CPT code 20693: Fixator adjustment, requiring anesthesia2026 Medicare rate & RVUs

Medicare pays $429.87 for 20693 nationally in a facility.

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

What 20693 covers

An orthopedic surgeon reports this service for adjustment or revision of an external fixation system when anesthesia is required. The work may address fracture alignment or correct a deformity using an existing frame. It is distinct from applying a new external fixator or removing the system. These procedures are commonly performed in an operating room or another setting equipped to provide anesthesia and manage the fixation device.

Select the code based on the documented adjustment or revision and the need for anesthesia. The operative record should identify the existing fixation system, the change made, the clinical purpose, and the anesthesia requirement. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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.

Where 20693 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

20693 rates by state

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

How the 20693 rate is calculated

Each of 20693’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.

Payment rules and modifiers for 20693

20693 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

20693 compared with similar codes

How to choose

20690External fixationUnilateral, single-plane frame

Use 20690 for initial application of a uniplane external fixation system. Use 20693 for adjustment or revision of an existing system requiring anesthesia.

20692External fixationMultiplane, unilateral

Use 20692 for initial application of a multiplane external fixation system. It does not describe adjustment or revision of an existing system.

20694Fixator removalUnder anesthesia

Use 20694 when the external fixation system is removed under anesthesia. Use 20693 when the service adjusts or revises the system instead.

20696External fixationInitial computer-adjusted application

20696 describes initial application of a multiplane system with stereotactic computer-assisted adjustment; 20693 describes adjustment or revision of an existing system requiring anesthesia.

Codes related to 20693

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

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

Open CMS sourceHow we calculate rates