CPT code 20697: Fixator adjustment, each strut2026 Medicare rate & RVUs in Alabama
Reports adjustment or exchange of individual struts on a multiplane external fixation system, commonly during staged correction of a fracture or limb deformity.
In Alabama, Medicare pays $1,671.41 for 20697 in the office.
Check a contract rate as a % of Medicare · 20697 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 20697 covers
This service covers changing or adjusting individual struts on a multiplane, or orthogonal, external fixation system. Orthopedic surgeons commonly perform it during staged treatment with a hexapod or similar frame, such as when correcting a fracture alignment or limb deformity. Unlike applying the frame, the work addresses its struts while the external fixation system remains in use.
Report the service for each strut adjusted or exchanged, and document the frame, the specific strut work, and the clinical reason for the change. CMS assigns this code a 0-day global period, so same-day preoperative and postoperative care is included. CMS classifies it as technical-component-only, with interpretation covered by a separate code. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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.
How Alabama compares for 20697
Across 109 of 109 payment localities, the office rate for 20697 runs from $1,640.80 in Arkansas to $2,754.08 in San Benito County, CA. Alabama pays $1,671.41. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$1,671.41
- Los Angeles, CA · California$2,259.64+$588.23
- Washington, DC area · District of Columbia$2,250.54+$579.13
- Miami, FL · Florida$1,990.35+$318.94
- Chicago, IL · Illinois$1,921.38+$249.97
- Manhattan, NY · New York$2,220.46+$549.05
- Alaska · Alaska$2,034.20+$362.79
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $1,640.80 | — |
| ArizonaArizona | $1,851.19 | — |
| Bakersfield, CACalifornia | $2,093.45 | — |
| Chico, CACalifornia | $2,093.38 | — |
| El Centro, CACalifornia | $2,093.39 | — |
| Fresno, CACalifornia | $2,093.38 | — |
| Hanford, CACalifornia | $2,093.38 | — |
| Madera, CACalifornia | $2,093.38 | — |
| Merced, CACalifornia | $2,093.38 | — |
| Modesto, CACalifornia | $2,093.38 | — |
| Napa, CACalifornia | $2,517.27 | — |
| Oxnard, CACalifornia | $2,257.69 | — |
| Redding, CACalifornia | $2,093.38 | — |
| Rest of CaliforniaCalifornia | $2,093.38 | — |
| Riverside, CACalifornia | $2,093.70 | — |
| Sacramento, CACalifornia | $2,221.32 | — |
| Salinas, CACalifornia | $2,213.68 | — |
| San Diego, CACalifornia | $2,284.34 | — |
| Marin County, CACalifornia | $2,692.90 | — |
| San Francisco, CACalifornia | $2,692.86 | — |
| San Benito County, CACalifornia | $2,754.08 | — |
| Santa Clara County, CACalifornia | $2,753.94 | — |
| San Luis Obispo, CACalifornia | $2,175.49 | — |
| Santa Cruz, CACalifornia | $2,320.62 | — |
| Santa Maria, CACalifornia | $2,227.05 | — |
| Santa Rosa, CACalifornia | $2,345.44 | — |
| Stockton, CACalifornia | $2,093.38 | — |
| Vallejo, CACalifornia | $2,517.22 | — |
| Visalia, CACalifornia | $2,093.38 | — |
| Yuba City, CACalifornia | $2,093.38 | — |
| ColoradoColorado | $2,032.52 | — |
| ConnecticutConnecticut | $2,057.78 | — |
| DelawareDelaware | $1,887.52 | — |
| Fort Lauderdale, FLFlorida | $1,936.17 | — |
| Rest of FloridaFlorida | $1,827.02 | — |
| Atlanta, GAGeorgia | $1,941.29 | — |
| Rest of GeorgiaGeorgia | $1,704.49 | — |
| Hawaii, Guam, HIHawaii | $2,171.72 | — |
| IowaIowa | $1,747.62 | — |
| IdahoIdaho | $1,757.24 | — |
| East St. Louis, ILIllinois | $1,758.79 | — |
| Rest of IllinoisIllinois | $1,744.97 | — |
| Suburban Chicago, ILIllinois | $1,962.86 | — |
| IndianaIndiana | $1,770.62 | — |
| KansasKansas | $1,726.72 | — |
| KentuckyKentucky | $1,698.49 | — |
| New Orleans, LALouisiana | $1,798.01 | — |
| Rest of LouisianaLouisiana | $1,690.89 | — |
| Metropolitan Boston, MAMassachusetts | $2,280.87 | — |
| Rest of MassachusettsMassachusetts | $2,011.53 | — |
| Baltimore area, MDMaryland | $2,050.16 | — |
| Rest of MarylandMaryland | $1,933.36 | — |
| Rest of MaineMaine | $1,757.39 | — |
| Southern Maine, MEMaine | $1,892.98 | — |
| Detroit, MIMichigan | $1,844.39 | — |
| Rest of MichiganMichigan | $1,744.53 | — |
| MinnesotaMinnesota | $1,965.20 | — |
| Metropolitan Kansas City, MOMissouri | $1,794.03 | — |
| Metropolitan St. Louis, MOMissouri | $1,818.88 | — |
| Rest of MissouriMissouri | $1,646.99 | — |
| MississippiMississippi | $1,644.85 | — |
| MontanaMontana | $1,910.53 | — |
| North CarolinaNorth Carolina | $1,782.23 | — |
| North DakotaNorth Dakota | $1,909.94 | — |
| NebraskaNebraska | $1,762.87 | — |
| New HampshireNew Hampshire | $1,988.70 | — |
| Northern New JerseyNew Jersey | $2,216.12 | — |
| Rest of New JerseyNew Jersey | $2,086.31 | — |
| New MexicoNew Mexico | $1,752.24 | — |
| NevadaNevada | $1,912.27 | — |
| NYC suburbs and Long Island, NYNew York | $2,272.29 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $2,092.15 | — |
| Queens, NYNew York | $2,258.51 | — |
| Rest of New YorkNew York | $1,814.76 | — |
| OhioOhio | $1,744.41 | — |
| OklahomaOklahoma | $1,705.99 | — |
| Portland, OROregon | $2,122.23 | — |
| Rest of OregonOregon | $1,902.60 | — |
| Metropolitan Philadelphia, PAPennsylvania | $1,989.02 | — |
| Rest of PennsylvaniaPennsylvania | $1,753.89 | — |
| Puerto RicoPuerto Rico | $1,931.52 | — |
| Rhode IslandRhode Island | $1,973.44 | — |
| South CarolinaSouth Carolina | $1,765.26 | — |
| South DakotaSouth Dakota | $1,909.87 | — |
| TennesseeTennessee | $1,736.30 | — |
| Austin, TXTexas | $2,021.17 | — |
| Beaumont, TXTexas | $1,738.60 | — |
| Brazoria, TXTexas | $1,893.13 | — |
| Dallas, TXTexas | $1,902.75 | — |
| Fort Worth, TXTexas | $1,883.67 | — |
| Galveston, TXTexas | $1,896.99 | — |
| Houston, TXTexas | $1,897.54 | — |
| Rest of TexasTexas | $1,813.05 | — |
| UtahUtah | $1,795.86 | — |
| VirginiaVirginia | $1,877.77 | — |
| Virgin Islands, VIUnited States Virgin Islands | $1,931.52 | — |
| VermontVermont | $1,890.94 | — |
| Rest of WashingtonWashington | $2,011.50 | — |
| King County, WAWashington | $2,343.81 | — |
| WisconsinWisconsin | $1,829.64 | — |
| West VirginiaWest Virginia | $1,660.81 | — |
| WyomingWyoming | $1,910.27 | — |
20697 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.
$1,640.80
$2,423.73
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $2,034.20 | 1 |
| AL | $1,671.41 | 1 |
| AR | $1,640.80 | 1 |
| AZ | $1,851.19 | 1 |
| CA | $2,093.38–$2,754.08 | 29 |
| CO | $2,032.52 | 1 |
| CT | $2,057.78 | 1 |
| DC | $2,250.54 | 1 |
| DE | $1,887.52 | 1 |
| FL | $1,827.02–$1,990.35 | 3 |
| GA | $1,704.49–$1,941.29 | 2 |
| GU | $2,171.72 | 1 |
| HI | $2,171.72 | 1 |
| IA | $1,747.62 | 1 |
| ID | $1,757.24 | 1 |
| IL | $1,744.97–$1,962.86 | 4 |
| IN | $1,770.62 | 1 |
| KS | $1,726.72 | 1 |
| KY | $1,698.49 | 1 |
| LA | $1,690.89–$1,798.01 | 2 |
| MA | $2,011.53–$2,280.87 | 2 |
| MD | $1,933.36–$2,250.54 | 3 |
| ME | $1,757.39–$1,892.98 | 2 |
| MI | $1,744.53–$1,844.39 | 2 |
| MN | $1,965.20 | 1 |
| MO | $1,646.99–$1,818.88 | 3 |
| MS | $1,644.85 | 1 |
| MT | $1,910.53 | 1 |
| NC | $1,782.23 | 1 |
| ND | $1,909.94 | 1 |
| NE | $1,762.87 | 1 |
| NH | $1,988.70 | 1 |
| NJ | $2,086.31–$2,216.12 | 2 |
| NM | $1,752.24 | 1 |
| NV | $1,912.27 | 1 |
| NY | $1,814.76–$2,272.29 | 5 |
| OH | $1,744.41 | 1 |
| OK | $1,705.99 | 1 |
| OR | $1,902.60–$2,122.23 | 2 |
| PA | $1,753.89–$1,989.02 | 2 |
| PR | $1,931.52 | 1 |
| RI | $1,973.44 | 1 |
| SC | $1,765.26 | 1 |
| SD | $1,909.87 | 1 |
| TN | $1,736.30 | 1 |
| TX | $1,738.60–$2,021.17 | 8 |
| UT | $1,795.86 | 1 |
| VA | $1,877.77–$2,250.54 | 2 |
| VI | $1,931.52 | 1 |
| VT | $1,890.94 | 1 |
| WA | $2,011.50–$2,343.81 | 2 |
| WI | $1,829.64 | 1 |
| WV | $1,660.81 | 1 |
| WY | $1,910.27 | 1 |
How the 20697 rate is calculated
Each of 20697’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 · 20697
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense57.17
57.17 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
57.2000
Conversion factor
$33.4009
Medicare rate
$1,910.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,789
- Code
- 20697
- Physician work
- 0.00
- Practice expense
- 57.17
- Malpractice
- 0.03
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 57.17 | × 0.875 | 50.0237 |
| Malpractice | 0.03 | × 0.566 | 0.0170 |
| Total RVUs | 50.0407 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$1671.41
Office: (0 × 1 + 57.17 × 0.875 + 0.03 × 0.566) × $33.4009 = $1671.41
Payment rules and modifiers for 20697
The CMS indicators that decide how 20697 is paid alongside other services.
CMS payment indicators · 20697
Fixator adjustment, each strut
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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 | 3 | Technical component only. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
20697 without 80 · national office
$1,910.53
Fixator adjustment, each strut
20697-80 · Assistant: 16%
$305.68
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
How 20697 has changed in Alabama
20697 · Office / nonfacility
$1671.41
Effective 2026-10-01
The base rate is $244.88 higher than on 2025-10-01, moving from $1426.53 to $1671.41 (17.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$1426.53changed to$1671.41
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 50.73 changed to 57.17
- Practice expense GPCI 0.869 changed to 0.875
- Malpractice GPCI 0.575 changed to 0.566
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1535.72changed to$1426.53
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 53.07 changed to 50.73
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1510.66changed to$1535.72
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1633.26changed to$1510.66
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 54.86 changed to 53.07
- Malpractice RVU 0.04 changed to 0.03
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$1736.31changed to$1633.26
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 56.46 changed to 54.86
- Practice expense GPCI 0.888 changed to 0.878
- Malpractice GPCI 0.921 changed to 0.748
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1896.95changed to$1736.31
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 61.18 changed to 56.46
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1854.56changed to$1896.95
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 57.78 changed to 61.18
- Malpractice RVU 0.03 changed to 0.04
- Practice expense GPCI 0.889 changed to 0.888
- Malpractice GPCI 0.707 changed to 0.921
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1889.42changed to$1854.56
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 58.89 changed to 57.78
- Practice expense GPCI 0.890 changed to 0.889
- Malpractice GPCI 0.492 changed to 0.707
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$1889.24changed to$1889.42
- Malpractice RVU 0.02 changed to 0.03
Held through RVU19D.
January 1, 2019
RVU19A
$1936.37changed to$1889.24
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 60.42 changed to 58.89
- Malpractice RVU 0.03 changed to 0.02
Held through RVU19B.
April 1, 2018
RVU18B
No ratechanged to$1936.37
Held through RVU18C, RVU18D.
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, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1,671.41 | Not available in this setting | RVU26D |
| 2026-07-01 | $1,671.41 | Not available in this setting | RVU26C |
| 2026-04-01 | $1,671.41 | Not available in this setting | RVU26B |
| 2026-01-01 | $1,671.41 | Not available in this setting | RVU26A |
| 2025-10-01 | $1,426.53 | Not available in this setting | RVU25D |
| 2025-07-01 | $1,426.53 | Not available in this setting | RVU25C |
| 2025-04-01 | $1,426.53 | Not available in this setting | RVU25B |
| 2025-01-01 | $1,426.53 | Not available in this setting | RVU25A |
| 2024-10-01 | $1,535.72 | Not available in this setting | RVU24D |
| 2024-07-01 | $1,535.72 | Not available in this setting | RVU24C |
| 2024-04-01 | $1,535.72 | Not available in this setting | RVU24B |
| 2024-03-09 | $1,535.72 | Not available in this setting | RVU24AR |
| 2024-01-01 | $1,510.66 | Not available in this setting | RVU24A |
| 2023-10-01 | $1,633.26 | Not available in this setting | RVU23D |
| 2023-07-01 | $1,633.26 | Not available in this setting | RVU23C |
| 2023-04-01 | $1,633.26 | Not available in this setting | RVU23B |
| 2023-01-01 | $1,633.26 | Not available in this setting | RVU23A |
| 2022-10-01 | $1,736.31 | Not available in this setting | RVU22D |
| 2022-07-01 | $1,736.31 | Not available in this setting | RVU22C |
| 2022-04-01 | $1,736.31 | Not available in this setting | RVU22B |
| 2022-01-01 | $1,736.31 | Not available in this setting | RVU22A |
| 2021-10-01 | $1,896.95 | Not available in this setting | RVU21D |
| 2021-07-01 | $1,896.95 | Not available in this setting | RVU21C |
| 2021-04-01 | $1,896.95 | Not available in this setting | RVU21B |
| 2021-01-01 | $1,896.95 | Not available in this setting | RVU21A |
| 2020-10-01 | $1,854.56 | Not available in this setting | RVU20D |
| 2020-07-01 | $1,854.56 | Not available in this setting | RVU20C |
| 2020-04-01 | $1,854.56 | Not available in this setting | RVU20B |
| 2020-01-01 | $1,854.56 | Not available in this setting | RVU20A |
| 2019-10-01 | $1,889.42 | Not available in this setting | RVU19D |
| 2019-07-01 | $1,889.42 | Not available in this setting | RVU19C |
| 2019-04-01 | $1,889.24 | Not available in this setting | RVU19B |
| 2019-01-01 | $1,889.24 | Not available in this setting | RVU19A |
| 2018-10-01 | $1,936.37 | Not available in this setting | RVU18D |
| 2018-07-01 | $1,936.37 | Not available in this setting | RVU18C |
| 2018-04-01 | $1,936.37 | Not available in this setting | RVU18B |
| 2018-01-01 | Rate data unavailable | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Not available in this setting | RVU17D |
| 2017-07-01 | Rate data unavailable | Not available in this setting | RVU17C |
| 2017-04-01 | Rate data unavailable | Not available in this setting | RVU17B |
| 2017-01-01 | Rate data unavailable | Not available in this setting | RVU17A |
| 2016-10-01 | Rate data unavailable | Not available in this setting | RVU16D |
| 2016-07-01 | Rate data unavailable | Not available in this setting | RVU16C |
| 2016-04-01 | Rate data unavailable | Not available in this setting | RVU16B |
| 2016-01-01 | Rate data unavailable | Not available in this setting | RVU16A |
| 2015-10-01 | Rate data unavailable | Not available in this setting | RVU15D |
| 2015-07-01 | Rate data unavailable | Not available in this setting | RVU15C |
| 2015-04-01 | Rate data unavailable | Not available in this setting | RVU15B |
| 2015-01-01 | Rate data unavailable | Not available in this setting | RVU15A |
| 2014-10-01 | Rate data unavailable | Not available in this setting | RVU14D |
| 2014-07-01 | Rate data unavailable | Not available in this setting | RVU14C |
| 2014-04-01 | Rate data unavailable | Not available in this setting | RVU14B |
| 2014-01-01 | Rate data unavailable | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Alabama rate applies
Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.
- Abanda
- Abbeville
- Adamsville
- Addison
- Akron
- Alabaster
- Albertville
- Alexander City
20697 billing questions
How does this differ from 20696?
20696 reports initial application of a multiplane external fixation system. Use 20697 for subsequent strut adjustment or exchange on the frame.
How does this differ from 20693?
20693 describes adjustment or revision of an external fixation system that requires anesthesia. Code 20697 is specific to strut adjustment or exchange on a multiplane orthogonal system.
How many units should be reported?
The code is reported for each strut adjusted or exchanged. Document which struts were changed and the work performed on each.
Is same-day postoperative care separately reported?
No. CMS assigns a 0-day global period, which includes same-day preoperative and postoperative care.
Can modifier 50 be used when struts on both sides are adjusted?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the struts treated, not with modifier 50.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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
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