FeeBase
Log inGet started
Menu

CPT code 20680: Implant removal, deep implant2026 Medicare rate & RVUs in Houston, TX

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 Houston, TX, Medicare pays $643.99 for 20680 in the office and $408.17 when it’s performed in a hospital or facility.

$643.99Office (non-facility)
$408.17Hospital or facility
+1.9%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $643.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

20680 in Houston, TX vs other payment areas
  1. Houston, TX · this page$643.99
  2. Austin, TX · Texas$651.64+$7.65
  3. Beaumont, TX · Texas$593.21−$50.78
  4. Brazoria, TX · Texas$622.09−$21.90
  5. Dallas, TX · Texas$627.05−$16.94
  6. Fort Worth, TX · Texas$623.49−$20.50
  7. Galveston, TX · Texas$624.59−$19.40

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

Every other payment area

20680 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$607.98$382.62
Los Angeles, CACalifornia$701.66$420.72
Washington, DC areaDistrict of Columbia$718.07$438.31
Miami, FLFlorida$702.58$455.36
Chicago, ILIllinois$681.17$442.50
Manhattan, NYNew York$730.31$454.36
AlaskaAlaska$739.24$486.32
AlabamaAlabama$566.27$358.47

20680 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 20680 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work5.81× 1.0085.8565
Practice expense12.05× 0.99311.9657
Malpractice1.06× 1.3761.4586
Total RVUs19.2807
Conversion factor× 33.4009

Office rate, Houston, TX$643.99

Office: (5.81 × 1.008 + 12.05 × 0.993 + 1.06 × 1.376) × $33.4009 = $643.99

Facility: (5.81 × 1.008 + 4.94 × 0.993 + 1.06 × 1.376) × $33.4009 = $408.17

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

Codes related to 20680

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

Codes related to 20680
CodeHow it relatesOffice range, Houston, TX
Same family
20670Implant removal, superficial hardwareRemoval of a superficial implant rather than deeply buried hardware.$372.15
Used instead
20650Skeletal traction, bone pin insertionFor insertion and removal of a bone pin in a skeletal-traction service.$253.73
20694Fixator removal, under anesthesiaFor removal of an external fixation system under anesthesia.$470.90
22850Spinal hardware removal, posterior, nonsegmentalSpecific code for removal of nonsegmental posterior spinal instrumentation.No office rate
22852Spinal hardware removal, posterior segmental constructSpecific code for removal of segmental posterior spinal instrumentation.No office rate
22855Hardware removal, anterior spinal instrumentationSpecific code for removal of anterior spinal instrumentation.No office rate

How 20680 has changed in Houston, TX

20680 · Office / nonfacility

$643.99

Effective 2026-10-01

The base rate is $43.71 higher than on 2025-10-01, moving from $600.28 to $643.99 (7.3%).

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

    $600.28changed to$643.99

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $621.15changed to$600.28

    • 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

    $611.01changed to$621.15

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $628.32changed to$611.01

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 1.02 changed to 1.06
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $636.24changed to$628.32

    • 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
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $649.50changed to$636.24

    • 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

    $645.12changed to$649.50

    • 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
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $641.61changed to$645.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.66 changed to 10.63
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $643.12changed to$641.61

    • 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

    $638.14changed to$643.12

    • 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
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $636.65changed to$638.14

    • 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
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $639.31changed to$636.65

    • 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

    $636.13changed to$639.31

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $630.99changed to$636.13

    • 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
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $639.14changed to$630.99

    • 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
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $639.14

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$643.99$408.17RVU26D
2026-07-01$643.99$408.17RVU26C
2026-04-01$643.99$408.17RVU26B
2026-01-01$643.99$408.17RVU26A
2025-10-01$600.28$430.92RVU25D
2025-07-01$600.28$430.92RVU25C
2025-04-01$600.28$430.92RVU25B
2025-01-01$600.28$430.92RVU25A
2024-10-01$621.15$440.86RVU24D
2024-07-01$621.15$440.86RVU24C
2024-04-01$621.15$440.86RVU24B
2024-03-09$621.15$440.86RVU24AR
2024-01-01$611.01$433.67RVU24A
2023-10-01$628.32$438.62RVU23D
2023-07-01$628.32$438.62RVU23C
2023-04-01$628.32$438.62RVU23B
2023-01-01$628.32$438.62RVU23A
2022-10-01$636.24$437.18RVU22D
2022-07-01$636.24$437.18RVU22C
2022-04-01$636.24$437.18RVU22B
2022-01-01$636.24$437.18RVU22A
2021-10-01$649.50$439.10RVU21D
2021-07-01$649.50$439.10RVU21C
2021-04-01$649.50$439.10RVU21B
2021-01-01$649.50$439.10RVU21A
2020-10-01$645.12$444.13RVU20D
2020-07-01$645.12$444.13RVU20C
2020-04-01$645.12$444.13RVU20B
2020-01-01$645.12$444.13RVU20A
2019-10-01$641.61$441.74RVU19D
2019-07-01$641.61$441.74RVU19C
2019-04-01$641.61$441.74RVU19B
2019-01-01$641.61$441.74RVU19A
2018-10-01$643.12$442.38RVU18D
2018-07-01$643.12$442.38RVU18C
2018-04-01$643.12$442.38RVU18B
2018-01-01$643.12$442.38RVU18AR1
2017-10-01$638.14$440.43RVU17D
2017-07-01$638.14$440.43RVU17C
2017-04-01$638.14$440.43RVU17B
2017-01-01$638.14$440.43RVU17A
2016-10-01$636.65$439.62RVU16D
2016-07-01$636.65$439.62RVU16C
2016-04-01$636.65$439.62RVU16B
2016-01-01$636.65$439.62RVU16A
2015-10-01$639.31$440.85RVU15D
2015-07-01$639.31$440.85RVU15C
2015-04-01$636.13$438.66RVU15B
2015-01-01$636.13$438.66RVU15A
2014-10-01$630.99$436.77RVU14D
2014-07-01$630.99$436.77RVU14C
2014-04-01$630.99$436.77RVU14B
2014-01-01$630.99$436.77RVU14A
2013-10-01$639.14$431.53RVU13D
2013-07-01$639.14$431.53RVU13C
2013-04-01$639.14$431.53RVU13B
2013-01-01$639.14$431.53RVU13AR

Price 20680 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 20680 pays in Houston, TX?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 20680 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist