No office rate
Choose 20827 for a completely severed thumb. Code 20824 describes revascularization after an incomplete thumb amputation.
On this page
CMS RVU26D · Effective 2026-10-01
20827 Thumb replantation Medicare reimbursement rates
Reports microsurgical reattachment of a completely amputated thumb, including operative work to restore circulation and reconstruct injured structures. Compare 20827 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 20827?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 20827 pays more and less
Hand surgery
About 20827: Complete thumb replantation surgery
Reports microsurgical reattachment of a completely amputated thumb, including operative work to restore circulation and reconstruct injured structures.
This service covers surgery to reattach a thumb that has been completely severed. A hand surgeon or other surgeon with microsurgical expertise typically performs the urgent procedure in an operating room, using techniques to reconnect blood vessels and repair injured structures needed for thumb function. The code is specific to the thumb; a completely amputated nonthumb digit or a larger part of the hand has a different code in the replantation family.
Choose this code when the thumb was fully separated, rather than incompletely amputated with circulation requiring restoration. The operative report should establish the thumb as the replantation site, document complete separation, and describe the reconstruction performed. 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 is paid in full and other procedures are subject to the standard 50% reduction. For bilateral service, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 20827
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU26.79 · 54%
- Practice expense (office) RVU16.71 · 34%
- Malpractice RVU5.71 · 12%
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.
20827 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Code 20816 is for complete replantation of a nonthumb digit; 20827 is specific to the thumb.
No office rate
Code 20808 applies when the replantation site is the hand. Code 20827 identifies a completely amputated thumb.
See how rates vary across the country
20827 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 20827 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1491.12 |
| Alaska* | Office Unavailable | Facility $2041.71 |
| Arizona | Office Unavailable | Facility $1598.89 |
| Arkansas | Office Unavailable | Facility $1472.46 |
| Atlanta | Office Unavailable | Facility $1693.61 |
| Austin | Office Unavailable | Facility $1656.08 |
| Bakersfield | Office Unavailable | Facility $1639.67 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1743.92 |
| Beaumont | Office Unavailable | Facility $1579.89 |
| Brazoria | Office Unavailable | Facility $1603.84 |
| Chicago | Office Unavailable | Facility $1899.69 |
| Chico | Office Unavailable | Facility $1623.96 |
| Colorado | Office Unavailable | Facility $1648.35 |
| Connecticut | Office Unavailable | Facility $1744.58 |
| Dallas | Office Unavailable | Facility $1622.40 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1812.88 |
| Delaware | Office Unavailable | Facility $1622.17 |
| Detroit | Office Unavailable | Facility $1754.96 |
| East St. Louis | Office Unavailable | Facility $1792.40 |
| El Centro | Office Unavailable | Facility $1624.91 |
| Fort Lauderdale | Office Unavailable | Facility $1805.02 |
| Fort Worth | Office Unavailable | Facility $1619.30 |
| Fresno | Office Unavailable | Facility $1623.96 |
| Galveston | Office Unavailable | Facility $1614.11 |
| Hanford-Corcoran | Office Unavailable | Facility $1623.96 |
| Hawaii, Guam | Office Unavailable | Facility $1639.83 |
| Houston | Office Unavailable | Facility $1718.62 |
| Idaho | Office Unavailable | Facility $1498.50 |
| Indiana | Office Unavailable | Facility $1504.89 |
| Iowa | Office Unavailable | Facility $1481.21 |
| Kansas | Office Unavailable | Facility $1495.48 |
| Kentucky | Office Unavailable | Facility $1565.49 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1718.40 |
| Madera | Office Unavailable | Facility $1623.96 |
| Manhattan | Office Unavailable | Facility $1903.10 |
| Merced | Office Unavailable | Facility $1623.96 |
| Metropolitan Boston | Office Unavailable | Facility $1767.64 |
| Metropolitan Kansas City | Office Unavailable | Facility $1605.23 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1719.46 |
| Metropolitan St. Louis | Office Unavailable | Facility $1617.25 |
| Miami | Office Unavailable | Facility $1958.15 |
| Minnesota | Office Unavailable | Facility $1525.58 |
| Mississippi | Office Unavailable | Facility $1516.30 |
| Modesto | Office Unavailable | Facility $1623.96 |
| Montana** | Office Unavailable | Facility $1643.28 |
| Napa | Office Unavailable | Facility $1783.68 |
| Nebraska | Office Unavailable | Facility $1482.06 |
| Nevada** | Office Unavailable | Facility $1612.37 |
| New Hampshire | Office Unavailable | Facility $1642.70 |
| New Mexico | Office Unavailable | Facility $1635.67 |
| New Orleans | Office Unavailable | Facility $1636.67 |
| North Carolina | Office Unavailable | Facility $1537.41 |
| North Dakota** | Office Unavailable | Facility $1530.37 |
| Northern Nj | Office Unavailable | Facility $1802.30 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1969.86 |
| Ohio | Office Unavailable | Facility $1596.63 |
| Oklahoma | Office Unavailable | Facility $1541.41 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1698.39 |
| Portland | Office Unavailable | Facility $1671.10 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1777.00 |
| Puerto Rico | Office Unavailable | Facility $1646.94 |
| Queens | Office Unavailable | Facility $1886.80 |
| Redding | Office Unavailable | Facility $1623.96 |
| Rest Of California | Office Unavailable | Facility $1623.96 |
| Rest Of Florida | Office Unavailable | Facility $1715.03 |
| Rest Of Georgia | Office Unavailable | Facility $1620.00 |
| Rest Of Illinois | Office Unavailable | Facility $1702.48 |
| Rest Of Louisiana | Office Unavailable | Facility $1571.46 |
| Rest Of Maine | Office Unavailable | Facility $1526.92 |
| Rest Of Maryland | Office Unavailable | Facility $1643.66 |
| Rest Of Massachusetts | Office Unavailable | Facility $1648.84 |
| Rest Of Michigan | Office Unavailable | Facility $1619.70 |
| Rest Of Missouri | Office Unavailable | Facility $1561.68 |
| Rest Of New Jersey | Office Unavailable | Facility $1749.30 |
| Rest Of New York | Office Unavailable | Facility $1559.11 |
| Rest Of Oregon | Office Unavailable | Facility $1584.78 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1587.40 |
| Rest Of Texas | Office Unavailable | Facility $1596.69 |
| Rest Of Washington | Office Unavailable | Facility $1639.29 |
| Rhode Island | Office Unavailable | Facility $1658.48 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1685.31 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1678.35 |
| Salinas | Office Unavailable | Facility $1671.65 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1692.55 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1854.32 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1847.83 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1900.29 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1873.78 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1647.96 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1693.95 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1672.87 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1709.26 |
| Seattle (King Cnty) | Office Unavailable | Facility $1780.19 |
| South Carolina | Office Unavailable | Facility $1572.63 |
| South Dakota** | Office Unavailable | Facility $1517.02 |
| Southern Maine | Office Unavailable | Facility $1568.26 |
| Stockton | Office Unavailable | Facility $1623.96 |
| Suburban Chicago | Office Unavailable | Facility $1812.23 |
| Tennessee | Office Unavailable | Facility $1504.57 |
| Utah | Office Unavailable | Facility $1590.72 |
| Vallejo | Office Unavailable | Facility $1774.34 |
| Vermont | Office Unavailable | Facility $1543.86 |
| Virgin Islands | Office Unavailable | Facility $1646.94 |
| Virginia | Office Unavailable | Facility $1578.10 |
| Visalia | Office Unavailable | Facility $1623.96 |
| West Virginia | Office Unavailable | Facility $1652.74 |
| Wisconsin | Office Unavailable | Facility $1488.24 |
| Wyoming** | Office Unavailable | Facility $1594.07 |
| Yuba City | Office Unavailable | Facility $1623.96 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
20827 billing questions
How is this code distinguished from 20824?
Use 20827 when the thumb was completely severed before replantation. Code 20824 is for an incompletely amputated thumb requiring revascularization.
When is 20816 more appropriate?
Code 20816 is for complete replantation of a nonthumb digit. The thumb is reported with 20827 when completely amputated.
Are the preoperative visit and postoperative care separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral thumb replantation reported?
For bilateral service, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
What happens when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,79920816,,Replantation digit complete,A,,31.15,17.18,NA,17.18,,6.63,54.96,54.96,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80020822,,Replantation digit complete,A,,25.99,16.45,NA,16.45,,5.54,47.98,47.98,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80120824,,Replantation thumb complete,A,,31.15,17.34,NA,17.34,,6.63,55.12,55.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80220827,,Replantation thumb complete,A,,26.79,16.71,NA,16.71,,5.71,49.21,49.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80320838,,Replantation foot complete,A,,41.81,23.93,NA,23.93,,8.93,74.67,74.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80420900,,Removal of bone for graft,A,,2.93,8.51,,1.40,,0.48,11.92,4.81,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80520902,,Removal of bone for graft,A,,4.47,1.94,NA,1.94,,0.83,7.24,7.24,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00