CPT code 20704: Drug device placement, intra-articular preparation and insertion2026 Medicare rate & RVUs in Alabama
This add-on covers manual preparation and placement of a drug-delivery device within a joint during a related primary orthopedic procedure.
In Alabama, Medicare pays $141.53 for 20704 in the office and $117.86 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 20704 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 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.
How Alabama compares for 20704
Across 109 of 109 payment localities, the office rate for 20704 runs from $139.80 in Arkansas to $193.91 in Alaska. Alabama pays $141.53. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$141.53
- Los Angeles, CA · California$163.24+$21.71
- Washington, DC area · District of Columbia$171.73+$30.20
- Miami, FL · Florida$183.90+$42.37
- Chicago, IL · Illinois$178.57+$37.04
- Manhattan, NY · New York$179.77+$38.24
- Alaska · Alaska$193.91+$52.38
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $139.80 | $116.56 |
| ArizonaArizona | $151.53 | $125.31 |
| Bakersfield, CACalifornia | $155.76 | $126.11 |
| Chico, CACalifornia | $154.35 | $124.70 |
| El Centro, CACalifornia | $154.43 | $124.78 |
| Fresno, CACalifornia | $154.35 | $124.70 |
| Hanford, CACalifornia | $154.35 | $124.70 |
| Madera, CACalifornia | $154.35 | $124.70 |
| Merced, CACalifornia | $154.35 | $124.70 |
| Modesto, CACalifornia | $154.35 | $124.70 |
| Napa, CACalifornia | $169.71 | $134.05 |
| Oxnard, CACalifornia | $161.39 | $129.41 |
| Redding, CACalifornia | $154.35 | $124.70 |
| Rest of CaliforniaCalifornia | $154.35 | $124.70 |
| Riverside, CACalifornia | $159.83 | $130.18 |
| Sacramento, CACalifornia | $159.56 | $128.10 |
| Salinas, CACalifornia | $158.92 | $127.57 |
| San Diego, CACalifornia | $160.93 | $128.57 |
| Marin County, CACalifornia | $176.54 | $138.39 |
| San Francisco, CACalifornia | $175.96 | $137.81 |
| San Benito County, CACalifornia | $180.85 | $141.83 |
| Santa Clara County, CACalifornia | $178.48 | $139.46 |
| San Luis Obispo, CACalifornia | $156.66 | $125.85 |
| Santa Cruz, CACalifornia | $161.09 | $128.22 |
| Santa Maria, CACalifornia | $159.05 | $127.50 |
| Santa Rosa, CACalifornia | $162.55 | $129.33 |
| Stockton, CACalifornia | $154.35 | $124.70 |
| Vallejo, CACalifornia | $168.88 | $133.22 |
| Visalia, CACalifornia | $154.35 | $124.70 |
| Yuba City, CACalifornia | $154.35 | $124.70 |
| ColoradoColorado | $156.38 | $127.59 |
| ConnecticutConnecticut | $165.06 | $135.92 |
| DelawareDelaware | $153.71 | $126.98 |
| Fort Lauderdale, FLFlorida | $170.11 | $142.70 |
| Rest of FloridaFlorida | $161.85 | $135.99 |
| Atlanta, GAGeorgia | $160.19 | $132.70 |
| Rest of GeorgiaGeorgia | $153.11 | $128.98 |
| Hawaii, Guam, HIHawaii | $155.84 | $125.08 |
| IowaIowa | $140.81 | $116.05 |
| IdahoIdaho | $142.37 | $117.48 |
| East St. Louis, ILIllinois | $168.62 | $143.73 |
| Rest of IllinoisIllinois | $160.56 | $135.86 |
| Suburban Chicago, ILIllinois | $170.84 | $143.06 |
| IndianaIndiana | $142.97 | $117.89 |
| KansasKansas | $142.04 | $117.58 |
| KentuckyKentucky | $148.23 | $124.18 |
| New Orleans, LALouisiana | $154.79 | $129.33 |
| Rest of LouisianaLouisiana | $148.75 | $124.81 |
| Metropolitan Boston, MAMassachusetts | $167.69 | $135.38 |
| Rest of MassachusettsMassachusetts | $156.40 | $127.91 |
| Baltimore area, MDMaryland | $164.97 | $135.94 |
| Rest of MarylandMaryland | $155.75 | $128.37 |
| Rest of MaineMaine | $144.91 | $120.02 |
| Southern Maine, MEMaine | $148.88 | $122.07 |
| Detroit, MIMichigan | $165.45 | $139.34 |
| Rest of MichiganMichigan | $153.17 | $128.47 |
| MinnesotaMinnesota | $145.22 | $117.38 |
| Metropolitan Kansas City, MOMissouri | $151.98 | $126.57 |
| Metropolitan St. Louis, MOMissouri | $153.10 | $127.34 |
| Rest of MissouriMissouri | $147.78 | $124.46 |
| MississippiMississippi | $143.73 | $120.43 |
| MontanaMontana | $155.61 | $128.56 |
| North CarolinaNorth Carolina | $145.90 | $120.65 |
| North DakotaNorth Dakota | $145.53 | $118.47 |
| NebraskaNebraska | $140.91 | $115.94 |
| New HampshireNew Hampshire | $155.72 | $127.56 |
| Northern New JerseyNew Jersey | $170.76 | $139.37 |
| Rest of New JerseyNew Jersey | $165.64 | $136.10 |
| New MexicoNew Mexico | $154.61 | $129.80 |
| NevadaNevada | $152.86 | $125.78 |
| NYC suburbs and Long Island, NYNew York | $185.84 | $153.67 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $168.15 | $138.53 |
| Queens, NYNew York | $178.39 | $146.42 |
| Rest of New YorkNew York | $147.90 | $122.20 |
| OhioOhio | $151.11 | $126.41 |
| OklahomaOklahoma | $146.10 | $121.94 |
| Portland, OROregon | $158.61 | $128.56 |
| Rest of OregonOregon | $150.37 | $123.43 |
| Metropolitan Philadelphia, PAPennsylvania | $162.67 | $134.50 |
| Rest of PennsylvaniaPennsylvania | $150.30 | $125.47 |
| Puerto RicoPuerto Rico | $155.98 | $128.63 |
| Rhode IslandRhode Island | $157.19 | $129.25 |
| South CarolinaSouth Carolina | $149.01 | $124.01 |
| South DakotaSouth Dakota | $144.34 | $117.28 |
| TennesseeTennessee | $142.87 | $118.27 |
| Austin, TXTexas | $156.99 | $128.37 |
| Beaumont, TXTexas | $149.60 | $124.98 |
| Brazoria, TXTexas | $152.10 | $125.28 |
| Dallas, TXTexas | $153.78 | $126.83 |
| Fort Worth, TXTexas | $153.46 | $126.79 |
| Galveston, TXTexas | $153.02 | $126.16 |
| Houston, TXTexas | $162.36 | $135.49 |
| Rest of TexasTexas | $151.25 | $125.58 |
| UtahUtah | $150.68 | $125.25 |
| VirginiaVirginia | $149.73 | $123.13 |
| Virgin Islands, VIUnited States Virgin Islands | $155.98 | $128.63 |
| VermontVermont | $146.70 | $119.91 |
| Rest of WashingtonWashington | $155.53 | $127.04 |
| King County, WAWashington | $168.98 | $135.78 |
| WisconsinWisconsin | $141.60 | $115.68 |
| West VirginiaWest Virginia | $155.95 | $132.43 |
| WyomingWyoming | $151.22 | $124.16 |
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.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,794
- Code
- 20704
- Physician work
- 2.54
- Practice expense
- 1.61
- Malpractice
- 0.51
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.54 | × 1.000 | 2.5400 |
| Practice expense | 1.61 | × 0.875 | 1.4088 |
| Malpractice | 0.51 | × 0.566 | 0.2887 |
| Total RVUs | 4.2374 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$141.53
Office: (2.54 × 1 + 1.61 × 0.875 + 0.51 × 0.566) × $33.4009 = $141.53
Facility: (2.54 × 1 + 0.8 × 0.875 + 0.51 × 0.566) × $33.4009 = $117.86
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. |
How 20704 has changed in Alabama
20704 · Office / nonfacility
$141.53
Effective 2026-10-01
The base rate is $8.97 higher than on 2025-10-01, moving from $132.56 to $141.53 (6.8%).
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
$132.56changed to$141.53
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.60 changed to 2.54
- Practice expense RVU 1.38 changed to 1.61
- Malpractice RVU 0.52 changed to 0.51
- 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
$135.26changed to$132.56
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.34 changed to 1.38
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$133.05changed to$135.26
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$138.31changed to$133.05
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.27 changed to 1.34
- Malpractice RVU 0.49 changed to 0.52
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$148.06changed to$138.31
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.33 changed to 1.27
- Malpractice RVU 0.54 changed to 0.49
- 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
$142.70changed to$148.06
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.19 changed to 1.33
- Malpractice RVU 0.47 changed to 0.54
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$142.98changed to$142.70
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.15 changed to 1.19
- Malpractice RVU 0.48 changed to 0.47
- 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
No ratechanged to$142.98
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 | $141.53 | $117.86 | RVU26D |
| 2026-07-01 | $141.53 | $117.86 | RVU26C |
| 2026-04-01 | $141.53 | $117.86 | RVU26B |
| 2026-01-01 | $141.53 | $117.86 | RVU26A |
| 2025-10-01 | $132.56 | $132.56 | RVU25D |
| 2025-07-01 | $132.56 | $132.56 | RVU25C |
| 2025-04-01 | $132.56 | $132.56 | RVU25B |
| 2025-01-01 | $132.56 | $132.56 | RVU25A |
| 2024-10-01 | $135.26 | $135.26 | RVU24D |
| 2024-07-01 | $135.26 | $135.26 | RVU24C |
| 2024-04-01 | $135.26 | $135.26 | RVU24B |
| 2024-03-09 | $135.26 | $135.26 | RVU24AR |
| 2024-01-01 | $133.05 | $133.05 | RVU24A |
| 2023-10-01 | $138.31 | $138.31 | RVU23D |
| 2023-07-01 | $138.31 | $138.31 | RVU23C |
| 2023-04-01 | $138.31 | $138.31 | RVU23B |
| 2023-01-01 | $138.31 | $138.31 | RVU23A |
| 2022-10-01 | $148.06 | $148.06 | RVU22D |
| 2022-07-01 | $148.06 | $148.06 | RVU22C |
| 2022-04-01 | $148.06 | $148.06 | RVU22B |
| 2022-01-01 | $148.06 | $148.06 | RVU22A |
| 2021-10-01 | $142.70 | $142.70 | RVU21D |
| 2021-07-01 | $142.70 | $142.70 | RVU21C |
| 2021-04-01 | $142.70 | $142.70 | RVU21B |
| 2021-01-01 | $142.70 | $142.70 | RVU21A |
| 2020-10-01 | $142.98 | $142.98 | RVU20D |
| 2020-07-01 | $142.98 | $142.98 | RVU20C |
| 2020-04-01 | $142.98 | $142.98 | RVU20B |
| 2020-01-01 | $142.98 | $142.98 | 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 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
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
Fee sheets · Coming soon
Put 20704 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist