CPT code 20900: Bone graft harvest, minor or small graft2026 Medicare rate & RVUs in Madera, CA
Reports harvesting a small autogenous bone graft from a donor site for use in a reconstructive or orthopedic procedure requiring bone grafting.
In Madera, CA, Medicare pays $419.65 for 20900 in the office and $159.37 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 20900 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 20900 covers
This service covers obtaining a small piece of the patient’s own bone for grafting, such as a small dowel- or button-shaped piece. An orthopedic, spine, or reconstructive surgeon may harvest it during an operation in which another site needs bone graft material. The operative record should identify the donor site and describe the harvested graft and the procedure for which it is used.
Select this code when the harvested graft is minor or small; code 20902 represents a major or large harvest. Report the harvest with the procedure that uses the graft when separately supported by the operative work. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
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 Madera, CA compares for 20900
Across 109 of 109 payment localities, the office rate for 20900 runs from $350.28 in Arkansas to $527.10 in San Benito County, CA. Madera, CA pays $419.65. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Madera, CA · this page$419.65
- Bakersfield, CA · California$421.02+$1.37
- Chico, CA · California$419.65
- El Centro, CA · California$419.73+$0.08
- Fresno, CA · California$419.65
- Hanford, CA · California$419.65
- Los Angeles, CA · California$448.78+$29.13
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Merced, CACalifornia | $419.65 | $159.37 |
| Modesto, CACalifornia | $419.65 | $159.37 |
| Napa, CACalifornia | $486.81 | $173.81 |
| Oxnard, CACalifornia | $446.57 | $165.86 |
| Redding, CACalifornia | $419.65 | $159.37 |
| Rest of CaliforniaCalifornia | $419.65 | $159.37 |
| Riverside, CACalifornia | $424.83 | $164.55 |
| Sacramento, CACalifornia | $440.55 | $164.36 |
| Salinas, CACalifornia | $438.93 | $163.69 |
| San Diego, CACalifornia | $449.44 | $165.42 |
| Marin County, CACalifornia | $515.30 | $180.45 |
| San Francisco, CACalifornia | $514.76 | $179.91 |
| San Benito County, CACalifornia | $527.10 | $184.65 |
| Santa Clara County, CACalifornia | $524.87 | $182.42 |
| San Luis Obispo, CACalifornia | $431.87 | $161.38 |
| Santa Cruz, CACalifornia | $453.87 | $165.33 |
| Santa Maria, CACalifornia | $440.62 | $163.72 |
| Santa Rosa, CACalifornia | $458.44 | $166.82 |
| Stockton, CACalifornia | $419.65 | $159.37 |
| Vallejo, CACalifornia | $486.02 | $173.02 |
| Visalia, CACalifornia | $419.65 | $159.37 |
| Yuba City, CACalifornia | $419.65 | $159.37 |
| Washington, DC areaDistrict of Columbia | $455.83 | $176.08 |
| Miami, FLFlorida | $434.31 | $187.09 |
| Chicago, ILIllinois | $421.01 | $182.34 |
| Manhattan, NYNew York | $459.84 | $183.89 |
| AlaskaAlaska | $458.35 | $205.43 |
| AlabamaAlabama | $355.65 | $147.86 |
| ArkansasArkansas | $350.28 | $146.29 |
| ArizonaArizona | $387.02 | $156.90 |
| ColoradoColorado | $413.99 | $161.31 |
| ConnecticutConnecticut | $425.35 | $169.58 |
| DelawareDelaware | $393.60 | $158.97 |
| Fort Lauderdale, FLFlorida | $414.79 | $174.22 |
| Rest of FloridaFlorida | $393.70 | $166.67 |
| Atlanta, GAGeorgia | $406.20 | $164.92 |
| Rest of GeorgiaGeorgia | $370.52 | $158.69 |
| Hawaii, Guam, HIHawaii | $430.33 | $160.31 |
| IowaIowa | $364.31 | $147.02 |
| IdahoIdaho | $366.95 | $148.47 |
| East St. Louis, ILIllinois | $391.66 | $173.17 |
| Rest of IllinoisIllinois | $382.44 | $165.62 |
| Suburban Chicago, ILIllinois | $418.88 | $174.98 |
| IndianaIndiana | $369.15 | $149.00 |
| KansasKansas | $362.90 | $148.22 |
| KentuckyKentucky | $365.23 | $154.11 |
| New Orleans, LALouisiana | $383.55 | $160.08 |
| Rest of LouisianaLouisiana | $364.78 | $154.61 |
| Metropolitan Boston, MAMassachusetts | $455.53 | $171.98 |
| Rest of MassachusettsMassachusetts | $411.51 | $161.45 |
| Baltimore area, MDMaryland | $424.25 | $169.44 |
| Rest of MarylandMaryland | $401.21 | $160.88 |
| Rest of MaineMaine | $369.34 | $150.86 |
| Southern Maine, MEMaine | $389.66 | $154.32 |
| Detroit, MIMichigan | $399.19 | $170.02 |
| Rest of MichiganMichigan | $375.48 | $158.66 |
| MinnesotaMinnesota | $395.09 | $150.73 |
| Metropolitan Kansas City, MOMissouri | $380.43 | $157.44 |
| Metropolitan St. Louis, MOMissouri | $384.53 | $158.45 |
| Rest of MissouriMissouri | $358.50 | $153.79 |
| MississippiMississippi | $354.44 | $149.97 |
| MontanaMontana | $398.11 | $160.63 |
| North CarolinaNorth Carolina | $373.31 | $151.74 |
| North DakotaNorth Dakota | $388.62 | $151.14 |
| NebraskaNebraska | $366.28 | $147.09 |
| New HampshireNew Hampshire | $407.79 | $160.57 |
| Northern New JerseyNew Jersey | $450.87 | $175.40 |
| Rest of New JerseyNew Jersey | $429.76 | $170.43 |
| New MexicoNew Mexico | $377.77 | $160.00 |
| NevadaNevada | $395.75 | $158.03 |
| NYC suburbs and Long Island, NYNew York | $471.86 | $189.50 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $432.91 | $172.87 |
| Queens, NYNew York | $463.22 | $182.52 |
| Rest of New YorkNew York | $379.17 | $153.56 |
| OhioOhio | $373.54 | $156.72 |
| OklahomaOklahoma | $364.15 | $152.08 |
| Portland, OROregon | $427.15 | $163.31 |
| Rest of OregonOregon | $392.24 | $155.71 |
| Metropolitan Philadelphia, PAPennsylvania | $414.65 | $167.43 |
| Rest of PennsylvaniaPennsylvania | $373.95 | $155.94 |
| Puerto RicoPuerto Rico | $401.02 | $160.93 |
| Rhode IslandRhode Island | $407.65 | $162.33 |
| South CarolinaSouth Carolina | $374.13 | $154.70 |
| South DakotaSouth Dakota | $387.49 | $150.01 |
| TennesseeTennessee | $364.85 | $148.98 |
| Austin, TXTexas | $412.99 | $161.74 |
| Beaumont, TXTexas | $371.42 | $155.31 |
| Brazoria, TXTexas | $392.84 | $157.49 |
| Dallas, TXTexas | $395.61 | $159.08 |
| Fort Worth, TXTexas | $392.97 | $158.82 |
| Galveston, TXTexas | $394.17 | $158.36 |
| Houston, TXTexas | $402.96 | $167.14 |
| Rest of TexasTexas | $382.09 | $156.72 |
| UtahUtah | $379.45 | $156.22 |
| VirginiaVirginia | $388.59 | $155.15 |
| Virgin Islands, VIUnited States Virgin Islands | $401.02 | $160.93 |
| VermontVermont | $387.38 | $152.27 |
| Rest of WashingtonWashington | $410.64 | $160.58 |
| King County, WAWashington | $464.62 | $173.23 |
| WisconsinWisconsin | $375.11 | $147.60 |
| West VirginiaWest Virginia | $367.81 | $161.44 |
| WyomingWyoming | $393.97 | $156.49 |
20900 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.
$350.28
$473.38
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 | $458.35 | 1 |
| AL | $355.65 | 1 |
| AR | $350.28 | 1 |
| AZ | $387.02 | 1 |
| CA | $419.65–$527.10 | 29 |
| CO | $413.99 | 1 |
| CT | $425.35 | 1 |
| DC | $455.83 | 1 |
| DE | $393.60 | 1 |
| FL | $393.70–$434.31 | 3 |
| GA | $370.52–$406.20 | 2 |
| GU | $430.33 | 1 |
| HI | $430.33 | 1 |
| IA | $364.31 | 1 |
| ID | $366.95 | 1 |
| IL | $382.44–$421.01 | 4 |
| IN | $369.15 | 1 |
| KS | $362.90 | 1 |
| KY | $365.23 | 1 |
| LA | $364.78–$383.55 | 2 |
| MA | $411.51–$455.53 | 2 |
| MD | $401.21–$455.83 | 3 |
| ME | $369.34–$389.66 | 2 |
| MI | $375.48–$399.19 | 2 |
| MN | $395.09 | 1 |
| MO | $358.50–$384.53 | 3 |
| MS | $354.44 | 1 |
| MT | $398.11 | 1 |
| NC | $373.31 | 1 |
| ND | $388.62 | 1 |
| NE | $366.28 | 1 |
| NH | $407.79 | 1 |
| NJ | $429.76–$450.87 | 2 |
| NM | $377.77 | 1 |
| NV | $395.75 | 1 |
| NY | $379.17–$471.86 | 5 |
| OH | $373.54 | 1 |
| OK | $364.15 | 1 |
| OR | $392.24–$427.15 | 2 |
| PA | $373.95–$414.65 | 2 |
| PR | $401.02 | 1 |
| RI | $407.65 | 1 |
| SC | $374.13 | 1 |
| SD | $387.49 | 1 |
| TN | $364.85 | 1 |
| TX | $371.42–$412.99 | 8 |
| UT | $379.45 | 1 |
| VA | $388.59–$455.83 | 2 |
| VI | $401.02 | 1 |
| VT | $387.38 | 1 |
| WA | $410.64–$464.62 | 2 |
| WI | $375.11 | 1 |
| WV | $367.81 | 1 |
| WY | $393.97 | 1 |
How the 20900 rate is calculated
Each of 20900’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 · 20900
RVUs × geographic indexes × conversion factor
Work2.93
2.93 RVUs× 1.000 GPCI
Practice expense8.51
8.51 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
11.9200
Conversion factor
$33.4009
Medicare rate
$398.14
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Madera, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,804
- Code
- 20900
- Physician work
- 2.93
- Practice expense
- 8.51
- Malpractice
- 0.48
GPCI2026.csv
14
- Locality
- Madera, CA
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.017 | 2.9798 |
| Practice expense | 8.51 | × 1.096 | 9.3270 |
| Malpractice | 0.48 | × 0.536 | 0.2573 |
| Total RVUs | 12.5640 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Madera, CA$419.65
Office: (2.93 × 1.017 + 8.51 × 1.096 + 0.48 × 0.536) × $33.4009 = $419.65
Facility: (2.93 × 1.017 + 1.4 × 1.096 + 0.48 × 0.536) × $33.4009 = $159.37
Payment rules and modifiers for 20900
The CMS indicators that decide how 20900 is paid alongside other services.
CMS payment indicators · 20900
Bone graft harvest, minor or small graft
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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 | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20900 without 51 · national office
$398.14
Bone graft harvest, minor or small graft
20900-51 · Second procedure: 50%
$199.07
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 20900 has changed in Madera, CA
20900 · Office / nonfacility
$419.65
Effective 2026-10-01
The base rate is $32.89 higher than on 2025-10-01, moving from $386.76 to $419.65 (8.5%).
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
$386.76changed to$419.65
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.00 changed to 2.93
- Practice expense RVU 7.90 changed to 8.51
- Malpractice RVU 0.50 changed to 0.48
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$403.83changed to$386.76
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.06 changed to 7.90
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$397.24changed to$403.83
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$415.09changed to$397.24
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.24 changed to 8.06
- Malpractice RVU 0.51 changed to 0.50
- Work GPCI 1.021 changed to 1.014
- Practice expense GPCI 1.079 changed to 1.093
- Malpractice GPCI 0.579 changed to 0.560
January 1, 2023
RVU23A
$422.16changed to$415.09
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.27 changed to 8.24
- Malpractice RVU 0.52 changed to 0.51
- Work GPCI 1.027 changed to 1.021
- Practice expense GPCI 1.065 changed to 1.079
- Malpractice GPCI 0.597 changed to 0.579
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$437.72changed to$422.16
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.60 changed to 8.27
- Malpractice RVU 0.51 changed to 0.52
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$435.49changed to$437.72
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.13 changed to 8.60
- Work GPCI 1.024 changed to 1.027
- Practice expense GPCI 1.070 changed to 1.065
- Malpractice GPCI 0.580 changed to 0.597
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$438.39changed to$435.49
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.21 changed to 8.13
- Work GPCI 1.020 changed to 1.024
- Practice expense GPCI 1.074 changed to 1.070
- Malpractice GPCI 0.562 changed to 0.580
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$444.11changed to$438.39
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.36 changed to 8.21
- Malpractice RVU 0.53 changed to 0.51
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$444.25changed to$444.11
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.32 changed to 8.36
- Malpractice RVU 0.54 changed to 0.53
- Work GPCI 1.024 changed to 1.020
- Practice expense GPCI 1.079 changed to 1.074
- Malpractice GPCI 0.610 changed to 0.562
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$444.25
Held through RVU17B, RVU17C, RVU17D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $419.65 | $159.37 | RVU26D |
| 2026-07-01 | $419.65 | $159.37 | RVU26C |
| 2026-04-01 | $419.65 | $159.37 | RVU26B |
| 2026-01-01 | $419.65 | $159.37 | RVU26A |
| 2025-10-01 | $386.76 | $175.34 | RVU25D |
| 2025-07-01 | $386.76 | $175.34 | RVU25C |
| 2025-04-01 | $386.76 | $175.34 | RVU25B |
| 2025-01-01 | $386.76 | $175.34 | RVU25A |
| 2024-10-01 | $403.83 | $179.35 | RVU24D |
| 2024-07-01 | $403.83 | $179.35 | RVU24C |
| 2024-04-01 | $403.83 | $179.35 | RVU24B |
| 2024-03-09 | $403.83 | $179.35 | RVU24AR |
| 2024-01-01 | $397.24 | $176.42 | RVU24A |
| 2023-10-01 | $415.09 | $182.91 | RVU23D |
| 2023-07-01 | $415.09 | $182.91 | RVU23C |
| 2023-04-01 | $415.09 | $182.91 | RVU23B |
| 2023-01-01 | $415.09 | $182.91 | RVU23A |
| 2022-10-01 | $422.16 | $184.81 | RVU22D |
| 2022-07-01 | $422.16 | $184.81 | RVU22C |
| 2022-04-01 | $422.16 | $184.81 | RVU22B |
| 2022-01-01 | $422.16 | $184.81 | RVU22A |
| 2021-10-01 | $437.72 | $186.88 | RVU21D |
| 2021-07-01 | $437.72 | $186.88 | RVU21C |
| 2021-04-01 | $437.72 | $186.88 | RVU21B |
| 2021-01-01 | $437.72 | $186.88 | RVU21A |
| 2020-10-01 | $435.49 | $191.82 | RVU20D |
| 2020-07-01 | $435.49 | $191.82 | RVU20C |
| 2020-04-01 | $435.49 | $191.82 | RVU20B |
| 2020-01-01 | $435.49 | $191.82 | RVU20A |
| 2019-10-01 | $438.39 | $192.60 | RVU19D |
| 2019-07-01 | $438.39 | $192.60 | RVU19C |
| 2019-04-01 | $438.39 | $192.60 | RVU19B |
| 2019-01-01 | $438.39 | $192.60 | RVU19A |
| 2018-10-01 | $444.11 | $194.73 | RVU18D |
| 2018-07-01 | $444.11 | $194.73 | RVU18C |
| 2018-04-01 | $444.11 | $194.73 | RVU18B |
| 2018-01-01 | $444.11 | $194.73 | RVU18AR1 |
| 2017-10-01 | $444.25 | $196.42 | RVU17D |
| 2017-07-01 | $444.25 | $196.42 | RVU17C |
| 2017-04-01 | $444.25 | $196.42 | RVU17B |
| 2017-01-01 | $444.25 | $196.42 | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Madera, CA rate applies
Madera, CA is a Medicare payment area, not a city. Our Census mapping connects it to 17 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Madera
- Ahwahnee
- Bass Lake
- Bonadelle Ranchos
- Chowchilla
- Coarsegold
- Fairmead
- La Vina
20900 billing questions
How is 20900 distinguished from 20902?
Use 20900 for a minor or small bone harvest and 20902 for a major or large harvest. The operative documentation should support the extent of the harvest.
Is 20900 an add-on code?
No add-on status is listed for 20900. Report it for the separately performed small bone harvest when the operative record supports that work.
Can 20900 be reported with a spinal graft code?
A small separate-site harvest is distinct from local spinal autograft represented by 20936. Codes 20937 and 20938 describe other spinal autograft approaches, so select based on the documented graft and harvest method.
Should modifier 50 be appended for bilateral harvesting?
No. Modifier 50 is inappropriate for 20900 under the CMS bilateral adjustment rule.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. When other procedures are performed in the same session, standard multiple-procedure payment reduction applies.
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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