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CPT code 20931: Spinal bone graft, structural allograft2026 Medicare rate & RVUs

Report 20931 with spine surgery when a surgeon implants structural donor bone as support, rather than morselized graft material.

CMS RVU26DEffective Oct 1, 2026109 payment localities7.8K Medicare services in 2024

Medicare pays $98.20 for 20931 nationally in a facility.

Medicare rate · 20931

Spinal bone graft, structural allograft

Office or facility?

Work RVUs
1.76
Total RVUs
2.94
Global days
ZZZ

National rate · 2026

$98.20

Facility setting, before claim adjustments.

See every locality for 20931 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 20931 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 20931 covers

CPT 20931 captures placement of a shaped, donor-derived bone graft that provides structural support during spinal reconstruction or fusion. Unlike chips or granules used to fill a fusion bed, this graft retains a block or strut form and may help maintain spacing or support between vertebrae. A spine surgeon typically places it during an operative spinal fusion, such as an interbody fusion, in a hospital or ambulatory surgical setting. The graft is allograft tissue, not bone harvested from the patient during the operation.

Report 20931 only alongside an eligible primary spine procedure; it is an add-on, not a stand-alone service. The operative report should identify the structural allograft and its role in the spinal reconstruction, distinguishing it from morselized allograft and structural autograft. CMS pays this add-on within the primary procedure’s global period.

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 20931 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

20931 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$87.18
AlaskaUnavailable$120.02
ArizonaUnavailable$94.75
ArkansasUnavailable$85.86
Atlanta, GAUnavailable$102.65
Austin, TXUnavailable$97.21
Bakersfield, CAUnavailable$93.50
Baltimore area, MDUnavailable$105.25
Beaumont, TXUnavailable$95.03
Brazoria, TXUnavailable$94.16

20931 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
20931 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 20931 rate is calculated

Each of 20931’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 · 20931

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.76

1.76 RVUs× 1.000 GPCI

Practice expense0.59

0.59 RVUs× 1.000 GPCI

Malpractice0.59

0.59 RVUs× 1.000 GPCI

Adjusted RVUs

2.9400

Conversion factor

$33.4009

Medicare rate

$98.20

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 20931

The CMS indicators that decide how 20931 is paid alongside other services.

CMS payment indicators · 20931

Spinal bone graft, structural allograft

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

20931 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 20931

    Spinal bone graft, structural allograft1.76 wRVU

    Not priced

  • 20930

    Spinal graft material, morselized allograft0 wRVU

    Not priced

  • 20938

    Spinal bone graft, structural autograft, separate incision2.94 wRVU

    Not priced

  • 20936

    Spinal autograft, local, same incision0 wRVU

    Not priced

How to choose

20930Spinal graft materialMorselized allograft
Choose 20931 for structural donor bone used as support; choose 20930 for morselized donor bone used as graft material.
20938Spinal bone graftStructural autograft, separate incision
Both involve structural grafting during spine surgery. The source differs: 20931 is donor bone, while 20938 is bone harvested from the patient.
20936Spinal autograftLocal, same incision
20936 describes local bone from the operative site used as graft material. It is not the structural donor-bone service reported with 20931.

Codes related to 20931

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

Codes related to 20931
CodeHow it relatesNational office range
Same family
20930Spinal graft material, morselized allograftSpine-surgery allograft code for morselized donor bone rather than a structural graft.No office rate
20938Spinal bone graft, structural autograft, separate incisionStructural spinal graft code for patient-derived bone rather than donor bone.No office rate
20936Spinal autograft, local, same incisionSpinal graft code for local bone harvested from the operative site.No office rate
Primary code
22551ACDF, one cervical interspace with decompressionStructural allograft may accompany anterior cervical discectomy and fusion.No office rate
22612Spinal fusion, posterior lumbar, single levelStructural allograft may accompany posterior lumbar arthrodesis.No office rate

20931 billing questions

Can 20931 be reported without a primary spine procedure?

No. It is an add-on code and must be reported with a primary procedure.

How does 20931 differ from 20930?

20931 represents structural donor bone used as a supporting graft. Code 20930 is for morselized donor bone, such as chips or granules used to fill a fusion bed.

How does 20931 differ from 20938?

Both describe structural grafting for spine surgery, but 20931 is for donor bone and 20938 is for bone graft taken from the patient.

What documentation supports reporting 20931?

The operative report should identify the donor-derived graft as structural and describe its placement and role in the spinal reconstruction.

How does CMS treat payment for 20931?

CMS treats it as an add-on paid within the primary procedure’s global period.

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 20931PPRRVU2026_Oct_nonQPP.csv, line 1,812 (RVU26D)

Open CMS sourceHow we calculate rates

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