CPT code 20680: Implant removal, deep implant2026 Medicare rate & RVUs in South Dakota

Reports operative removal of deeply buried orthopedic hardware, such as a plate, screw, or rod, when removal is a distinct surgical service.

CMS RVU26DEffective Oct 1, 2026One payment locality59.9K Medicare services in 2024

In South Dakota, Medicare pays $608.44 for 20680 in the office and $370.96 when it’s performed in a hospital or facility.

$608.44Office (non-facility)
$370.96Hospital or facility
−3.7%vs the national office rate ($631.95)

Check a contract rate as a % of Medicare · 20680 nationwide

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

We’ll open 20680 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 20680 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 20680 covers

An orthopedic surgeon typically reports this service when removing hardware buried beneath soft tissue or bone, such as a plate and screws or an intramedullary rod. Removal may require an incision and dissection to expose the implant. It is performed in settings ranging from an operating room to a procedure room when the depth and complexity are suitable. The operative report should identify the implant, its anatomic site, and the work needed to reach and remove it.

Choose this code for deep hardware rather than a superficial implant removable with less extensive exposure. Report it for a distinct removal service, not merely to describe hardware taken out as an integral part of another operation. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. 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 South Dakota compares for 20680

Across 109 of 109 payment localities, the office rate for 20680 runs from $558.02 in Arkansas to $814.76 in San Benito County, CA. South Dakota pays $608.44. The RVUs are the same everywhere; the geographic indexes change the dollars.

20680 in South Dakota vs other payment areas
  1. South Dakota · this page$608.44
  2. Los Angeles, CA · California$701.66+$93.22
  3. Washington, DC area · District of Columbia$718.07+$109.63
  4. Miami, FL · Florida$702.58+$94.14
  5. Chicago, IL · Illinois$681.17+$72.73
  6. Manhattan, NY · New York$730.31+$121.87
  7. Alaska · Alaska$739.24+$130.80

Other areas in South Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

20680 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$566.27$358.47
ArkansasArkansas$558.02$354.03
ArizonaArizona$614.37$384.25
Bakersfield, CACalifornia$660.43$400.15
Chico, CACalifornia$657.45$397.18
El Centro, CACalifornia$657.63$397.35
Fresno, CACalifornia$657.45$397.18
Hanford, CACalifornia$657.45$397.18

20680 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.

$558.02

$739.24

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
20680 office rate range by state
State / territoryOffice rate rangeLocalities
AK$739.241
AL$566.271
AR$558.021
AZ$614.371
CA$657.45–$814.7629
CO$652.281
CT$674.251
DC$718.071
DE$624.511
FL$632.04–$702.583
GA$595.27–$646.082
GU$672.181
HI$672.181
IA$576.381
ID$581.091
IL$616.86–$681.174
IN$584.371
KS$575.751
KY$584.261
LA$584.17–$613.012
MA$649.19–$714.092
MD$635.81–$718.073
ME$586.36–$615.262
MI$601.50–$642.152
MN$618.691
MO$575.48–$612.703
MS$566.761
MT$631.871
NC$592.201
ND$610.911
NE$578.931
NH$644.021
NJ$680.17–$710.982
NM$605.661
NV$626.431
NY$601.31–$750.785
OH$597.211
OK$580.981
OR$619.82–$670.662
PA$596.99–$658.772
PR$635.841
RI$645.091
SC$596.051
SD$608.441
TN$578.931
TX$593.21–$651.648
UT$604.181
VA$614.69–$718.072
VI$635.841
VT$610.431
WA$647.34–$726.532
WI$590.541
WV$594.481
WY$622.741

See 20680 in every payment locality

How the 20680 rate is calculated

Each of 20680’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 · 20680

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.81

5.81 RVUs× 1.000 GPCI

Practice expense12.05

12.05 RVUs× 1.000 GPCI

Malpractice1.06

1.06 RVUs× 1.000 GPCI

Adjusted RVUs

18.9200

Conversion factor

$33.4009

Medicare rate

$631.95

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

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,783

Code
20680
Physician work
5.81
Practice expense
12.05
Malpractice
1.06

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 20680 in South Dakota
ComponentRVULocality factorAdjusted
Physician work5.81× 1.0005.8100
Practice expense12.05× 1.00012.0500
Malpractice1.06× 0.3360.3562
Total RVUs18.2162
Conversion factor× 33.4009

Office rate, South Dakota$608.44

Office: (5.81 × 1 + 12.05 × 1 + 1.06 × 0.336) × $33.4009 = $608.44

Facility: (5.81 × 1 + 4.94 × 1 + 1.06 × 0.336) × $33.4009 = $370.96

Open 20680 in the RVU calculator

Payment rules and modifiers for 20680

20680 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20680

Implant removal, deep implant

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)0The 150% bilateral adjustment doesn’t apply.
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 · 20680

Implant removal, deep implant

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 51 · payment effect

With and without the modifier

20680 without 51 · national office

$631.95

Implant removal, deep implant

20680-51 · Second procedure: 50%

$315.98

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 20680 has changed in South Dakota

20680 · Office / nonfacility

$608.44

Effective 2026-10-01

The base rate is $46.15 higher than on 2025-10-01, moving from $562.29 to $608.44 (8.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $562.29changed to$608.44

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.96 changed to 5.81
    • Practice expense RVU 11.03 changed to 12.05
    • Malpractice RVU 1.03 changed to 1.06
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $581.03changed to$562.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.09 changed to 11.03
    • Malpractice RVU 1.06 changed to 1.03

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $571.55changed to$581.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $590.36changed to$571.55

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 1.02 changed to 1.06
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $598.72changed to$590.36

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.98 changed to 11.09
    • Malpractice RVU 1.04 changed to 1.02
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $611.81changed to$598.72

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.22 changed to 10.98
    • Malpractice RVU 1.02 changed to 1.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $612.01changed to$611.81

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.63 changed to 11.22
    • Malpractice RVU 1.00 changed to 1.02
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $612.99changed to$612.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.66 changed to 10.63
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $614.70changed to$612.99

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.73 changed to 10.66
    • Malpractice RVU 0.99 changed to 1.00

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $610.65changed to$614.70

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.66 changed to 10.73
    • Malpractice RVU 1.00 changed to 0.99
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $610.03changed to$610.65

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.67 changed to 10.66
    • Malpractice RVU 1.02 changed to 1.00
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $612.59changed to$610.03

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.68 changed to 10.67

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $609.55changed to$612.59

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $607.56changed to$609.55

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.58 changed to 10.68
    • Malpractice RVU 1.01 changed to 1.02
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $618.81changed to$607.56

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.77 changed to 10.58
    • Malpractice RVU 1.06 changed to 1.01
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $618.81

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$608.44$370.96RVU26D
2026-07-01$608.44$370.96RVU26C
2026-04-01$608.44$370.96RVU26B
2026-01-01$608.44$370.96RVU26A
2025-10-01$562.29$393.45RVU25D
2025-07-01$562.29$393.45RVU25C
2025-04-01$562.29$393.45RVU25B
2025-01-01$562.29$393.45RVU25A
2024-10-01$581.03$401.28RVU24D
2024-07-01$581.03$401.28RVU24C
2024-04-01$581.03$401.28RVU24B
2024-03-09$581.03$401.28RVU24AR
2024-01-01$571.55$394.73RVU24A
2023-10-01$590.36$403.64RVU23D
2023-07-01$590.36$403.64RVU23C
2023-04-01$590.36$403.64RVU23B
2023-01-01$590.36$403.64RVU23A
2022-10-01$598.72$405.27RVU22D
2022-07-01$598.72$405.27RVU22C
2022-04-01$598.72$405.27RVU22B
2022-01-01$598.72$405.27RVU22A
2021-10-01$611.81$407.34RVU21D
2021-07-01$611.81$407.34RVU21C
2021-04-01$611.81$407.34RVU21B
2021-01-01$611.81$407.34RVU21A
2020-10-01$612.01$414.96RVU20D
2020-07-01$612.01$414.96RVU20C
2020-04-01$612.01$414.96RVU20B
2020-01-01$612.01$414.96RVU20A
2019-10-01$612.99$415.49RVU19D
2019-07-01$612.99$415.49RVU19C
2019-04-01$612.99$415.49RVU19B
2019-01-01$612.99$415.49RVU19A
2018-10-01$614.70$416.34RVU18D
2018-07-01$614.70$416.34RVU18C
2018-04-01$614.70$416.34RVU18B
2018-01-01$614.70$416.34RVU18AR1
2017-10-01$610.65$414.69RVU17D
2017-07-01$610.65$414.69RVU17C
2017-04-01$610.65$414.69RVU17B
2017-01-01$610.65$414.69RVU17A
2016-10-01$610.03$414.18RVU16D
2016-07-01$610.03$414.18RVU16C
2016-04-01$610.03$414.18RVU16B
2016-01-01$610.03$414.18RVU16A
2015-10-01$612.59$415.32RVU15D
2015-07-01$612.59$415.32RVU15C
2015-04-01$609.55$413.25RVU15B
2015-01-01$609.55$413.25RVU15A
2014-10-01$607.56$414.12RVU14D
2014-07-01$607.56$414.12RVU14C
2014-04-01$607.56$414.12RVU14B
2014-01-01$607.56$414.12RVU14A
2013-10-01$618.81$411.61RVU13D
2013-07-01$618.81$411.61RVU13C
2013-04-01$618.81$411.61RVU13B
2013-01-01$618.81$411.61RVU13AR

Price 20680 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

20680 billing questions

How does this differ from 20670?

Use 20680 for deeply buried hardware requiring operative exposure and dissection. Code 20670 describes removal of a superficial implant.

Can removal be reported with a reconstruction at the same site?

Removal may be separately reported when it is a distinct service rather than an integral step in the reconstruction. Document the separate removal work and check applicable code edits.

Is modifier 50 appropriate when hardware is removed on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

Does the code count each screw or plate component?

Do not treat every screw or component as a separate unit. Document the implant site and distinct removal work performed.

When can an assistant be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

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 20680PPRRVU2026_Oct_nonQPP.csv, line 1,783 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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