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CPT code 20900: Bone graft harvest, minor or small graft2026 Medicare rate & RVUs in North Carolina

Reports harvesting a small autogenous bone graft from a donor site for use in a reconstructive or orthopedic procedure requiring bone grafting.

CMS RVU26DEffective Oct 1, 2026One payment locality7.9K Medicare services in 2024

In North Carolina, Medicare pays $373.31 for 20900 in the office and $151.74 when it’s performed in a hospital or facility.

$373.31Office (non-facility)
$151.74Hospital or facility
−6.2%vs the national office rate ($398.14)

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.

We’ll open 20900 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 20900 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 North Carolina 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. North Carolina pays $373.31. The RVUs are the same everywhere; the geographic indexes change the dollars.

20900 in North Carolina vs other payment areas
  1. North Carolina · this page$373.31
  2. Los Angeles, CA · California$448.78+$75.47
  3. Washington, DC area · District of Columbia$455.83+$82.52
  4. Miami, FL · Florida$434.31+$61.00
  5. Chicago, IL · Illinois$421.01+$47.70
  6. Manhattan, NY · New York$459.84+$86.53
  7. Alaska · Alaska$458.35+$85.04

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

20900 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$355.65$147.86
ArkansasArkansas$350.28$146.29
ArizonaArizona$387.02$156.90
Bakersfield, CACalifornia$421.02$160.74
Chico, CACalifornia$419.65$159.37
El Centro, CACalifornia$419.73$159.45
Fresno, CACalifornia$419.65$159.37
Hanford, CACalifornia$419.65$159.37

20900 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
20900 office rate range by state
State / territoryOffice rate rangeLocalities
AK$458.351
AL$355.651
AR$350.281
AZ$387.021
CA$419.65–$527.1029
CO$413.991
CT$425.351
DC$455.831
DE$393.601
FL$393.70–$434.313
GA$370.52–$406.202
GU$430.331
HI$430.331
IA$364.311
ID$366.951
IL$382.44–$421.014
IN$369.151
KS$362.901
KY$365.231
LA$364.78–$383.552
MA$411.51–$455.532
MD$401.21–$455.833
ME$369.34–$389.662
MI$375.48–$399.192
MN$395.091
MO$358.50–$384.533
MS$354.441
MT$398.111
NC$373.311
ND$388.621
NE$366.281
NH$407.791
NJ$429.76–$450.872
NM$377.771
NV$395.751
NY$379.17–$471.865
OH$373.541
OK$364.151
OR$392.24–$427.152
PA$373.95–$414.652
PR$401.021
RI$407.651
SC$374.131
SD$387.491
TN$364.851
TX$371.42–$412.998
UT$379.451
VA$388.59–$455.832
VI$401.021
VT$387.381
WA$410.64–$464.622
WI$375.111
WV$367.811
WY$393.971

See 20900 in every payment locality

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

Office or facility?

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 20900 in North Carolina
ComponentRVULocality factorAdjusted
Physician work2.93× 1.0002.9300
Practice expense8.51× 0.9337.9398
Malpractice0.48× 0.6390.3067
Total RVUs11.1766
Conversion factor× 33.4009

Office rate, North Carolina$373.31

Office: (2.93 × 1 + 8.51 × 0.933 + 0.48 × 0.639) × $33.4009 = $373.31

Facility: (2.93 × 1 + 1.4 × 0.933 + 0.48 × 0.639) × $33.4009 = $151.74

Open 20900 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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%).

When to use modifier 51

Codes related to 20900

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 20900
CodeHow it relatesOffice range, North Carolina
Same family
20902Bone graft harvest, major or large graftBone harvest in the same family, selected for a major or large graft.No office rate
Used instead
20936Spinal autograft, local, same incisionSpinal autograft obtained locally through the operative incision.No office rate
20937Spinal bone graft, morselized, separate incisionSpinal autograft harvested separately and used in morselized form.No office rate
20938Spinal bone graft, structural autograft, separate incisionSpinal autograft harvested separately and used as structural graft.No office rate
20930Spinal graft material, morselized allograftSpinal allograft material rather than bone harvested from the patient.No office rate

How 20900 has changed in North Carolina

20900 · Office / nonfacility

$373.31

Effective 2026-10-01

The base rate is $28.89 higher than on 2025-10-01, moving from $344.42 to $373.31 (8.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $344.42changed to$373.31

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $359.37changed to$344.42

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.06 changed to 7.90

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $353.51changed to$359.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $373.33changed to$353.51

    • 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
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $384.14changed to$373.33

    • 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
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $397.73changed to$384.14

    • 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.

  7. January 1, 2021

    RVU21A

    $395.07changed to$397.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.13 changed to 8.60
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $396.36changed to$395.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.21 changed to 8.13
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $401.45changed to$396.36

    • 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.

  10. January 1, 2018

    RVU18AR1

    $399.84changed to$401.45

    • 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
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $401.57changed to$399.84

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.38 changed to 8.32
    • Malpractice RVU 0.55 changed to 0.54
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $404.69changed to$401.57

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.43 changed to 8.38

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $402.68changed to$404.69

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $399.18changed to$402.68

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.34 changed to 8.43
    • Malpractice RVU 0.54 changed to 0.55
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $407.68changed to$399.18

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.27 changed to 8.34
    • Malpractice RVU 0.56 changed to 0.54
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $407.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$373.31$151.74RVU26D
2026-07-01$373.31$151.74RVU26C
2026-04-01$373.31$151.74RVU26B
2026-01-01$373.31$151.74RVU26A
2025-10-01$344.42$165.30RVU25D
2025-07-01$344.42$165.30RVU25C
2025-04-01$344.42$165.30RVU25B
2025-01-01$344.42$165.30RVU25A
2024-10-01$359.37$169.19RVU24D
2024-07-01$359.37$169.19RVU24C
2024-04-01$359.37$169.19RVU24B
2024-03-09$359.37$169.19RVU24AR
2024-01-01$353.51$166.43RVU24A
2023-10-01$373.33$173.86RVU23D
2023-07-01$373.33$173.86RVU23C
2023-04-01$373.33$173.86RVU23B
2023-01-01$373.33$173.86RVU23A
2022-10-01$384.14$177.33RVU22D
2022-07-01$384.14$177.33RVU22C
2022-04-01$384.14$177.33RVU22B
2022-01-01$384.14$177.33RVU22A
2021-10-01$397.73$179.16RVU21D
2021-07-01$397.73$179.16RVU21C
2021-04-01$397.73$179.16RVU21B
2021-01-01$397.73$179.16RVU21A
2020-10-01$395.07$183.29RVU20D
2020-07-01$395.07$183.29RVU20C
2020-04-01$395.07$183.29RVU20B
2020-01-01$395.07$183.29RVU20A
2019-10-01$396.36$183.30RVU19D
2019-07-01$396.36$183.30RVU19C
2019-04-01$396.36$183.30RVU19B
2019-01-01$396.36$183.30RVU19A
2018-10-01$401.45$185.27RVU18D
2018-07-01$401.45$185.27RVU18C
2018-04-01$401.45$185.27RVU18B
2018-01-01$401.45$185.27RVU18AR1
2017-10-01$399.84$186.00RVU17D
2017-07-01$399.84$186.00RVU17C
2017-04-01$399.84$186.00RVU17B
2017-01-01$399.84$186.00RVU17A
2016-10-01$401.57$186.80RVU16D
2016-07-01$401.57$186.80RVU16C
2016-04-01$401.57$186.80RVU16B
2016-01-01$401.57$186.80RVU16A
2015-10-01$404.69$187.81RVU15D
2015-07-01$404.69$187.81RVU15C
2015-04-01$402.68$186.88RVU15B
2015-01-01$402.68$186.88RVU15A
2014-10-01$399.18$186.52RVU14D
2014-07-01$399.18$186.52RVU14C
2014-04-01$399.18$186.52RVU14B
2014-01-01$399.18$186.52RVU14A
2013-10-01$407.68$200.78RVU13D
2013-07-01$407.68$200.78RVU13C
2013-04-01$407.68$200.78RVU13B
2013-01-01$407.68$200.78RVU13AR

Price 20900 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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
RVUs for 20900PPRRVU2026_Oct_nonQPP.csv, line 1,804 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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