CPT code 20703: Device removal, intramedullary placement2026 Medicare rate & RVUs in California
Report removal of a previously placed drug-delivery device from the medullary canal, alongside the primary procedure performed during that operative encounter.
Medicare pays $107.22–$125.52 for 20703 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
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 20703 covers
This code describes surgical removal of a drug-delivery device positioned within the medullary canal, such as an intramedullary antibiotic implant used in treating bone infection. An orthopedic surgeon typically performs the removal in an operating room, often during a subsequent procedure after the device has served its treatment purpose. The code is specific to intramedullary placement; removal from another deep site or from a joint has a different code in this family.
Report 20703 only with an eligible primary procedure for the operative encounter. CMS treats it as an add-on code paid within the primary procedure’s global period, so it is not reported as a stand-alone service. The operative note should identify the intramedullary location, the device removed, and the removal performed. It should also support the primary procedure billed with the add-on. The code describes removal, not preparation or insertion of a replacement device.
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 20703 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$107.22 to $125.52
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $108.27 | $88.13 |
| Chico, CA | $107.22 | $87.09 |
| El Centro, CA | $107.29 | $87.15 |
| Fresno, CA | $107.22 | $87.09 |
| Hanford, CA | $107.22 | $87.09 |
| Los Angeles, CA | $113.48 | $91.75 |
| Madera, CA | $107.22 | $87.09 |
| Marin County, CA | $122.47 | $96.57 |
| Merced, CA | $107.22 | $87.09 |
| Modesto, CA | $107.22 | $87.09 |
| Napa, CA | $117.80 | $93.59 |
| Oxnard, CA | $112.16 | $90.45 |
| Redding, CA | $107.22 | $87.09 |
| Rest of California | $107.22 | $87.09 |
| Riverside, CA | $111.30 | $91.17 |
| Sacramento, CA | $110.82 | $89.46 |
| Salinas, CA | $110.38 | $89.09 |
| San Benito County, CA | $125.52 | $99.03 |
| San Diego, CA | $111.77 | $89.80 |
| San Francisco, CA | $122.04 | $96.14 |
| San Luis Obispo, CA | $108.82 | $87.89 |
| Santa Clara County, CA | $123.75 | $97.26 |
| Santa Cruz, CA | $111.87 | $89.55 |
| Santa Maria, CA | $110.46 | $89.04 |
| Santa Rosa, CA | $112.88 | $90.32 |
| Stockton, CA | $107.22 | $87.09 |
| Vallejo, CA | $117.18 | $92.97 |
| Visalia, CA | $107.22 | $87.09 |
| Yuba City, CA | $107.22 | $87.09 |
How the 20703 rate is calculated
Each of 20703’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 · 20703
RVUs × geographic indexes × conversion factor
Work1.76
1.76 RVUs× 1.000 GPCI
Practice expense1.11
1.11 RVUs× 1.000 GPCI
Malpractice0.38
0.38 RVUs× 1.000 GPCI
Adjusted RVUs
3.2500
Conversion factor
$33.4009
Medicare rate
$108.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20703
The CMS indicators that decide how 20703 is paid alongside other services.
CMS payment indicators · 20703
Device removal, intramedullary placement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
20703 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20701Device removalDeep location
- Choose 20703 for an intramedullary device; 20701 is for removal from a deep site not classified as intramedullary.
- 20705Device removalIntra-articular drug delivery
- 20705 applies to removal of an intra-articular device. 20703 applies to removal from the medullary canal.
- 20702Drug deliveryIntramedullary insertion
- 20702 describes preparation and insertion of an intramedullary drug-delivery device. 20703 describes removal of one already in place.
20703 billing questions
How does 20703 differ from 20701?
20703 is for removal from the medullary canal. 20701 describes removal of a drug-delivery device from a deep site outside that specific intramedullary category.
When would 20705 be used instead?
Use 20705 for removal of a drug-delivery device placed intra-articularly. Use 20703 when the device being removed was positioned within the medullary canal.
Can 20703 be reported by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure and is paid within that procedure’s global period.
Does 20703 include inserting a replacement device?
No. It describes removal. If a new intramedullary drug-delivery device is prepared and inserted during the encounter, document that work separately for consideration of the applicable insertion code.
What should the operative note establish?
Document that the device was located in the medullary canal and was removed, identify the device, and describe the primary procedure performed with the add-on.
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.
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