No office rate
Choose 20660 for cranial tongs, calipers, or comparable traction hardware. Choose 20661 for application of a cranial halo.
On this page
CMS RVU26D · Effective 2026-10-01
20660 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$201.74
Base rate per service
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.
Orthopedic procedure
About 20660: Cranial skeletal traction tongs application
Reports application and removal of cranial tongs, calipers, or similar fixation hardware to provide skeletal traction, commonly for cervical spine injuries.
20660 covers placement of cranial tongs, calipers, or a comparable skull-anchored device to provide skeletal traction, with removal included. Orthopedic or spine surgeons commonly use it for cervical spine injuries requiring traction, often in an emergency department or hospital. The device applies controlled traction through cranial fixation rather than a halo frame.
Report the service when documentation supports application of cranial traction hardware, not placement of a cranial halo or a bone pin. Record the indication, device applied, and traction treatment; removal is included rather than separately reported. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. With other procedures in the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Bilateral adjustment is not appropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 20660
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.90 · 61%
- Practice expense (office) RVU1.27 · 20%
- Malpractice RVU1.26 · 20%
354
Medicare services in 2024 · #3846 by national volume
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.
20660 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
20664 describes cranial halo application when the frame uses six or more pins; 20660 describes cranial traction tongs, calipers, or similar hardware.
$123.68
20660 includes application and removal of cranial traction hardware. 20665 is for removal of a cranial device as a separate service.
The same code, a different location
How does El Centro compare?
20660 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 20660
Office
Unavailable
Facility
$201.53
No comparable office rate is available.
Modesto
California · 20660
Office
Unavailable
Facility
$201.53
No comparable office rate is available.
Napa
California · 20660
Office
Unavailable
Facility
$215.76
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 20660
Office
Unavailable
Facility
$210.27
No comparable office rate is available.
Redding
California · 20660
Office
Unavailable
Facility
$201.53
No comparable office rate is available.
Rest Of California
California · 20660
Office
Unavailable
Facility
$201.53
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 20660
Office
Unavailable
Facility
$215.00
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 20660
Office
Unavailable
Facility
$206.84
No comparable office rate is available.
Salinas
California · 20660
Office
Unavailable
Facility
$206.02
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 20660
Office
Unavailable
Facility
$207.71
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 20660
Office
Unavailable
Facility
$221.77
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 20660
Office
Unavailable
Facility
$220.34
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 20660
Office
Unavailable
Facility
$228.32
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 20660
Office
Unavailable
Facility
$222.47
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 20660
Office
Unavailable
Facility
$203.35
No comparable office rate is available.
Santa Cruz-Watsonville
California · 20660
Office
Unavailable
Facility
$207.10
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 20660
Office
Unavailable
Facility
$205.93
No comparable office rate is available.
Santa Rosa-Petaluma
California · 20660
Office
Unavailable
Facility
$208.82
No comparable office rate is available.
Stockton
California · 20660
Office
Unavailable
Facility
$201.53
No comparable office rate is available.
Vallejo
California · 20660
Office
Unavailable
Facility
$213.70
No comparable office rate is available.
Visalia
California · 20660
Office
Unavailable
Facility
$201.53
No comparable office rate is available.
Yuba City
California · 20660
Office
Unavailable
Facility
$201.53
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 20660
Office
Unavailable
Facility
$234.11
No comparable office rate is available.
Miami
Florida · 20660
Office
Unavailable
Facility
$280.86
No comparable office rate is available.
Chicago
Illinois · 20660
Office
Unavailable
Facility
$270.39
No comparable office rate is available.
Manhattan
New York · 20660
Office
Unavailable
Facility
$254.64
No comparable office rate is available.
Alaska*
Alaska · 20660
Office
Unavailable
Facility
$263.76
No comparable office rate is available.
Alabama
Alabama · 20660
Office
Unavailable
Facility
$191.20
No comparable office rate is available.
Arkansas
Arkansas · 20660
Office
Unavailable
Facility
$188.38
No comparable office rate is available.
Arizona
Arizona · 20660
Office
Unavailable
Facility
$207.39
No comparable office rate is available.
Colorado
Colorado · 20660
Office
Unavailable
Facility
$209.83
No comparable office rate is available.
Connecticut
Connecticut · 20660
Office
Unavailable
Facility
$229.48
No comparable office rate is available.
Delaware
Delaware · 20660
Office
Unavailable
Facility
$210.66
No comparable office rate is available.
Fort Lauderdale
Florida · 20660
Office
Unavailable
Facility
$249.32
No comparable office rate is available.
Rest Of Florida
Florida · 20660
Office
Unavailable
Facility
$234.07
No comparable office rate is available.
Atlanta
Georgia · 20660
Office
Unavailable
Facility
$224.30
No comparable office rate is available.
Rest Of Georgia
Georgia · 20660
Office
Unavailable
Facility
$218.27
No comparable office rate is available.
Hawaii, Guam
Hawaii · 20660
Office
Unavailable
Facility
$202.86
No comparable office rate is available.
Iowa
Iowa · 20660
Office
Unavailable
Facility
$185.78
No comparable office rate is available.
Idaho
Idaho · 20660
Office
Unavailable
Facility
$189.20
No comparable office rate is available.
East St. Louis
Illinois · 20660
Office
Unavailable
Facility
$254.05
No comparable office rate is available.
Rest Of Illinois
Illinois · 20660
Office
Unavailable
Facility
$234.77
No comparable office rate is available.
Suburban Chicago
Illinois · 20660
Office
Unavailable
Facility
$249.31
No comparable office rate is available.
Indiana
Indiana · 20660
Office
Unavailable
Facility
$190.04
No comparable office rate is available.
Kansas
Kansas · 20660
Office
Unavailable
Facility
$189.82
No comparable office rate is available.
Kentucky
Kentucky · 20660
Office
Unavailable
Facility
$206.48
No comparable office rate is available.
New Orleans
Louisiana · 20660
Office
Unavailable
Facility
$217.99
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 20660
Office
Unavailable
Facility
$208.12
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 20660
Office
Unavailable
Facility
$223.71
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 20660
Office
Unavailable
Facility
$210.56
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 20660
Office
Unavailable
Facility
$229.92
No comparable office rate is available.
Rest Of Maryland
Maryland · 20660
Office
Unavailable
Facility
$213.13
No comparable office rate is available.
Rest Of Maine
Maine · 20660
Office
Unavailable
Facility
$195.47
No comparable office rate is available.
Southern Maine
Maine · 20660
Office
Unavailable
Facility
$198.86
No comparable office rate is available.
Detroit
Michigan · 20660
Office
Unavailable
Facility
$242.15
No comparable office rate is available.
Rest Of Michigan
Michigan · 20660
Office
Unavailable
Facility
$216.51
No comparable office rate is available.
Minnesota
Minnesota · 20660
Office
Unavailable
Facility
$186.37
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 20660
Office
Unavailable
Facility
$211.21
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 20660
Office
Unavailable
Facility
$212.82
No comparable office rate is available.
Rest Of Missouri
Missouri · 20660
Office
Unavailable
Facility
$207.82
No comparable office rate is available.
Mississippi
Mississippi · 20660
Office
Unavailable
Facility
$197.89
No comparable office rate is available.
Montana**
Montana · 20660
Office
Unavailable
Facility
$214.68
No comparable office rate is available.
North Carolina
North Carolina · 20660
Office
Unavailable
Facility
$196.73
No comparable office rate is available.
North Dakota**
North Dakota · 20660
Office
Unavailable
Facility
$189.77
No comparable office rate is available.
Nebraska
Nebraska · 20660
Office
Unavailable
Facility
$185.32
No comparable office rate is available.
New Hampshire
New Hampshire · 20660
Office
Unavailable
Facility
$211.25
No comparable office rate is available.
Northern Nj
New Jersey · 20660
Office
Unavailable
Facility
$232.62
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 20660
Office
Unavailable
Facility
$227.96
No comparable office rate is available.
New Mexico
New Mexico · 20660
Office
Unavailable
Facility
$219.71
No comparable office rate is available.
Nevada**
Nevada · 20660
Office
Unavailable
Facility
$207.78
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 20660
Office
Unavailable
Facility
$267.19
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 20660
Office
Unavailable
Facility
$233.50
No comparable office rate is available.
Queens
New York · 20660
Office
Unavailable
Facility
$249.43
No comparable office rate is available.
Rest Of New York
New York · 20660
Office
Unavailable
Facility
$200.15
No comparable office rate is available.
Ohio
Ohio · 20660
Office
Unavailable
Facility
$211.41
No comparable office rate is available.
Oklahoma
Oklahoma · 20660
Office
Unavailable
Facility
$200.84
No comparable office rate is available.
Portland
Oregon · 20660
Office
Unavailable
Facility
$210.79
No comparable office rate is available.
Rest Of Oregon
Oregon · 20660
Office
Unavailable
Facility
$202.10
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 20660
Office
Unavailable
Facility
$226.97
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 20660
Office
Unavailable
Facility
$208.97
No comparable office rate is available.
Puerto Rico
Puerto Rico · 20660
Office
Unavailable
Facility
$214.60
No comparable office rate is available.
Rhode Island
Rhode Island · 20660
Office
Unavailable
Facility
$214.10
No comparable office rate is available.
South Carolina
South Carolina · 20660
Office
Unavailable
Facility
$205.23
No comparable office rate is available.
South Dakota**
South Dakota · 20660
Office
Unavailable
Facility
$186.82
No comparable office rate is available.
Tennessee
Tennessee · 20660
Office
Unavailable
Facility
$191.42
No comparable office rate is available.
Austin
Texas · 20660
Office
Unavailable
Facility
$212.69
No comparable office rate is available.
Beaumont
Texas · 20660
Office
Unavailable
Facility
$207.96
No comparable office rate is available.
Brazoria
Texas · 20660
Office
Unavailable
Facility
$206.17
No comparable office rate is available.
Dallas
Texas · 20660
Office
Unavailable
Facility
$209.79
No comparable office rate is available.
Fort Worth
Texas · 20660
Office
Unavailable
Facility
$209.92
No comparable office rate is available.
Galveston
Texas · 20660
Office
Unavailable
Facility
$208.27
No comparable office rate is available.
Houston
Texas · 20660
Office
Unavailable
Facility
$231.34
No comparable office rate is available.
Rest Of Texas
Texas · 20660
Office
Unavailable
Facility
$208.52
No comparable office rate is available.
Utah
Utah · 20660
Office
Unavailable
Facility
$207.93
No comparable office rate is available.
Virginia
Virginia · 20660
Office
Unavailable
Facility
$201.67
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 20660
Office
Unavailable
Facility
$214.60
No comparable office rate is available.
Vermont
Vermont · 20660
Office
Unavailable
Facility
$193.55
No comparable office rate is available.
Rest Of Washington
Washington · 20660
Office
Unavailable
Facility
$208.65
No comparable office rate is available.
Seattle (King Cnty)
Washington · 20660
Office
Unavailable
Facility
$223.21
No comparable office rate is available.
Wisconsin
Wisconsin · 20660
Office
Unavailable
Facility
$183.86
No comparable office rate is available.
West Virginia
West Virginia · 20660
Office
Unavailable
Facility
$227.35
No comparable office rate is available.
Wyoming**
Wyoming · 20660
Office
Unavailable
Facility
$203.83
No comparable office rate is available.
See how rates vary across the country
20660 · 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 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 20660 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$221.91
$201.74 × 110% = $221.91
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 20660 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
1,776
- Code
- 20660
- Physician work
- 3.90
- Practice expense
- 1.27
- Malpractice
- 1.26
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.90 | × 1.017 | 3.9663 |
| Practice expense | 1.27 | × 1.096 | 1.3919 |
| Malpractice | 1.26 | × 0.541 | 0.6817 |
| Total RVUs | 6.0399 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$201.74
Open 20660 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.9 | 1.017 |
| Practice expense | 1.27 | 1.096 |
| Malpractice | 1.26 | 0.541 |
(3.9 × 1.017 + 1.27 × 1.096 + 1.26 × 0.541) × $33.4009 = $201.74
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
20660 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $201.74 | RVU26D |
| 2026-07-01 | Not available in this setting | $201.74 | RVU26C |
| 2026-04-01 | Not available in this setting | $201.74 | RVU26B |
| 2026-01-01 | Not available in this setting | $201.74 | RVU26A |
| 2025-10-01 | Not available in this setting | $224.81 | RVU25D |
| 2025-07-01 | Not available in this setting | $224.81 | RVU25C |
| 2025-04-01 | Not available in this setting | $224.81 | RVU25B |
| 2025-01-01 | Not available in this setting | $224.81 | RVU25A |
20660 billing questions
How does 20660 differ from cranial halo application?
20660 is for cranial tongs, calipers, or similar hardware used for skeletal traction. Use the halo application code when the service places a cranial halo frame.
Is removal separately reported after application?
Removal of the cranial traction device is included in 20660. A removal-only service is distinct from an application-and-removal service.
What documentation supports reporting 20660?
Document the clinical indication, the cranial traction device applied, and the traction treatment provided. The record should distinguish the device from a halo frame or bone pin.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction. Medicare also does not pay an assistant at surgery for 20660.
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.
1,77320612,,Aspirate/inj ganglion cyst,A,,0.68,1.26,,0.33,,0.09,2.03,1.10,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77420615,,Treatment of bone cyst,A,,2.27,4.95,,1.80,,0.25,7.47,4.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77520650,,Insert and remove bone pin,A,,2.22,4.87,,2.19,,0.38,7.47,4.79,0,010,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77620660,,Apply rem fixation device,A,,3.90,1.27,NA,1.27,,1.26,6.43,6.43,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77720661,,Application halo cranial,A,,5.13,9.68,NA,9.68,,1.76,16.57,16.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77820662,,Application halo pelvic,A,,6.22,7.46,NA,7.46,,1.32,15.00,15.00,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77920663,,Application halo femoral,A,,5.60,7.11,NA,7.11,,1.21,13.92,13.92,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664