CPT code 20696: External fixation, initial computer-adjusted application2026 Medicare rate & RVUs in Missouri
Reports initial placement of a unilateral multiplane external fixation system that uses computer-assisted adjustment, such as a spatial frame for fracture or deformity treatment.
CMS doesn’t publish an office rate for 20696 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 20696 covers
An orthopedic surgeon or other qualified surgeon uses this code for initial placement of a unilateral external fixation system with pins or wires positioned in more than one plane and stereotactic computer-assisted adjustment. A spatial or hexapod frame may be used to manage a complex fracture or gradually correct a bone deformity. The service is generally performed in an operating room or another surgical setting, with the frame applied to the affected limb.
Documentation should identify the treated bone or segment, the multiplane fixation construct, the computer-assisted adjustment capability, and that this is the initial application. The 90-day global period includes 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 other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. 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 20696 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,035.75 |
| Metropolitan St. Louis, MO | Unavailable | $1,043.32 |
| Rest of Missouri | Unavailable | $1,005.46 |
How the 20696 rate is calculated
Each of 20696’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 · 20696
RVUs × geographic indexes × conversion factor
Work17.12
17.12 RVUs× 1.000 GPCI
Practice expense11.66
11.66 RVUs× 1.000 GPCI
Malpractice3.01
3.01 RVUs× 1.000 GPCI
Adjusted RVUs
31.7900
Conversion factor
$33.4009
Medicare rate
$1,061.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20696
20696 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20696
External fixation, initial computer-adjusted application
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 20696
External fixation, initial computer-adjusted application
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20696 without 51 · national facility
$1,061.81
External fixation, initial computer-adjusted application
20696-51 · Second procedure: 50%
$530.91
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%).
20696 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20692External fixationMultiplane, unilateral
- Choose 20696 for initial placement of a multiplane frame with stereotactic computer-assisted adjustment; 20692 describes multiplane fixation without that feature.
- 20690External fixationUnilateral, single-plane frame
- 20690 is for a unilateral frame with pins or wires in one plane. 20696 requires a multiplane construct and computer-assisted adjustment.
- 20697Fixator adjustmentEach strut
- 20696 covers the initial segment of the computer-adjusted system; 20697 is used for each additional segment.
20696 billing questions
How does 20696 differ from 20692?
20696 is for initial application of a multiplane frame with stereotactic computer-assisted adjustment. Use 20692 for a multiplane external fixation system without that computer-assisted adjustment.
When is 20697 reported with 20696?
20697 describes each additional segment when the computer-adjusted multiplane system extends beyond the initial segment. Document the additional segment separately.
Can modifier 50 be used for bilateral application?
No. CMS identifies bilateral adjustment as inappropriate for this code; its descriptor and anatomy make modifier 50 inappropriate.
Is an assistant at surgery payable?
Assistant-at-surgery payment may be made for 20696. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
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