CPT code 20902: Bone graft harvest, major or large graft2026 Medicare rate & RVUs in Missouri
Reports harvesting a major or large autogenous bone graft from a donor site, such as the iliac crest, for use in reconstruction or fusion.
CMS doesn’t publish an office rate for 20902 in Missouri.
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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What 20902 covers
This service covers taking a substantial amount of the patient’s own bone from a donor site for use elsewhere in a reconstructive procedure. A common source is the iliac crest. Orthopedic and reconstructive surgeons may harvest bone for procedures such as treating a nonunion, filling a defect, or supporting a fusion. The code represents the harvest, not the work of placing the graft at the recipient site.
Choose this level when the harvest is major or large, rather than a small graft or bone obtained locally through the operative exposure. The operative report should identify the donor site, describe the extent of the harvest, and explain the graft’s intended use. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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 20902 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $237.23 |
| Metropolitan St. Louis, MO | Unavailable | $238.77 |
| Rest of Missouri | Unavailable | $232.16 |
How the 20902 rate is calculated
Each of 20902’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 · 20902
RVUs × geographic indexes × conversion factor
Work4.47
4.47 RVUs× 1.000 GPCI
Practice expense1.94
1.94 RVUs× 1.000 GPCI
Malpractice0.83
0.83 RVUs× 1.000 GPCI
Adjusted RVUs
7.2400
Conversion factor
$33.4009
Medicare rate
$241.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20902
The CMS indicators that decide how 20902 is paid alongside other services.
CMS payment indicators · 20902
Bone graft harvest, major or large 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
20902 without 51 · national facility
$241.82
Bone graft harvest, major or large graft
20902-51 · Second procedure: 50%
$120.91
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%).
20902 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 20900Bone graft harvestMinor or small graft
- 20900 is for a minor or small bone graft harvest. Use 20902 when the documented harvest is major or large.
- 20936Spinal autograftLocal, same incision
- 20936 covers local bone used in spinal surgery and obtained through the same incision. 20902 describes a major or large harvest from a donor site.
- 20937Spinal bone graftMorselized, separate incision
- 20937 is specific to morselized autograft for spinal surgery, with harvest through a separate incision. 20902 is not limited to that spinal graft configuration.
- 20930Spinal graft materialMorselized allograft
- 20930 concerns morselized donor allograft for spinal surgery; 20902 concerns harvesting the patient's own major or large bone graft.
20902 billing questions
How does 20902 differ from 20900?
20902 is for a major or large bone harvest; 20900 represents a minor or small harvest. The operative note should support the extent of the graft taken.
Can 20902 be reported for bone harvested locally during spine surgery?
Codes 20936–20938 describe specific spinal autograft situations and include harvesting. For local bone obtained through the same incision, compare 20936 rather than separately reporting 20902 for that harvest.
What should the operative note document?
Document the donor site, the nature and extent of the bone harvest, and the intended recipient use. This supports selection of the major-or-large level rather than the minor-or-small level.
Should modifier 50 be appended for bilateral donor-site harvest?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. The global period is 0 days.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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