CPT code 20936: Spinal autograft, local, same incision2026 Medicare rate & RVUs in Michigan
Reports use of a patient’s own local bone, obtained through the spinal operative incision and used as graft material during spine surgery.
CMS doesn’t publish an office rate for 20936 in Michigan.
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 20936 covers
This add-on code describes use of the patient’s own bone as graft material during spine surgery. The bone is obtained through the same incision as the spinal procedure and may include local bone removed during the operation, such as spinous-process or laminar fragments. Spine surgeons report it with the related spinal procedure when local bone is prepared and used as graft material, including during spinal fusion.
Medicare assigns this code physician fee schedule status B: it is bundled and never paid separately, with payment included in payment for other services. Report it as an add-on with the applicable primary spinal procedure, not by itself. The selection turns on graft source and access: the patient’s own bone is obtained locally through the operative incision. Autograft harvested through a separate incision is distinguished by whether it is morselized or structural; donor allograft is a different graft material.
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 20936 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
How the 20936 rate is calculated
Each of 20936’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 · 20936
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20936
20936 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 20936
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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20936 isn’t priced in this setting.
20936 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 20937Spinal bone graftMorselized, separate incision
- 20936 is for local autograft obtained through the spinal incision; 20937 is for morselized autograft obtained from a separate incision.
- 20938Spinal bone graftStructural autograft, separate incision
- 20936 covers local bone from the spinal incision; 20938 covers structural autograft obtained from a separate incision.
- 20930Spinal graft materialMorselized allograft
- 20936 uses the patient’s own locally obtained bone. Code 20930 is for morselized donor allograft used in spine surgery.
- 20931Spinal bone graftStructural allograft
- 20936 uses the patient’s local bone from the operative incision; 20931 describes structural donor allograft.
20936 billing questions
When should 20936 be chosen over 20937?
Use 20936 when the patient’s own bone is obtained locally through the spinal procedure incision. Code 20937 describes morselized autograft obtained from a separate incision.
How does 20936 differ from 20938?
Code 20936 covers local autograft from the spinal operative incision. Code 20938 describes structural autograft obtained from a separate incision.
Can 20936 be reported by itself?
No. It is an add-on for spine surgery and is reported with the applicable primary spinal procedure.
Does Medicare pay 20936 separately?
No. Medicare assigns status B, so the code is bundled and its payment is included in payment for other services.
What should the operative note establish?
Document that the patient’s local bone was obtained through the same incision as the spinal procedure and used as graft material.
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
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