CPT code 20703: Device removal, intramedullary placement2026 Medicare rate & RVUs in Vallejo, CA
Report removal of a previously placed drug-delivery device from the medullary canal, alongside the primary procedure performed during that operative encounter.
In Vallejo, CA, Medicare pays $117.18 for 20703 in the office and $92.97 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 20703 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 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.
How Vallejo, CA compares for 20703
Across 109 of 109 payment localities, the office rate for 20703 runs from $97.17 in Arkansas to $134.66 in Alaska. Vallejo, CA pays $117.18. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Vallejo, CA · this page$117.18
- Bakersfield, CA · California$108.27−$8.91
- Chico, CA · California$107.22−$9.96
- El Centro, CA · California$107.29−$9.89
- Fresno, CA · California$107.22−$9.96
- Hanford, CA · California$107.22−$9.96
- Los Angeles, CA · California$113.48−$3.70
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | $107.22 | $87.09 |
| Merced, CACalifornia | $107.22 | $87.09 |
| Modesto, CACalifornia | $107.22 | $87.09 |
| Napa, CACalifornia | $117.80 | $93.59 |
| Oxnard, CACalifornia | $112.16 | $90.45 |
| Redding, CACalifornia | $107.22 | $87.09 |
| Rest of CaliforniaCalifornia | $107.22 | $87.09 |
| Riverside, CACalifornia | $111.30 | $91.17 |
| Sacramento, CACalifornia | $110.82 | $89.46 |
| Salinas, CACalifornia | $110.38 | $89.09 |
| San Diego, CACalifornia | $111.77 | $89.80 |
| Marin County, CACalifornia | $122.47 | $96.57 |
| San Francisco, CACalifornia | $122.04 | $96.14 |
| San Benito County, CACalifornia | $125.52 | $99.03 |
| Santa Clara County, CACalifornia | $123.75 | $97.26 |
| San Luis Obispo, CACalifornia | $108.82 | $87.89 |
| Santa Cruz, CACalifornia | $111.87 | $89.55 |
| Santa Maria, CACalifornia | $110.46 | $89.04 |
| Santa Rosa, CACalifornia | $112.88 | $90.32 |
| Stockton, CACalifornia | $107.22 | $87.09 |
| Visalia, CACalifornia | $107.22 | $87.09 |
| Yuba City, CACalifornia | $107.22 | $87.09 |
| Washington, DC areaDistrict of Columbia | $119.76 | $98.12 |
| Miami, FLFlorida | $129.48 | $110.36 |
| Chicago, ILIllinois | $125.59 | $107.12 |
| Manhattan, NYNew York | $125.76 | $104.41 |
| AlaskaAlaska | $134.66 | $115.09 |
| AlabamaAlabama | $98.41 | $82.34 |
| ArkansasArkansas | $97.17 | $81.39 |
| ArizonaArizona | $105.58 | $87.77 |
| ColoradoColorado | $108.85 | $89.31 |
| ConnecticutConnecticut | $115.25 | $95.46 |
| DelawareDelaware | $107.12 | $88.97 |
| Fort Lauderdale, FLFlorida | $119.29 | $100.68 |
| Rest of FloridaFlorida | $113.31 | $95.74 |
| Atlanta, GAGeorgia | $111.87 | $93.21 |
| Rest of GeorgiaGeorgia | $106.99 | $90.60 |
| Hawaii, Guam, HIHawaii | $108.29 | $87.40 |
| IowaIowa | $97.75 | $80.94 |
| IdahoIdaho | $98.90 | $82.00 |
| East St. Louis, ILIllinois | $118.46 | $101.56 |
| Rest of IllinoisIllinois | $112.47 | $95.70 |
| Suburban Chicago, ILIllinois | $119.76 | $100.90 |
| IndianaIndiana | $99.32 | $82.29 |
| KansasKansas | $98.70 | $82.09 |
| KentuckyKentucky | $103.36 | $87.03 |
| New Orleans, LALouisiana | $108.09 | $90.81 |
| Rest of LouisianaLouisiana | $103.76 | $87.50 |
| Metropolitan Boston, MAMassachusetts | $116.76 | $94.83 |
| Rest of MassachusettsMassachusetts | $108.88 | $89.54 |
| Baltimore area, MDMaryland | $115.21 | $95.50 |
| Rest of MarylandMaryland | $108.54 | $89.95 |
| Rest of MaineMaine | $100.79 | $83.89 |
| Southern Maine, MEMaine | $103.54 | $85.33 |
| Detroit, MIMichigan | $115.96 | $98.23 |
| Rest of MichiganMichigan | $106.96 | $90.19 |
| MinnesotaMinnesota | $100.69 | $81.79 |
| Metropolitan Kansas City, MOMissouri | $106.00 | $88.75 |
| Metropolitan St. Louis, MOMissouri | $106.80 | $89.31 |
| Rest of MissouriMissouri | $103.11 | $87.27 |
| MississippiMississippi | $100.09 | $84.27 |
| MontanaMontana | $108.53 | $90.16 |
| North CarolinaNorth Carolina | $101.49 | $84.35 |
| North DakotaNorth Dakota | $101.01 | $82.64 |
| NebraskaNebraska | $97.80 | $80.85 |
| New HampshireNew Hampshire | $108.49 | $89.36 |
| Northern New JerseyNew Jersey | $119.05 | $97.74 |
| Rest of New JerseyNew Jersey | $115.55 | $95.49 |
| New MexicoNew Mexico | $108.03 | $91.18 |
| NevadaNevada | $106.47 | $88.08 |
| NYC suburbs and Long Island, NYNew York | $130.20 | $108.36 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $117.39 | $97.27 |
| Queens, NYNew York | $124.67 | $102.96 |
| Rest of New YorkNew York | $102.93 | $85.48 |
| OhioOhio | $105.43 | $88.66 |
| OklahomaOklahoma | $101.76 | $85.35 |
| Portland, OROregon | $110.36 | $89.95 |
| Rest of OregonOregon | $104.63 | $86.34 |
| Metropolitan Philadelphia, PAPennsylvania | $113.58 | $94.46 |
| Rest of PennsylvaniaPennsylvania | $104.81 | $87.95 |
| Puerto RicoPuerto Rico | $108.77 | $90.20 |
| Rhode IslandRhode Island | $109.52 | $90.55 |
| South CarolinaSouth Carolina | $103.83 | $86.86 |
| South DakotaSouth Dakota | $100.13 | $81.75 |
| TennesseeTennessee | $99.30 | $82.60 |
| Austin, TXTexas | $109.37 | $89.94 |
| Beaumont, TXTexas | $104.32 | $87.60 |
| Brazoria, TXTexas | $105.90 | $87.69 |
| Dallas, TXTexas | $107.13 | $88.83 |
| Fort Worth, TXTexas | $106.93 | $88.81 |
| Galveston, TXTexas | $106.58 | $88.34 |
| Houston, TXTexas | $113.54 | $95.29 |
| Rest of TexasTexas | $105.43 | $88.00 |
| UtahUtah | $105.03 | $87.77 |
| VirginiaVirginia | $104.19 | $86.13 |
| Virgin Islands, VIUnited States Virgin Islands | $108.77 | $90.20 |
| VermontVermont | $101.91 | $83.73 |
| Rest of WashingtonWashington | $108.25 | $88.90 |
| King County, WAWashington | $117.59 | $95.04 |
| WisconsinWisconsin | $98.21 | $80.61 |
| West VirginiaWest Virginia | $109.17 | $93.20 |
| WyomingWyoming | $105.25 | $86.88 |
20703 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.
$97.17
$134.66
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 | $134.66 | 1 |
| AL | $98.41 | 1 |
| AR | $97.17 | 1 |
| AZ | $105.58 | 1 |
| CA | $107.22–$125.52 | 29 |
| CO | $108.85 | 1 |
| CT | $115.25 | 1 |
| DC | $119.76 | 1 |
| DE | $107.12 | 1 |
| FL | $113.31–$129.48 | 3 |
| GA | $106.99–$111.87 | 2 |
| GU | $108.29 | 1 |
| HI | $108.29 | 1 |
| IA | $97.75 | 1 |
| ID | $98.90 | 1 |
| IL | $112.47–$125.59 | 4 |
| IN | $99.32 | 1 |
| KS | $98.70 | 1 |
| KY | $103.36 | 1 |
| LA | $103.76–$108.09 | 2 |
| MA | $108.88–$116.76 | 2 |
| MD | $108.54–$119.76 | 3 |
| ME | $100.79–$103.54 | 2 |
| MI | $106.96–$115.96 | 2 |
| MN | $100.69 | 1 |
| MO | $103.11–$106.80 | 3 |
| MS | $100.09 | 1 |
| MT | $108.53 | 1 |
| NC | $101.49 | 1 |
| ND | $101.01 | 1 |
| NE | $97.80 | 1 |
| NH | $108.49 | 1 |
| NJ | $115.55–$119.05 | 2 |
| NM | $108.03 | 1 |
| NV | $106.47 | 1 |
| NY | $102.93–$130.20 | 5 |
| OH | $105.43 | 1 |
| OK | $101.76 | 1 |
| OR | $104.63–$110.36 | 2 |
| PA | $104.81–$113.58 | 2 |
| PR | $108.77 | 1 |
| RI | $109.52 | 1 |
| SC | $103.83 | 1 |
| SD | $100.13 | 1 |
| TN | $99.30 | 1 |
| TX | $104.32–$113.54 | 8 |
| UT | $105.03 | 1 |
| VA | $104.19–$119.76 | 2 |
| VI | $108.77 | 1 |
| VT | $101.91 | 1 |
| WA | $108.25–$117.59 | 2 |
| WI | $98.21 | 1 |
| WV | $109.17 | 1 |
| WY | $105.25 | 1 |
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.
The exact Vallejo, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,793
- Code
- 20703
- Physician work
- 1.76
- Practice expense
- 1.11
- Malpractice
- 0.38
GPCI2026.csv
33
- Locality
- Vallejo, CA
- Physician work
- 1.063
- Practice expense
- 1.318
- Malpractice
- 0.459
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.76 | × 1.063 | 1.8709 |
| Practice expense | 1.11 | × 1.318 | 1.4630 |
| Malpractice | 0.38 | × 0.459 | 0.1744 |
| Total RVUs | 3.5083 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Vallejo, CA$117.18
Office: (1.76 × 1.063 + 1.11 × 1.318 + 0.38 × 0.459) × $33.4009 = $117.18
Facility: (1.76 × 1.063 + 0.56 × 1.318 + 0.38 × 0.459) × $33.4009 = $92.97
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. |
How 20703 has changed in Vallejo, CA
20703 · Office / nonfacility
$117.18
Effective 2026-10-01
The base rate is $9.12 higher than on 2025-10-01, moving from $108.06 to $117.18 (8.4%).
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
$108.06changed to$117.18
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.80 changed to 1.76
- Practice expense RVU 0.96 changed to 1.11
- Work GPCI 1.058 changed to 1.063
- Practice expense GPCI 1.310 changed to 1.318
- Malpractice GPCI 0.470 changed to 0.459
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$109.74changed to$108.06
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.93 changed to 0.96
- Malpractice RVU 0.37 changed to 0.38
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$107.94changed to$109.74
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$108.46changed to$107.94
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.90 changed to 0.93
- Malpractice RVU 0.35 changed to 0.37
- Work GPCI 1.051 changed to 1.058
- Practice expense GPCI 1.265 changed to 1.310
- Malpractice GPCI 0.487 changed to 0.470
January 1, 2023
RVU23A
$109.91changed to$108.46
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.91 changed to 0.90
- Malpractice RVU 0.37 changed to 0.35
- Work GPCI 1.044 changed to 1.051
- Practice expense GPCI 1.220 changed to 1.265
- Malpractice GPCI 0.504 changed to 0.487
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$106.11changed to$109.91
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.82 changed to 0.91
- Malpractice RVU 0.32 changed to 0.37
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$109.44changed to$106.11
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.80 changed to 0.82
- Malpractice RVU 0.31 changed to 0.32
- Work GPCI 1.049 changed to 1.044
- Practice expense GPCI 1.238 changed to 1.220
- Malpractice GPCI 0.496 changed to 0.504
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$109.44
Held through RVU20B, RVU20C, RVU20D.
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, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $117.18 | $92.97 | RVU26D |
| 2026-07-01 | $117.18 | $92.97 | RVU26C |
| 2026-04-01 | $117.18 | $92.97 | RVU26B |
| 2026-01-01 | $117.18 | $92.97 | RVU26A |
| 2025-10-01 | $108.06 | $108.06 | RVU25D |
| 2025-07-01 | $108.06 | $108.06 | RVU25C |
| 2025-04-01 | $108.06 | $108.06 | RVU25B |
| 2025-01-01 | $108.06 | $108.06 | RVU25A |
| 2024-10-01 | $109.74 | $109.74 | RVU24D |
| 2024-07-01 | $109.74 | $109.74 | RVU24C |
| 2024-04-01 | $109.74 | $109.74 | RVU24B |
| 2024-03-09 | $109.74 | $109.74 | RVU24AR |
| 2024-01-01 | $107.94 | $107.94 | RVU24A |
| 2023-10-01 | $108.46 | $108.46 | RVU23D |
| 2023-07-01 | $108.46 | $108.46 | RVU23C |
| 2023-04-01 | $108.46 | $108.46 | RVU23B |
| 2023-01-01 | $108.46 | $108.46 | RVU23A |
| 2022-10-01 | $109.91 | $109.91 | RVU22D |
| 2022-07-01 | $109.91 | $109.91 | RVU22C |
| 2022-04-01 | $109.91 | $109.91 | RVU22B |
| 2022-01-01 | $109.91 | $109.91 | RVU22A |
| 2021-10-01 | $106.11 | $106.11 | RVU21D |
| 2021-07-01 | $106.11 | $106.11 | RVU21C |
| 2021-04-01 | $106.11 | $106.11 | RVU21B |
| 2021-01-01 | $106.11 | $106.11 | RVU21A |
| 2020-10-01 | $109.44 | $109.44 | RVU20D |
| 2020-07-01 | $109.44 | $109.44 | RVU20C |
| 2020-04-01 | $109.44 | $109.44 | RVU20B |
| 2020-01-01 | $109.44 | $109.44 | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Vallejo, CA rate applies
Vallejo, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Vallejo
- Allendale
- Benicia
- Dixon
- Elmira
- Fairfield
- Green Valley
- Hartley
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.
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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