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CPT code 20955: Bone graft, fibula, microvascular2026 Medicare rate & RVUs

Reports transfer of vascularized fibular bone using microvascular anastomosis, commonly to reconstruct a major mandibular or skeletal defect.

CMS RVU26DEffective Oct 1, 2026109 payment localities85 Medicare services in 2024

Medicare pays $2,267.92 for 20955 nationally in a facility.

Medicare rate · 20955

Bone graft, fibula, microvascular

Office or facility?

Work RVUs
39.25
Total RVUs
67.90
Global days
090

National rate · 2026

$2,267.92

Facility setting, before claim adjustments.

See every locality for 20955 →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 20955 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 20955 covers

This service transfers vascularized bone from the fibula to repair a substantial bone defect. The surgeon harvests the fibular graft and uses microsurgical techniques to connect its blood supply at the recipient site. It is commonly performed by reconstructive, oral and maxillofacial, or orthopedic surgeons, including during reconstruction after head and neck tumor removal, major trauma, or bone loss. A fibular graft can provide a long segment of living bone for reconstruction, such as for a mandibular defect.

Report this code when the donor bone is fibula and the graft is transferred with microvascular anastomosis; the operative note should identify the donor bone and document the vascularized transfer. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and 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.

Where 20955 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

20955 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,072.96
AlaskaUnavailable$2,860.29
ArizonaUnavailable$2,210.70
ArkansasUnavailable$2,049.12
Atlanta, GAUnavailable$2,332.27
Austin, TXUnavailable$2,284.11
Bakersfield, CAUnavailable$2,265.95
Baltimore area, MDUnavailable$2,398.74
Beaumont, TXUnavailable$2,186.43
Brazoria, TXUnavailable$2,218.35

20955 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
20955 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 20955 rate is calculated

Each of 20955’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 · 20955

RVUs × geographic indexes × conversion factor

Office or facility?

Work39.25

39.25 RVUs× 1.000 GPCI

Practice expense21.35

21.35 RVUs× 1.000 GPCI

Malpractice7.30

7.30 RVUs× 1.000 GPCI

Adjusted RVUs

67.9000

Conversion factor

$33.4009

Medicare rate

$2,267.92

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

Payment rules and modifiers for 20955

20955 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20955

Bone graft, fibula, microvascular

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 20955

Bone graft, fibula, microvascular

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

20955 without 51 · national facility

$2,267.92

Bone graft, fibula, microvascular

20955-51 · Second procedure: 50%

$1,133.96

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

20955 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 20955

    Bone graft, fibula, microvascular39.25 wRVU

    Not priced

  • 20956

    Bone graft, iliac, microvascular40.15 wRVU

    Not priced

  • 20962

    Bone graft, other donor site38.23 wRVU

    Not priced

  • 20969

    Bone-skin graft, other donor site44.29 wRVU

    Not priced

How to choose

20956Bone graftIliac, microvascular
Both are microvascular bone grafts, but 20956 identifies iliac bone as the donor source; 20955 identifies fibula.
20962Bone graftOther donor site
20955 is specific to a fibular graft. Consider 20962 when the microvascular bone graft comes from another source covered by that code.
20969Bone-skin graftOther donor site
20969 describes a microvascular bone-and-skin graft. 20955 identifies a fibular bone graft without that bone-and-skin distinction.

Codes related to 20955

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

Codes related to 20955
CodeHow it relatesNational office range
Same family
20956Bone graft, iliac, microvascularMicrovascular bone graft using iliac bone rather than fibula.No office rate
20957Bone graft, metatarsal, microvascular transferMicrovascular bone graft using metatarsal bone rather than fibula.No office rate
20962Bone graft, other donor siteMicrovascular bone graft from a source other than the specifically named bones.No office rate
Used instead
20969Bone-skin graft, other donor siteFor a microvascular bone-and-skin graft rather than a bone-only fibular graft.No office rate

20955 billing questions

How is this code different from 20956?

Both describe microvascular transfer of bone, but 20955 identifies fibula as the donor bone and 20956 identifies iliac bone.

When should 20955 be selected instead of 20962?

Use 20955 for a fibular graft. Code 20962 is for a microvascular bone graft from another source covered by that code.

What operative details support reporting 20955?

Document the fibula as the donor site and the microvascular transfer, including the vascular anastomosis. The record should also describe the defect being reconstructed.

Can modifier 50 be used for bilateral work?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the global period affect postoperative billing?

The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

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
RVUs for 20955PPRRVU2026_Oct_nonQPP.csv, line 1,821 (RVU26D)

Open CMS sourceHow we calculate rates

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