CPT code 20694: Fixator removal, under anesthesia2026 Medicare rate & RVUs in Merced, CA

Removal of an external fixation frame under anesthesia, typically after fracture healing or completion of staged bone correction.

CMS RVU26DEffective Oct 1, 2026One payment locality5.2K Medicare services in 2024

In Merced, CA, Medicare pays $480.50 for 20694 in the office and $334.07 when it’s performed in a hospital or facility.

$480.50Office (non-facility)
$334.07Hospital or facility
+4.0%vs the national office rate ($461.93)

Check a contract rate as a % of Medicare · 20694 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 20694 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Merced, CA
  2. What 20694 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 20694 covers

An orthopedic surgeon removes an external fixation system while the patient is under anesthesia. The device may stabilize a fracture, support an osteotomy, or maintain alignment during limb-lengthening or deformity correction. This service is commonly performed in an operating room or another setting where anesthesia is provided. It concerns removal of the external frame and its fixation elements, rather than removal of buried internal plates, screws, or other implants.

Report this code when the external fixation system is removed under anesthesia; documentation should identify the device, the reason for removal, and the work performed. CMS assigns 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, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery billing 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 Merced, CA compares for 20694

Across 109 of 109 payment localities, the office rate for 20694 runs from $407.36 in Arkansas to $595.96 in San Benito County, CA. Merced, CA pays $480.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

20694 in Merced, CA vs other payment areas
  1. Merced, CA · this page$480.50
  2. Bakersfield, CA · California$482.71+$2.21
  3. Chico, CA · California$480.50
  4. El Centro, CA · California$480.63+$0.13
  5. Fresno, CA · California$480.50
  6. Hanford, CA · California$480.50
  7. Los Angeles, CA · California$513.00+$32.50

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

Every other payment area

20694 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$480.50$334.07
Modesto, CACalifornia$480.50$334.07
Napa, CACalifornia$551.94$375.85
Oxnard, CACalifornia$509.81$351.89
Redding, CACalifornia$480.50$334.07
Rest of CaliforniaCalifornia$480.50$334.07
Riverside, CACalifornia$489.00$342.57
Sacramento, CACalifornia$503.00$347.62

20694 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.

$407.36

$538.98

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

View every state and territory as a table
20694 office rate range by state
State / territoryOffice rate rangeLocalities
AK$538.981
AL$413.451
AR$407.361
AZ$448.951
CA$480.50–$595.9629
CO$476.791
CT$493.071
DC$525.171
DE$456.411
FL$462.17–$514.433
GA$435.00–$472.402
GU$491.411
HI$491.411
IA$420.841
ID$424.331
IL$451.02–$498.564
IN$426.741
KS$420.411
KY$426.811
LA$426.76–$448.042
MA$474.51–$522.222
MD$464.72–$525.173
ME$428.26–$449.532
MI$439.56–$469.672
MN$451.951
MO$420.36–$447.773
MS$413.871
MT$461.881
NC$432.561
ND$446.261
NE$422.711
NH$470.781
NJ$497.32–$519.912
NM$442.651
NV$457.821
NY$439.28–$549.465
OH$436.371
OK$424.351
OR$452.91–$490.292
PA$436.19–$481.682
PR$464.801
RI$471.511
SC$435.461
SD$444.411
TN$422.761
TX$433.40–$476.398
UT$441.471
VA$449.14–$525.172
VI$464.801
VT$445.941
WA$473.14–$531.322
WI$431.231
WV$434.501
WY$455.071

See 20694 in every payment locality

How the 20694 rate is calculated

Each of 20694’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 · 20694

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.17

4.17 RVUs× 1.000 GPCI

Practice expense8.87

8.87 RVUs× 1.000 GPCI

Malpractice0.79

0.79 RVUs× 1.000 GPCI

Adjusted RVUs

13.8300

Conversion factor

$33.4009

Medicare rate

$461.93

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

The exact Merced, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,787

Code
20694
Physician work
4.17
Practice expense
8.87
Malpractice
0.79

GPCI2026.csv

15

Locality
Merced, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 20694 in Merced, CA
ComponentRVULocality factorAdjusted
Physician work4.17× 1.0174.2409
Practice expense8.87× 1.0969.7215
Malpractice0.79× 0.5360.4234
Total RVUs14.3858
Conversion factor× 33.4009

Office rate, Merced, CA$480.50

Office: (4.17 × 1.017 + 8.87 × 1.096 + 0.79 × 0.536) × $33.4009 = $480.50

Facility: (4.17 × 1.017 + 4.87 × 1.096 + 0.79 × 0.536) × $33.4009 = $334.07

Open 20694 in the RVU calculator

Payment rules and modifiers for 20694

20694 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20694

Fixator removal, under anesthesia

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)1Not paid (statutory restriction).
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 · 20694

Fixator removal, under anesthesia

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

20694 without 51 · national office

$461.93

Fixator removal, under anesthesia

20694-51 · Second procedure: 50%

$230.97

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 20694 has changed in Merced, CA

20694 · Office / nonfacility

$480.50

Effective 2026-10-01

The base rate is $39.79 higher than on 2025-10-01, moving from $440.71 to $480.50 (9.0%).

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

    $440.71changed to$480.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.28 changed to 4.17
    • Practice expense RVU 8.09 changed to 8.87
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $451.53changed to$440.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.04 changed to 8.09
    • Malpractice RVU 0.78 changed to 0.79

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $444.16changed to$451.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $453.15changed to$444.16

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.93 changed to 8.04
    • Malpractice RVU 0.77 changed to 0.78
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $453.28changed to$453.15

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.74 changed to 7.93
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $455.88changed to$453.28

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.72 changed to 7.74
    • Malpractice RVU 0.75 changed to 0.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $452.32changed to$455.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.20 changed to 7.72
    • Malpractice RVU 0.77 changed to 0.75
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $449.88changed to$452.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.15 changed to 7.20
    • Malpractice RVU 0.78 changed to 0.77
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $448.61changed to$449.88

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.13 changed to 7.15

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $447.93changed to$448.61

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.07 changed to 7.13
    • Malpractice RVU 0.77 changed to 0.78
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$447.93

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$480.50$334.07RVU26D
2026-07-01$480.50$334.07RVU26C
2026-04-01$480.50$334.07RVU26B
2026-01-01$480.50$334.07RVU26A
2025-10-01$440.71$348.44RVU25D
2025-07-01$440.71$348.44RVU25C
2025-04-01$440.71$348.44RVU25B
2025-01-01$440.71$348.44RVU25A
2024-10-01$451.53$354.02RVU24D
2024-07-01$451.53$354.02RVU24C
2024-04-01$451.53$354.02RVU24B
2024-03-09$451.53$354.02RVU24AR
2024-01-01$444.16$348.24RVU24A
2023-10-01$453.15$354.06RVU23D
2023-07-01$453.15$354.06RVU23C
2023-04-01$453.15$354.06RVU23B
2023-01-01$453.15$354.06RVU23A
2022-10-01$453.28$353.04RVU22D
2022-07-01$453.28$353.04RVU22C
2022-04-01$453.28$353.04RVU22B
2022-01-01$453.28$353.04RVU22A
2021-10-01$455.88$352.95RVU21D
2021-07-01$455.88$352.95RVU21C
2021-04-01$455.88$352.95RVU21B
2021-01-01$455.88$352.95RVU21A
2020-10-01$452.32$354.62RVU20D
2020-07-01$452.32$354.62RVU20C
2020-04-01$452.32$354.62RVU20B
2020-01-01$452.32$354.62RVU20A
2019-10-01$449.88$353.89RVU19D
2019-07-01$449.88$353.89RVU19C
2019-04-01$449.88$353.89RVU19B
2019-01-01$449.88$353.89RVU19A
2018-10-01$448.61$353.89RVU18D
2018-07-01$448.61$353.89RVU18C
2018-04-01$448.61$353.89RVU18B
2018-01-01$448.61$353.89RVU18AR1
2017-10-01$447.93$354.21RVU17D
2017-07-01$447.93$354.21RVU17C
2017-04-01$447.93$354.21RVU17B
2017-01-01$447.93$354.21RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 20694 for an earlier date of service

Where the Merced, CA rate applies

Merced, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Merced
  • Atwater
  • Ballico
  • Bear Creek
  • Cressey
  • Delhi
  • Dos Palos
  • Dos Palos Y

Browse all communities in California

20694 billing questions

When should this code be chosen instead of 20693?

Use 20694 when the external fixation system is removed under anesthesia. Code 20693 describes adjustment or revision of the system under anesthesia when it remains in place.

Is this the code for removing buried plates or screws?

No. It covers removal of an external fixation system. Codes 20670 and 20680 concern removal of superficial and deep internal implants, respectively.

Can modifier 50 be used when fixators are removed on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the documented procedure rather than appending modifier 50.

What documentation supports reporting 20694?

Document the external fixation device, the clinical reason for removal, that removal was performed under anesthesia, and the operative work completed.

How does the 90-day global period affect follow-up billing?

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

Can an assistant surgeon or co-surgeon be reported?

CMS lists a statutory restriction on assistant-at-surgery payment for this code. 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 20694PPRRVU2026_Oct_nonQPP.csv, line 1,787 (RVU26D)
Geographic factors for Merced, CAGPCI2026.csv, line 15 (RVU26D)

Open CMS sourceHow we calculate rates

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