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CPT code 20692: External fixation, multiplane, unilateral2026 Medicare rate & RVUs

Reports surgical application of a unilateral multiplane external fixation system, such as a ring frame, to stabilize a fracture or correct a bone deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.6K Medicare services in 2024

Medicare pays $1,047.12 for 20692 nationally in a facility.

Medicare rate · 20692

External fixation, multiplane, unilateral

Office or facility?

Work RVUs
15.86
Total RVUs
31.35
Global days
090

National rate · 2026

$1,047.12

Facility setting, before claim adjustments.

See every locality for 20692 →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 20692 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 20692 covers

An orthopedic surgeon applies this external fixation system when pins or wires are positioned in more than one plane to stabilize bone. Common settings include the operating room for complex fractures, limb deformity correction, or bone lengthening; an Ilizarov-type ring frame is a familiar example. The code distinguishes multiplane construction from a uniplane frame and describes application to one side.

Documentation should identify the treated bone and side, the indication, and the multiplane pin-or-wire arrangement. Report application rather than a later adjustment, revision, or removal service. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is inappropriate for this unilateral service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 20692 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

20692 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$952.21
AlaskaUnavailable$1,295.31
ArizonaUnavailable$1,020.02
ArkansasUnavailable$940.50
Atlanta, GAUnavailable$1,075.09
Austin, TXUnavailable$1,061.35
Bakersfield, CAUnavailable$1,059.19
Baltimore area, MDUnavailable$1,109.41
Beaumont, TXUnavailable$1,002.41
Brazoria, TXUnavailable$1,026.05

20692 rates by state

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

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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
20692 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 20692 rate is calculated

Each of 20692’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 · 20692

RVUs × geographic indexes × conversion factor

Office or facility?

Work15.86

15.86 RVUs× 1.000 GPCI

Practice expense12.56

12.56 RVUs× 1.000 GPCI

Malpractice2.93

2.93 RVUs× 1.000 GPCI

Adjusted RVUs

31.3500

Conversion factor

$33.4009

Medicare rate

$1,047.12

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

Payment rules and modifiers for 20692

20692 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20692

External fixation, multiplane, unilateral

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 20692

External fixation, multiplane, unilateral

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

20692 without 51 · national facility

$1,047.12

External fixation, multiplane, unilateral

20692-51 · Second procedure: 50%

$523.56

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

20692 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 20692

    External fixation, multiplane, unilateral15.86 wRVU

    Not priced

  • 20690

    External fixation, unilateral, single-plane frame8.56 wRVU

    Not priced

  • 20696

    External fixation, initial computer-adjusted application17.12 wRVU

    Not priced

  • 20693

    Fixator adjustment, requiring anesthesia5.91 wRVU

    Not priced

  • 20694

    Fixator removal, under anesthesia4.17 wRVU

    $461.93

How to choose

20690External fixationUnilateral, single-plane frame
20690 describes a uniplane frame. Choose 20692 when the pins or wires are placed in more than one plane.
20696External fixationInitial computer-adjusted application
20696 is for multiplane external fixation with stereotactic computer-assisted adjustment; 20692 describes multiplane application without that feature.
20693Fixator adjustmentRequiring anesthesia
20693 reports adjustment or revision of an external fixation system under anesthesia, not initial frame application.
20694Fixator removalUnder anesthesia
20694 reports removal of an external fixation system under anesthesia, rather than its application.

Codes related to 20692

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

Codes related to 20692
CodeHow it relatesNational office range
Same family
20690External fixation, unilateral, single-plane frameUnilateral uniplane external fixation; distinguish by pin-or-wire plane arrangement.No office rate
Used instead
20696External fixation, initial computer-adjusted applicationMultiplane fixation with stereotactic computer-assisted adjustment.No office rate
20697Fixator adjustment, each strutRelated computer-assisted multiplane fixation code for an additional bone.$1,640.80–$2,754.08

20692 billing questions

How does 20692 differ from 20690?

Use 20692 for a frame with pins or wires arranged in more than one plane. Code 20690 describes a uniplane arrangement.

Can modifier 50 be reported?

No. The unilateral service and its anatomy make the bilateral adjustment inappropriate.

What documentation supports the multiplane code?

Document the bone and side treated, the reason for fixation, and the pin-or-wire configuration showing placement in multiple planes.

Is adjustment or removal included in the application code?

The application code reports placement of the frame. A later adjustment or revision under anesthesia and removal under anesthesia have distinct codes, 20693 and 20694.

How does the global period affect related postoperative care?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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 20692PPRRVU2026_Oct_nonQPP.csv, line 1,785 (RVU26D)

Open CMS sourceHow we calculate rates

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