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

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 Utah, Medicare pays $604.18 for 20680 in the office and $380.95 when it’s performed in a hospital or facility.

$604.18Office (non-facility)
$380.95Hospital or facility
−4.4%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 Utah
  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 Utah 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. Utah pays $604.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

20680 in Utah vs other payment areas
  1. Utah · this page$604.18
  2. Los Angeles, CA · California$701.66+$97.48
  3. Washington, DC area · District of Columbia$718.07+$113.89
  4. Miami, FL · Florida$702.58+$98.40
  5. Chicago, IL · Illinois$681.17+$76.99
  6. Manhattan, NY · New York$730.31+$126.13
  7. Alaska · Alaska$739.24+$135.06

Other areas in Utah 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.

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 Utah 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

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 20680 in Utah
ComponentRVULocality factorAdjusted
Physician work5.81× 1.0005.8100
Practice expense12.05× 0.94011.3270
Malpractice1.06× 0.8980.9519
Total RVUs18.0889
Conversion factor× 33.4009

Office rate, Utah$604.18

Office: (5.81 × 1 + 12.05 × 0.94 + 1.06 × 0.898) × $33.4009 = $604.18

Facility: (5.81 × 1 + 4.94 × 0.94 + 1.06 × 0.898) × $33.4009 = $380.95

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, Utah
Same family
20670Implant removal, superficial hardwareRemoval of a superficial implant rather than deeply buried hardware.$351.32
Used instead
20650Skeletal traction, bone pin insertionFor insertion and removal of a bone pin in a skeletal-traction service.$238.45
20694Fixator removal, under anesthesiaFor removal of an external fixation system under anesthesia.$441.47
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 Utah

20680 · Office / nonfacility

$604.18

Effective 2026-10-01

The base rate is $47.53 higher than on 2025-10-01, moving from $556.65 to $604.18 (8.5%).

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

    $556.65changed to$604.18

    • 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
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $575.63changed to$556.65

    • 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

    $566.24changed to$575.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $579.87changed to$566.24

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 1.02 changed to 1.06
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $584.21changed to$579.87

    • 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
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $596.19changed to$584.21

    • 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

    $604.63changed to$596.19

    • 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
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $612.91changed to$604.63

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.66 changed to 10.63
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $614.16changed to$612.91

    • 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

    $609.66changed to$614.16

    • 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 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $608.32changed to$609.66

    • 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
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $610.85changed to$608.32

    • 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

    $607.81changed to$610.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $602.91changed to$607.81

    • 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
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $609.33changed to$602.91

    • 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
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $609.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$604.18$380.95RVU26D
2026-07-01$604.18$380.95RVU26C
2026-04-01$604.18$380.95RVU26B
2026-01-01$604.18$380.95RVU26A
2025-10-01$556.65$399.11RVU25D
2025-07-01$556.65$399.11RVU25C
2025-04-01$556.65$399.11RVU25B
2025-01-01$556.65$399.11RVU25A
2024-10-01$575.63$407.92RVU24D
2024-07-01$575.63$407.92RVU24C
2024-04-01$575.63$407.92RVU24B
2024-03-09$575.63$407.92RVU24AR
2024-01-01$566.24$401.27RVU24A
2023-10-01$579.87$406.96RVU23D
2023-07-01$579.87$406.96RVU23C
2023-04-01$579.87$406.96RVU23B
2023-01-01$579.87$406.96RVU23A
2022-10-01$584.21$406.43RVU22D
2022-07-01$584.21$406.43RVU22C
2022-04-01$584.21$406.43RVU22B
2022-01-01$584.21$406.43RVU22A
2021-10-01$596.19$408.28RVU21D
2021-07-01$596.19$408.28RVU21C
2021-04-01$596.19$408.28RVU21B
2021-01-01$596.19$408.28RVU21A
2020-10-01$604.63$422.75RVU20D
2020-07-01$604.63$422.75RVU20C
2020-04-01$604.63$422.75RVU20B
2020-01-01$604.63$422.75RVU20A
2019-10-01$612.91$429.83RVU19D
2019-07-01$612.91$429.83RVU19C
2019-04-01$612.91$429.83RVU19B
2019-01-01$612.91$429.83RVU19A
2018-10-01$614.16$430.28RVU18D
2018-07-01$614.16$430.28RVU18C
2018-04-01$614.16$430.28RVU18B
2018-01-01$614.16$430.28RVU18AR1
2017-10-01$609.66$428.40RVU17D
2017-07-01$609.66$428.40RVU17C
2017-04-01$609.66$428.40RVU17B
2017-01-01$609.66$428.40RVU17A
2016-10-01$608.32$427.75RVU16D
2016-07-01$608.32$427.75RVU16C
2016-04-01$608.32$427.75RVU16B
2016-01-01$608.32$427.75RVU16A
2015-10-01$610.85$428.96RVU15D
2015-07-01$610.85$428.96RVU15C
2015-04-01$607.81$426.82RVU15B
2015-01-01$607.81$426.82RVU15A
2014-10-01$602.91$425.14RVU14D
2014-07-01$602.91$425.14RVU14C
2014-04-01$602.91$425.14RVU14B
2014-01-01$602.91$425.14RVU14A
2013-10-01$609.33$419.54RVU13D
2013-07-01$609.33$419.54RVU13C
2013-04-01$609.33$419.54RVU13B
2013-01-01$609.33$419.54RVU13AR

Price 20680 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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 UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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