CPT code 20969: Bone-skin graft, other donor site2026 Medicare rate & RVUs

Medicare pays $2,322.36 for 20969 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 20969 covers

This service covers transfer of a vascularized flap containing bone and skin, with the flap’s blood supply connected to vessels at the recipient site using microsurgical technique. It is used when reconstruction requires both structural bone and skin or soft-tissue coverage, such as rebuilding a defect after tumor removal or severe trauma. Reconstructive, oral and maxillofacial, orthopedic, or head and neck surgeons may perform the procedure in an operating room.

Select this code when the graft is a bone-and-skin flap from a donor site not represented by a named-site code in this family; the donor tissue, rather than the recipient defect, determines the choice. The operative report should identify the donor site, transferred bone and skin, recipient defect, and microvascular anastomosis. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; 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 20969 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

20969 rates by state

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

How the 20969 rate is calculated

Each of 20969’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.

Payment rules and modifiers for 20969

20969 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

20969 compared with similar codes

How to choose

20962Bone graftOther donor site

This code is for a composite bone-and-skin graft. Use 20962 for a microvascular bone graft without the skin component.

20955Bone graftFibula, microvascular

20955 identifies a microvascular bone graft from the fibula. This code is for a bone-and-skin graft from a donor site not represented by a named-site option.

20970Bone and skin graftIliac crest, microvascular

20970 identifies a bone-and-skin graft by its iliac crest donor site. This code is used when the donor site is not covered by a named-site variant.

20972Free flapMetatarsal bone and skin

20972 identifies a bone-and-skin graft from a metatarsal donor site; this code is for an otherwise unlisted donor site within the family.

Codes related to 20969

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

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

Open CMS sourceHow we calculate rates