
| Visalia, CACalifornia | — | $472.17 |
| Yuba City, CACalifornia | — | $472.17 |
| ColoradoColorado | — | $473.53 |
| ConnecticutConnecticut | — | $495.45 |
| DelawareDelaware | — | $458.94 |
| Fort Lauderdale, FLFlorida | — | $500.68 |
| Rest of FloridaFlorida | — | $474.82 |
| Atlanta, GAGeorgia | — | $477.42 |
| Rest of GeorgiaGeorgia | — | $447.05 |
| Hawaii, Guam, HIHawaii | — | $480.46 |
| IowaIowa | — | $420.38 |
| IdahoIdaho | — | $424.64 |
| East St. Louis, ILIllinois | — | $486.92 |
| Rest of IllinoisIllinois | — | $467.03 |
| Suburban Chicago, ILIllinois | — | $503.86 |
| IndianaIndiana | — | $426.83 |
| KansasKansas | — | $422.10 |
| KentuckyKentucky | — | $435.14 |
| New Orleans, LALouisiana | — | $456.43 |
| Rest of LouisianaLouisiana | — | $435.93 |
| Metropolitan Boston, MAMassachusetts | — | $514.23 |
| Rest of MassachusettsMassachusetts | — | $472.32 |
| Baltimore area, MDMaryland | — | $494.85 |
| Rest of MarylandMaryland | — | $466.35 |
| Rest of MaineMaine | — | $430.67 |
| Southern Maine, MEMaine | — | $447.89 |
| Detroit, MIMichigan | — | $484.35 |
| Rest of MichiganMichigan | — | $449.49 |
| MinnesotaMinnesota | — | $443.38 |
| Metropolitan Kansas City, MOMissouri | — | $449.52 |
| Metropolitan St. Louis, MOMissouri | — | $453.62 |
| Rest of MissouriMissouri | — | $431.12 |
| MississippiMississippi | — | $421.38 |
| MontanaMontana | — | $464.86 |
| North CarolinaNorth Carolina | — | $434.44 |
| North DakotaNorth Dakota | — | $440.93 |
| NebraskaNebraska | — | $421.52 |
| New HampshireNew Hampshire | — | $469.63 |
| Northern New JerseyNew Jersey | — | $517.47 |
| Rest of New JerseyNew Jersey | — | $498.19 |
| New MexicoNew Mexico | — | $453.35 |
| NevadaNevada | — | $458.43 |
| NYC suburbs and Long Island, NYNew York | — | $556.43 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $504.41 |
| Queens, NYNew York | — | $538.00 |
| Rest of New YorkNew York | — | $441.06 |
| OhioOhio | — | $444.60 |
| OklahomaOklahoma | — | $430.52 |
| Portland, OROregon | — | $483.95 |
| Rest of OregonOregon | — | $451.99 |
| Metropolitan Philadelphia, PAPennsylvania | — | $485.84 |
| Rest of PennsylvaniaPennsylvania | — | $443.24 |
| Puerto RicoPuerto Rico | — | $466.95 |
| Rhode IslandRhode Island | — | $471.97 |
| South CarolinaSouth Carolina | — | $440.83 |
| South DakotaSouth Dakota | — | $438.10 |
| TennesseeTennessee | — | $424.62 |
| Austin, TXTexas | — | $474.48 |
| Beaumont, TXTexas | — | $440.70 |
| Brazoria, TXTexas | — | $455.41 |
| Dallas, TXTexas | — | $459.94 |
| Fort Worth, TXTexas | — | $458.09 |
| Galveston, TXTexas | — | $457.82 |
| Houston, TXTexas | — | $479.97 |
| Rest of TexasTexas | — | $448.91 |
| UtahUtah | — | $446.57 |
| VirginiaVirginia | — | $449.02 |
| Virgin Islands, VIUnited States Virgin Islands | — | $466.95 |
| VermontVermont | — | $442.60 |
| WisconsinWisconsin | — | $427.00 |
| West VirginiaWest Virginia | — | $451.25 |
| WyomingWyoming | — | $454.43 |
20663 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact King County, WA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,779
- Code
- 20663
- Physician work
- 5.60
- Practice expense
- 7.11
- Malpractice
- 1.21
GPCI2026.csv
108
- Locality
- King County, WA
- Physician work
- 1.050
- Practice expense
- 1.227
- Malpractice
- 0.817
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.60 | × 1.050 | 5.8800 |
| Practice expense | 7.11 | × 1.227 | 8.7240 |
| Malpractice | 1.21 | × 0.817 | 0.9886 |
| Total RVUs | 15.5925 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, King County, WA$520.80
Facility: (5.6 × 1.05 + 7.11 × 1.227 + 1.21 × 0.817) × $33.4009 = $520.80
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share 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.
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).
How 20663 has changed in King County, WA
20663 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $520.80 | RVU26D |
| 2026-07-01 | Not available in this setting | $520.80 | RVU26C |
| 2026-04-01 | Not available in this setting | $520.80 | RVU26B |
| 2026-01-01 | Not available in this setting | $520.80 | RVU26A |
| 2025-10-01 | Not available in this setting | $538.60 | RVU25D |
| 2025-07-01 | Not available in this setting | $538.60 | RVU25C |
| 2025-04-01 | Not available in this setting | $538.60 | RVU25B |
| 2025-01-01 | Not available in this setting | $538.60 | RVU25A |
| 2024-10-01 | Not available in this setting | $548.90 | RVU24D |
| 2024-07-01 | Not available in this setting | $548.90 | RVU24C |
| 2024-04-01 | Not available in this setting | $548.90 | RVU24B |
| 2024-03-09 | Not available in this setting | $548.90 | RVU24AR |
| 2024-01-01 | Not available in this setting | $539.95 | RVU24A |
| 2023-10-01 | Not available in this setting | $544.71 | RVU23D |
| 2023-07-01 | Not available in this setting | $544.71 | RVU23C |
| 2023-04-01 | Not available in this setting | $544.71 | RVU23B |
| 2023-01-01 | Not available in this setting | $544.71 | RVU23A |
| 2022-10-01 | Not available in this setting | $540.35 | RVU22D |
| 2022-07-01 | Not available in this setting | $540.35 | RVU22C |
| 2022-04-01 | Not available in this setting | $540.35 | RVU22B |
| 2022-01-01 | Not available in this setting | $540.35 | RVU22A |
| 2021-10-01 | Not available in this setting | $538.19 | RVU21D |
| 2021-07-01 | Not available in this setting | $538.19 | RVU21C |
| 2021-04-01 | Not available in this setting | $538.19 | RVU21B |
| 2021-01-01 | Not available in this setting | $538.19 | RVU21A |
| 2020-10-01 | Not available in this setting | $532.88 | RVU20D |
| 2020-07-01 | Not available in this setting | $532.88 | RVU20C |
| 2020-04-01 | Not available in this setting | $532.88 | RVU20B |
| 2020-01-01 | Not available in this setting | $532.88 | RVU20A |
| 2019-10-01 | Not available in this setting | $525.87 | RVU19D |
| 2019-07-01 | Not available in this setting | $525.87 | RVU19C |
| 2019-04-01 | Not available in this setting | $525.87 | RVU19B |
| 2019-01-01 | Not available in this setting | $525.87 | RVU19A |
| 2018-10-01 | Not available in this setting | $523.30 | RVU18D |
| 2018-07-01 | Not available in this setting | $523.30 | RVU18C |
| 2018-04-01 | Not available in this setting | $523.30 | RVU18B |
| 2018-01-01 | Not available in this setting | $523.30 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $495.89 | RVU17D |
| 2017-07-01 | Not available in this setting | $495.89 | RVU17C |
| 2017-04-01 | Not available in this setting | $495.89 | RVU17B |
| 2017-01-01 | Not available in this setting | $495.89 | RVU17A |
| 2016-10-01 | Not available in this setting | $502.02 | RVU16D |
| 2016-07-01 | Not available in this setting | $502.02 | RVU16C |
| 2016-04-01 | Not available in this setting | $502.02 | RVU16B |
| 2016-01-01 | Not available in this setting | $502.02 | RVU16A |
| 2015-10-01 | Not available in this setting | $423.44 | RVU15D |
| 2015-07-01 | Not available in this setting | $423.44 | RVU15C |
| 2015-04-01 | Not available in this setting | $421.33 | RVU15B |
| 2015-01-01 | Not available in this setting | $421.33 | RVU15A |
| 2014-10-01 | Not available in this setting | $484.80 | RVU14D |
| 2014-07-01 | Not available in this setting | $484.80 | RVU14C |
| 2014-04-01 | Not available in this setting | $484.80 | RVU14B |
| 2014-01-01 | Not available in this setting | $484.80 | RVU14A |
| 2013-10-01 | Not available in this setting | $511.08 | RVU13D |
| 2013-07-01 | Not available in this setting | $511.08 | RVU13C |
| 2013-04-01 | Not available in this setting | $511.08 | RVU13B |
| 2013-01-01 | Not available in this setting | $511.08 | RVU13AR |
Where the King County, WA rate applies
King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.
- Seattle
- Algona
- Ames Lake
- 20663 in Auburn · multiple payment areas
- Baring
- Beaux Arts Village
- Bellevue
- Black Diamond
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
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