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CPT code 20985: Surgical navigation, image-less2026 Medicare rate & RVUs

Reports intraoperative computer navigation without image-based planning during a musculoskeletal operation, commonly to guide alignment in joint replacement surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities86.8K Medicare services in 2024

Medicare pays $123.92 for 20985 nationally in a facility.

Medicare rate · 20985

Surgical navigation, image-less

Office or facility?

Work RVUs
2.44
Total RVUs
3.71
Global days
ZZZ

National rate · 2026

$123.92

Facility setting, before claim adjustments.

See every locality for 20985 →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 20985 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 20985 covers

This add-on describes a surgeon’s use of computer navigation during a musculoskeletal operation without a preloaded CT or MRI image set. The system registers the patient’s anatomy during surgery and tracks instruments to help guide their position or alignment. Orthopedic surgeons commonly use this approach during joint replacement, including total knee arthroplasty, in hospital operating rooms and ambulatory surgical settings.

Report 20985 with the primary operation for which the navigation was used, not by itself. The operative record should identify the musculoskeletal procedure and support that image-less computer navigation was performed, such as intraoperative anatomy registration and instrument tracking. Medicare treats 20985 as an add-on: it is billed with a primary procedure and paid within that procedure’s global period. The navigation service supplements the operative work; the primary code still identifies the surgery performed.

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 20985 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

20985 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$113.45
AlaskaUnavailable$158.84
ArizonaUnavailable$120.72
ArkansasUnavailable$112.19
Atlanta, GAUnavailable$127.93
Austin, TXUnavailable$123.67
Bakersfield, CAUnavailable$121.40
Baltimore area, MDUnavailable$131.06
Beaumont, TXUnavailable$120.42
Brazoria, TXUnavailable$120.66

20985 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
20985 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 20985 rate is calculated

Each of 20985’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 · 20985

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.44

2.44 RVUs× 1.000 GPCI

Practice expense0.77

0.77 RVUs× 1.000 GPCI

Malpractice0.50

0.50 RVUs× 1.000 GPCI

Adjusted RVUs

3.7100

Conversion factor

$33.4009

Medicare rate

$123.92

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

Payment rules and modifiers for 20985

The CMS indicators that decide how 20985 is paid alongside other services.

CMS payment indicators · 20985

Surgical navigation, image-less

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

20985 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 20985

    Surgical navigation, image-less2.44 wRVU

    Not priced

  • 0054T

    Surgical navigation, fluoroscopic imaging0 wRVU

    Not priced

  • 27447

    Total knee replacement, medial and lateral compartments19.11 wRVU

    Not priced

  • 27130

    Hip replacement, total joint, primary procedure19.11 wRVU

    Not priced

How to choose

0054TSurgical navigationFluoroscopic imaging
20985 describes image-less navigation using anatomy registered during surgery. 0054T is the image-guided navigation code, associated with preoperative imaging.
27447Total knee replacementMedial and lateral compartments
27447 reports the total knee replacement itself. Add 20985 only when image-less computer navigation is also used during that operation.
27130Hip replacementTotal joint, primary procedure
27130 reports total hip arthroplasty, not navigation. 20985 is an add-on when image-less navigation is used during the hip procedure.

Codes related to 20985

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

Codes related to 20985
CodeHow it relatesNational office range
Primary code
27447Total knee replacement, medial and lateral compartmentsPrimary total knee arthroplasty code that may be reported with navigation.No office rate
27130Hip replacement, total joint, primary procedurePrimary total hip arthroplasty code that may be reported with navigation.No office rate
27486Knee revision, one prosthetic componentPrimary revision knee arthroplasty code that may be reported with navigation.No office rate
Used instead
0054TSurgical navigation, fluoroscopic imagingDescribes image-guided musculoskeletal navigation rather than the image-less method.No office rate

20985 billing questions

When should 20985 be chosen over image-guided navigation?

Use 20985 for image-less navigation, where the system registers anatomy during surgery rather than relying on a preloaded CT or MRI image set. Code 0054T describes the image-guided navigation approach.

Can 20985 be billed by itself?

No. It is an add-on code and must be reported with the primary musculoskeletal operation for which navigation was used.

What documentation supports 20985?

The operative record should identify the primary surgery and document the use of image-less computer navigation, including relevant registration or instrument-tracking activity.

Is 20985 the code for the joint replacement itself?

No. The primary code reports the replacement, such as 27447 for total knee arthroplasty; 20985 reports the image-less navigation used during that operation.

How does Medicare treat payment for 20985?

Medicare treats it as an add-on billed with a primary procedure, with payment made within that 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 20985PPRRVU2026_Oct_nonQPP.csv, line 1,834 (RVU26D)

Open CMS sourceHow we calculate rates

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