CPT code 20704: Drug device placement, intra-articular preparation and insertion2026 Medicare rate & RVUs
This add-on covers manual preparation and placement of a drug-delivery device within a joint during a related primary orthopedic procedure.
Medicare pays $155.65 for 20704 nationally in the office and $128.59 in a hospital or facility. Local office rates run $139.80–$193.91.
Medicare rate · 20704
Drug device placement, intra-articular preparation and insertion
- Work RVUs
- 2.54
- Total RVUs
- 4.66
- Global days
- ZZZ
National rate · 2026
$155.65
Office setting, before claim adjustments.
See every locality for 20704 →Billed by an NP, PA or therapist? →
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 10 sections
What 20704 covers
An orthopedic surgeon reports 20704 when manually preparing a drug-delivery device and placing it inside a joint during operative treatment. A common situation is staged management of an infected joint, with antibiotic mixed into cement and formed as an intra-articular spacer or beads. The work is performed in the operating room as part of the joint procedure; this code identifies device preparation and placement, not the underlying debridement, revision, or other primary operation.
Report 20704 only with a primary procedure; it is an add-on and is not submitted by itself. The operative note should identify the joint, describe manual preparation of the drug-delivery device and its intra-articular placement, and support the associated primary procedure. CMS places payment for this add-on within the primary procedure's global period. Select this code by the device's final location: placement in the joint, rather than deep soft tissue or the intramedullary canal, distinguishes it from neighboring insertion codes.
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 20704 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$139.80 to $193.91
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $141.53 | $117.86 |
| Alaska | $193.91 | $165.10 |
| Arizona | $151.53 | $125.31 |
| Arkansas | $139.80 | $116.56 |
| Atlanta, GA | $160.19 | $132.70 |
| Austin, TX | $156.99 | $128.37 |
| Bakersfield, CA | $155.76 | $126.11 |
| Baltimore area, MD | $164.97 | $135.94 |
| Beaumont, TX | $149.60 | $124.98 |
| Brazoria, TX | $152.10 | $125.28 |
| Chicago, IL | $178.57 | $151.38 |
| Chico, CA | $154.35 | $124.70 |
| Colorado | $156.38 | $127.59 |
| Connecticut | $165.06 | $135.92 |
| Dallas, TX | $153.78 | $126.83 |
| Delaware | $153.71 | $126.98 |
| Detroit, MI | $165.45 | $139.34 |
| East St. Louis, IL | $168.62 | $143.73 |
| El Centro, CA | $154.43 | $124.78 |
| Fort Lauderdale, FL | $170.11 | $142.70 |
| Fort Worth, TX | $153.46 | $126.79 |
| Fresno, CA | $154.35 | $124.70 |
| Galveston, TX | $153.02 | $126.16 |
| Hanford, CA | $154.35 | $124.70 |
| Hawaii, Guam, HI | $155.84 | $125.08 |
| Houston, TX | $162.36 | $135.49 |
| Idaho | $142.37 | $117.48 |
| Indiana | $142.97 | $117.89 |
| Iowa | $140.81 | $116.05 |
| Kansas | $142.04 | $117.58 |
| Kentucky | $148.23 | $124.18 |
| King County, WA | $168.98 | $135.78 |
| Los Angeles, CA | $163.24 | $131.24 |
| Madera, CA | $154.35 | $124.70 |
| Manhattan, NY | $179.77 | $148.33 |
| Marin County, CA | $176.54 | $138.39 |
| Merced, CA | $154.35 | $124.70 |
| Metropolitan Boston, MA | $167.69 | $135.38 |
| Metropolitan Kansas City, MO | $151.98 | $126.57 |
| Metropolitan Philadelphia, PA | $162.67 | $134.50 |
| Metropolitan St. Louis, MO | $153.10 | $127.34 |
| Miami, FL | $183.90 | $155.73 |
| Minnesota | $145.22 | $117.38 |
| Mississippi | $143.73 | $120.43 |
| Modesto, CA | $154.35 | $124.70 |
| Montana | $155.61 | $128.56 |
| Napa, CA | $169.71 | $134.05 |
| Nebraska | $140.91 | $115.94 |
| Nevada | $152.86 | $125.78 |
| New Hampshire | $155.72 | $127.56 |
| New Mexico | $154.61 | $129.80 |
| New Orleans, LA | $154.79 | $129.33 |
| North Carolina | $145.90 | $120.65 |
| North Dakota | $145.53 | $118.47 |
| Northern New Jersey | $170.76 | $139.37 |
| NYC suburbs and Long Island, NY | $185.84 | $153.67 |
| Ohio | $151.11 | $126.41 |
| Oklahoma | $146.10 | $121.94 |
| Oxnard, CA | $161.39 | $129.41 |
| Portland, OR | $158.61 | $128.56 |
| Poughkeepsie and northern NYC suburbs, NY | $168.15 | $138.53 |
| Puerto Rico | $155.98 | $128.63 |
| Queens, NY | $178.39 | $146.42 |
| Redding, CA | $154.35 | $124.70 |
| Rest of California | $154.35 | $124.70 |
| Rest of Florida | $161.85 | $135.99 |
| Rest of Georgia | $153.11 | $128.98 |
| Rest of Illinois | $160.56 | $135.86 |
| Rest of Louisiana | $148.75 | $124.81 |
| Rest of Maine | $144.91 | $120.02 |
| Rest of Maryland | $155.75 | $128.37 |
| Rest of Massachusetts | $156.40 | $127.91 |
| Rest of Michigan | $153.17 | $128.47 |
| Rest of Missouri | $147.78 | $124.46 |
| Rest of New Jersey | $165.64 | $136.10 |
| Rest of New York | $147.90 | $122.20 |
| Rest of Oregon | $150.37 | $123.43 |
| Rest of Pennsylvania | $150.30 | $125.47 |
| Rest of Texas | $151.25 | $125.58 |
| Rest of Washington | $155.53 | $127.04 |
| Rhode Island | $157.19 | $129.25 |
| Riverside, CA | $159.83 | $130.18 |
| Sacramento, CA | $159.56 | $128.10 |
| Salinas, CA | $158.92 | $127.57 |
| San Benito County, CA | $180.85 | $141.83 |
| San Diego, CA | $160.93 | $128.57 |
| San Francisco, CA | $175.96 | $137.81 |
| San Luis Obispo, CA | $156.66 | $125.85 |
| Santa Clara County, CA | $178.48 | $139.46 |
| Santa Cruz, CA | $161.09 | $128.22 |
| Santa Maria, CA | $159.05 | $127.50 |
| Santa Rosa, CA | $162.55 | $129.33 |
| South Carolina | $149.01 | $124.01 |
| South Dakota | $144.34 | $117.28 |
| Southern Maine, ME | $148.88 | $122.07 |
| Stockton, CA | $154.35 | $124.70 |
| Suburban Chicago, IL | $170.84 | $143.06 |
| Tennessee | $142.87 | $118.27 |
| Utah | $150.68 | $125.25 |
| Vallejo, CA | $168.88 | $133.22 |
| Vermont | $146.70 | $119.91 |
| Virgin Islands, VI | $155.98 | $128.63 |
| Virginia | $149.73 | $123.13 |
| Visalia, CA | $154.35 | $124.70 |
| Washington, DC area | $171.73 | $139.86 |
| West Virginia | $155.95 | $132.43 |
| Wisconsin | $141.60 | $115.68 |
| Wyoming | $151.22 | $124.16 |
| Yuba City, CA | $154.35 | $124.70 |
20704 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.
$139.80
$193.91
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 | $193.91 | 1 |
| AL | $141.53 | 1 |
| AR | $139.80 | 1 |
| AZ | $151.53 | 1 |
| CA | $154.35–$180.85 | 29 |
| CO | $156.38 | 1 |
| CT | $165.06 | 1 |
| DC | $171.73 | 1 |
| DE | $153.71 | 1 |
| FL | $161.85–$183.90 | 3 |
| GA | $153.11–$160.19 | 2 |
| GU | $155.84 | 1 |
| HI | $155.84 | 1 |
| IA | $140.81 | 1 |
| ID | $142.37 | 1 |
| IL | $160.56–$178.57 | 4 |
| IN | $142.97 | 1 |
| KS | $142.04 | 1 |
| KY | $148.23 | 1 |
| LA | $148.75–$154.79 | 2 |
| MA | $156.40–$167.69 | 2 |
| MD | $155.75–$171.73 | 3 |
| ME | $144.91–$148.88 | 2 |
| MI | $153.17–$165.45 | 2 |
| MN | $145.22 | 1 |
| MO | $147.78–$153.10 | 3 |
| MS | $143.73 | 1 |
| MT | $155.61 | 1 |
| NC | $145.90 | 1 |
| ND | $145.53 | 1 |
| NE | $140.91 | 1 |
| NH | $155.72 | 1 |
| NJ | $165.64–$170.76 | 2 |
| NM | $154.61 | 1 |
| NV | $152.86 | 1 |
| NY | $147.90–$185.84 | 5 |
| OH | $151.11 | 1 |
| OK | $146.10 | 1 |
| OR | $150.37–$158.61 | 2 |
| PA | $150.30–$162.67 | 2 |
| PR | $155.98 | 1 |
| RI | $157.19 | 1 |
| SC | $149.01 | 1 |
| SD | $144.34 | 1 |
| TN | $142.87 | 1 |
| TX | $149.60–$162.36 | 8 |
| UT | $150.68 | 1 |
| VA | $149.73–$171.73 | 2 |
| VI | $155.98 | 1 |
| VT | $146.70 | 1 |
| WA | $155.53–$168.98 | 2 |
| WI | $141.60 | 1 |
| WV | $155.95 | 1 |
| WY | $151.22 | 1 |
How the 20704 rate is calculated
Each of 20704’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 · 20704
RVUs × geographic indexes × conversion factor
Work2.54
2.54 RVUs× 1.000 GPCI
Practice expense1.61
1.61 RVUs× 1.000 GPCI
Malpractice0.51
0.51 RVUs× 1.000 GPCI
Adjusted RVUs
4.6600
Conversion factor
$33.4009
Medicare rate
$155.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20704
The CMS indicators that decide how 20704 is paid alongside other services.
CMS payment indicators · 20704
Drug device placement, intra-articular preparation and insertion
| 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. |
20704 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20700Drug-delivery deviceDeep placement
- Choose 20700 for a device placed in a deep location; 20704 is for placement within a joint.
- 20702Drug deliveryIntramedullary insertion
- Choose 20702 for placement in the intramedullary canal. Code 20704 applies when the device is placed intra-articularly.
- 20705Device removalIntra-articular drug delivery
- Code 20705 describes removal of an intra-articular device. Code 20704 describes its manual preparation and insertion.
20704 billing questions
Can 20704 be billed by itself?
No. It is an add-on code and must be billed with a primary procedure.
How is 20704 different from 20702?
Use 20704 when the device is placed inside a joint. Code 20702 is for placement in the intramedullary canal.
Does 20704 include the joint operation?
No. It reports manual preparation and intra-articular placement of the drug-delivery device; the associated primary procedure is reported separately.
What should the operative note support?
Document the joint involved, manual preparation of the device, its placement within the joint, and the related primary procedure.
Which code describes later removal of the device?
Code 20705 describes removal of an intra-articular drug-delivery device; 20704 describes preparation and insertion.
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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