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Billing code 20973: Bone/skin graftMedicare rate & RVUs

Report this vascularized bone-and-skin graft when tissue from the great toe is transferred to reconstruct a defect requiring both components.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,670.40 for 20973 nationally in a facility.

Medicare rate · 20973

Bone/skin graft

Swap in your local Medicare rate.

Work RVUs
46.09
Total RVUs
79.95
Global days
090

National rate · 2026

$2,670.40

Facility setting, before claim adjustments.

See every locality for 20973 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 20973 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 20973 covers

The surgeon harvests bone and an attached skin component from the great toe while preserving its blood supply, then transfers the graft to a recipient site and connects its vessels microsurgically. This service is used in reconstructive surgery when the defect calls for vascularized bone together with skin; plastic, reconstructive, or orthopedic surgeons may perform it in an operating room. The great toe donor source distinguishes this graft from similar bone-and-skin grafts taken from the metatarsal or iliac crest.

Select the code based on the graft’s donor site, not the recipient location. The operative report should identify the great toe source, the bone and skin components transferred, the recipient site, and the microvascular work. 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 one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 applies to bilateral procedures, paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 20973 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

20973 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,427.27
Alaska*Unavailable$3,344.36
ArizonaUnavailable$2,598.13
ArkansasUnavailable$2,397.65
AtlantaUnavailable$2,754.04
AustinUnavailable$2,682.43
BakersfieldUnavailable$2,647.84
Baltimore/Surr. CntysUnavailable$2,831.60
BeaumontUnavailable$2,574.87
BrazoriaUnavailable$2,603.05

20973 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
20973 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 20973 rate is calculated

Each of 20973’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 · 20973

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 46.09Practice expense 24.00Malpractice 9.86

79.9500 adjusted RVUs×$33.4009 conversion factor=$2,670.40

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 20973

20973 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20973

Bone/skin graft

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 20973

Bone/skin graft

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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 50 · payment effect

With and without the modifier

20973 without 50 · national facility

$2,670.40

Bone/skin graft

20973-50 · Bilateral: 150%

$4,005.60

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

20973 compared with similar codes

Compare codes

20973 vs 20972 vs 20970 vs 20955: national Medicare rates

Swap in your local Medicare rate.

  • 20973
    Bone/skin graft · 46.09 wRVU
    —
  • 20972
    Free flap · 43.4 wRVU
    —
  • 20970
    Bone and skin graft · 43.47 wRVU
    —
  • 20955
    Bone graft · 39.25 wRVU
    —

How to choose

20972Free flap
Use 20973 for a bone-and-skin graft from the great toe. Code 20972 identifies a metatarsal donor source.
20970Bone and skin graft
Both describe bone-and-skin grafts, but 20970 identifies the iliac crest as the donor site.
20955Bone graft
Code 20955 is a microvascular bone graft from the fibula; 20973 identifies a graft containing bone and skin from the great toe.

Codes related to 20973

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

Codes related to 20973
CodeHow it relatesNational office range
Same family
20972Free flapBone-and-skin graft from the metatarsal rather than the great toe.No office rate
20970Bone and skin graftBone-and-skin graft using the iliac crest donor site.No office rate
20969Bone-skin graftMicrovascular bone-and-skin graft code without the specific great toe donor-site designation.No office rate
20955Bone graftMicrovascular bone graft from the fibula, without the bone-and-skin graft designation.No office rate

20973 billing questions

How is this code distinguished from the metatarsal bone-and-skin graft?

Choose this code when the transferred bone and skin come from the great toe. The metatarsal graft code is for tissue taken from the metatarsal.

Does the service include the microvascular transfer?

The code represents a vascularized bone-and-skin graft transfer, including the microsurgical connection of its vessels. Document the graft components, donor site, recipient site, and vascular work.

How does CMS apply the 90-day global period?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How is modifier 50 handled for bilateral procedures?

CMS pays a bilateral procedure reported with modifier 50 at 150%. The operative documentation should support the bilateral service.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

What happens when this graft is performed with another procedure?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session 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 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 20973PPRRVU2026_Oct_nonQPP.csv, line 1,828 (RVU26D)

Open CMS sourceHow we calculate rates

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