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CMS RVU26D · Effective 2026-10-01

20650 in Redding

Office / nonfacility

$260.49

Base rate per service

Facility setting

$162.38

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 20650: Bone pin insertion for skeletal traction

Reports placement of a wire or pin into bone to establish skeletal traction, such as temporary traction for selected fractures, including pin removal when performed.

An orthopedic surgeon places a wire or pin through bone and connects it to a traction setup to apply controlled pulling force. A typical use is temporary skeletal traction during management of a fracture when traction through a pin is needed. The service may be performed in a hospital or another setting where the clinician can place and manage the traction apparatus. The code includes removal of the traction wire or pin when performed.

Report the service when documentation identifies the bone and insertion site, the clinical reason for skeletal traction, and the pin or wire placement and traction application. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 20650

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 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 paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.22 · 30%
  • Practice expense (office) RVU4.87 · 65%
  • Malpractice RVU0.38 · 5%

894

Medicare services in 2024 · #3050 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.

20650 compared with similar codes

Office rates for Redding, from the same CMS release.

20660

Cranial traction

Tongs or calipers

No office rate

20650 uses a wire or pin inserted into bone to apply skeletal traction. 20660 is for application of cranial tongs, calipers, or another cranial fixation device.

20661

Cranial halo

Four-pin application

No office rate

20661 describes application of a cranial halo. Choose 20650 for traction established by a wire or pin inserted into bone rather than a halo device.

20690

External fixation

Unilateral, single-plane frame

No office rate

20690 describes application of a uniplanar external fixation system. It is not the code for a bone pin used to apply skeletal traction.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 20650 is $261.57—$1.08 higher than the $260.49 rate in Redding. Both use the same code, release and participation basis.

20650 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $260.49

  2. $1.08 higher than Redding

  3. Chico

    $260.49

    The same base rate than Redding

  4. El Centro

    $260.56

    $0.07 higher than Redding

  5. Fresno

    $260.49

    The same base rate than Redding

  6. The same base rate than Redding

  7. $17.56 higher than Redding

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 20650 ranges from $220.41 in Arkansas to $323.67 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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
  • Madera

    California · 20650

    Office

    $260.49

    Facility

    $162.38

    The same base rate than Redding for the office setting.

  • Merced

    California · 20650

    Office

    $260.49

    Facility

    $162.38

    The same base rate than Redding for the office setting.

  • Modesto

    California · 20650

    Office

    $260.49

    Facility

    $162.38

    The same base rate than Redding for the office setting.

  • Napa

    California · 20650

    Office

    $299.66

    Facility

    $181.68

    $39.17 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 20650

    Office

    $276.40

    Facility

    $170.59

    $15.91 higher than Redding for the office setting.

  • Rest Of California

    California · 20650

    Office

    $260.49

    Facility

    $162.38

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 20650

    Office

    $264.59

    Facility

    $166.48

    $4.10 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 20650

    Office

    $272.80

    Facility

    $168.69

    $12.31 higher than Redding for the office setting.

  • Salinas

    California · 20650

    Office

    $271.78

    Facility

    $168.03

    $11.29 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 20650

    Office

    $277.80

    Facility

    $170.74

    $17.31 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 20650

    Office

    $316.37

    Facility

    $190.16

    $55.88 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 20650

    Office

    $315.94

    Facility

    $189.73

    $55.45 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 20650

    Office

    $323.67

    Facility

    $194.59

    $63.18 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 20650

    Office

    $321.90

    Facility

    $192.82

    $61.41 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 20650

    Office

    $267.49

    Facility

    $165.53

    $7.00 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 20650

    Office

    $280.15

    Facility

    $171.39

    $19.66 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 20650

    Office

    $272.69

    Facility

    $168.32

    $12.20 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 20650

    Office

    $282.93

    Facility

    $173.00

    $22.44 higher than Redding for the office setting.

  • Stockton

    California · 20650

    Office

    $260.49

    Facility

    $162.38

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 20650

    Office

    $299.04

    Facility

    $181.06

    $38.55 higher than Redding for the office setting.

  • Visalia

    California · 20650

    Office

    $260.49

    Facility

    $162.38

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 20650

    Office

    $260.49

    Facility

    $162.38

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 20650

    Office

    $283.90

    Facility

    $178.45

    $23.41 higher than Redding for the office setting.

  • Miami

    Florida · 20650

    Office

    $275.58

    Facility

    $182.40

    $15.09 higher than Redding for the office setting.

  • Chicago

    Illinois · 20650

    Office

    $267.27

    Facility

    $177.31

    $6.78 higher than Redding for the office setting.

  • Manhattan

    New York · 20650

    Office

    $288.04

    Facility

    $184.02

    $27.55 higher than Redding for the office setting.

  • Alaska*

    Alaska · 20650

    Office

    $291.45

    Facility

    $196.12

    $30.96 higher than Redding for the office setting.

  • Alabama

    Alabama · 20650

    Office

    $223.66

    Facility

    $145.34

    $36.83 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 20650

    Office

    $220.41

    Facility

    $143.52

    $40.08 lower than Redding for the office setting.

  • Arizona

    Arizona · 20650

    Office

    $242.63

    Facility

    $155.90

    $17.86 lower than Redding for the office setting.

  • Colorado

    Colorado · 20650

    Office

    $258.03

    Facility

    $162.78

    $2.46 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 20650

    Office

    $266.18

    Facility

    $169.77

    $5.69 higher than Redding for the office setting.

  • Delaware

    Delaware · 20650

    Office

    $246.64

    Facility

    $158.20

    $13.85 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 20650

    Office

    $261.87

    Facility

    $171.20

    $1.38 higher than Redding for the office setting.

  • Rest Of Florida

    Florida · 20650

    Office

    $248.73

    Facility

    $163.16

    $11.76 lower than Redding for the office setting.

  • Atlanta

    Georgia · 20650

    Office

    $254.88

    Facility

    $163.93

    $5.61 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 20650

    Office

    $234.37

    Facility

    $154.53

    $26.12 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 20650

    Office

    $266.45

    Facility

    $164.67

    $5.96 higher than Redding for the office setting.

  • Iowa

    Iowa · 20650

    Office

    $228.02

    Facility

    $146.12

    $32.47 lower than Redding for the office setting.

  • Idaho

    Idaho · 20650

    Office

    $229.80

    Facility

    $147.45

    $30.69 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 20650

    Office

    $249.36

    Facility

    $167.01

    $11.13 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 20650

    Office

    $242.50

    Facility

    $160.77

    $17.99 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 20650

    Office

    $264.21

    Facility

    $172.28

    $3.72 higher than Redding for the office setting.

  • Indiana

    Indiana · 20650

    Office

    $231.11

    Facility

    $148.13

    $29.38 lower than Redding for the office setting.

  • Kansas

    Kansas · 20650

    Office

    $227.59

    Facility

    $146.67

    $32.90 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 20650

    Office

    $230.37

    Facility

    $150.79

    $30.12 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 20650

    Office

    $241.63

    Facility

    $157.40

    $18.86 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 20650

    Office

    $230.27

    Facility

    $151.05

    $30.22 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 20650

    Office

    $282.71

    Facility

    $175.83

    $22.22 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 20650

    Office

    $256.74

    Facility

    $162.48

    $3.75 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 20650

    Office

    $265.57

    Facility

    $169.52

    $5.08 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 20650

    Office

    $251.16

    Facility

    $160.57

    $9.33 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 20650

    Office

    $231.69

    Facility

    $149.34

    $28.80 lower than Redding for the office setting.

  • Southern Maine

    Maine · 20650

    Office

    $243.36

    Facility

    $154.65

    $17.13 lower than Redding for the office setting.

  • Detroit

    Michigan · 20650

    Office

    $252.52

    Facility

    $166.14

    $7.97 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 20650

    Office

    $236.99

    Facility

    $155.26

    $23.50 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 20650

    Office

    $245.29

    Facility

    $153.18

    $15.20 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 20650

    Office

    $239.29

    Facility

    $155.24

    $21.20 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 20650

    Office

    $241.72

    Facility

    $156.50

    $18.77 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 20650

    Office

    $226.73

    Facility

    $149.57

    $33.76 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 20650

    Office

    $223.58

    Facility

    $146.51

    $36.91 lower than Redding for the office setting.

  • Montana**

    Montana · 20650

    Office

    $249.48

    Facility

    $159.96

    $11.01 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 20650

    Office

    $234.02

    Facility

    $150.51

    $26.47 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 20650

    Office

    $241.97

    Facility

    $152.45

    $18.52 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 20650

    Office

    $229.09

    Facility

    $146.46

    $31.40 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 20650

    Office

    $254.59

    Facility

    $161.40

    $5.90 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 20650

    Office

    $281.07

    Facility

    $177.23

    $20.58 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 20650

    Office

    $268.67

    Facility

    $170.92

    $8.18 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 20650

    Office

    $238.55

    Facility

    $156.47

    $21.94 lower than Redding for the office setting.

  • Nevada**

    Nevada · 20650

    Office

    $247.55

    Facility

    $157.94

    $12.94 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 20650

    Office

    $295.87

    Facility

    $189.44

    $35.38 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 20650

    Office

    $270.96

    Facility

    $172.94

    $10.47 higher than Redding for the office setting.

  • Queens

    New York · 20650

    Office

    $289.46

    Facility

    $183.66

    $28.97 higher than Redding for the office setting.

  • Rest Of New York

    New York · 20650

    Office

    $237.60

    Facility

    $152.56

    $22.89 lower than Redding for the office setting.

  • Ohio

    Ohio · 20650

    Office

    $235.45

    Facility

    $153.73

    $25.04 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 20650

    Office

    $229.27

    Facility

    $149.33

    $31.22 lower than Redding for the office setting.

  • Portland

    Oregon · 20650

    Office

    $265.50

    Facility

    $166.05

    $5.01 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 20650

    Office

    $245.08

    Facility

    $155.93

    $15.41 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 20650

    Office

    $259.96

    Facility

    $166.77

    $0.53 lower than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 20650

    Office

    $235.47

    Facility

    $153.29

    $25.02 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 20650

    Office

    $251.10

    Facility

    $160.60

    $9.39 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 20650

    Office

    $254.91

    Facility

    $162.44

    $5.58 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 20650

    Office

    $235.24

    Facility

    $152.53

    $25.25 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 20650

    Office

    $241.08

    Facility

    $151.56

    $19.41 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 20650

    Office

    $228.83

    Facility

    $147.46

    $31.66 lower than Redding for the office setting.

  • Austin

    Texas · 20650

    Office

    $257.64

    Facility

    $162.93

    $2.85 lower than Redding for the office setting.

  • Beaumont

    Texas · 20650

    Office

    $233.96

    Facility

    $152.51

    $26.53 lower than Redding for the office setting.

  • Brazoria

    Texas · 20650

    Office

    $245.84

    Facility

    $157.13

    $14.65 lower than Redding for the office setting.

  • Dallas

    Texas · 20650

    Office

    $247.72

    Facility

    $158.56

    $12.77 lower than Redding for the office setting.

  • Fort Worth

    Texas · 20650

    Office

    $246.26

    Facility

    $158.00

    $14.23 lower than Redding for the office setting.

  • Galveston

    Texas · 20650

    Office

    $246.78

    Facility

    $157.89

    $13.71 lower than Redding for the office setting.

  • Houston

    Texas · 20650

    Office

    $253.73

    Facility

    $164.84

    $6.76 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 20650

    Office

    $239.98

    Facility

    $155.03

    $20.51 lower than Redding for the office setting.

  • Utah

    Utah · 20650

    Office

    $238.45

    Facility

    $154.31

    $22.04 lower than Redding for the office setting.

  • Virginia

    Virginia · 20650

    Office

    $243.01

    Facility

    $155.02

    $17.48 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 20650

    Office

    $251.10

    Facility

    $160.60

    $9.39 lower than Redding for the office setting.

  • Vermont

    Vermont · 20650

    Office

    $241.61

    Facility

    $152.99

    $18.88 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 20650

    Office

    $256.06

    Facility

    $161.80

    $4.43 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 20650

    Office

    $287.81

    Facility

    $177.98

    $27.32 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 20650

    Office

    $233.89

    Facility

    $148.13

    $26.60 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 20650

    Office

    $233.67

    Facility

    $155.88

    $26.82 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 20650

    Office

    $246.20

    Facility

    $156.69

    $14.29 lower than Redding for the office setting.

See how rates vary across the country

20650 · 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.

$220.41

$292.08

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$291.451
AL$223.661
AR$220.411
AZ$242.631
CA$260.49–$323.6729
CO$258.031
CT$266.181
DC$283.901
DE$246.641
FL$248.73–$275.583
GA$234.37–$254.882
GU$266.451
HI$266.451
IA$228.021
ID$229.801
IL$242.50–$267.274
IN$231.111
KS$227.591
KY$230.371
LA$230.27–$241.632
MA$256.74–$282.712
MD$251.16–$283.903
ME$231.69–$243.362
MI$236.99–$252.522
MN$245.291
MO$226.73–$241.723
MS$223.581
MT$249.481
NC$234.021
ND$241.971
NE$229.091
NH$254.591
NJ$268.67–$281.072
NM$238.551
NV$247.551
NY$237.60–$295.875
OH$235.451
OK$229.271
OR$245.08–$265.502
PA$235.47–$259.962
PR$251.101
RI$254.911
SC$235.241
SD$241.081
TN$228.831
TX$233.96–$257.648
UT$238.451
VA$243.01–$283.902
VI$251.101
VT$241.611
WA$256.06–$287.812
WI$233.891
WV$233.671
WY$246.201

Explore 20650 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 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.

Why are the office and facility amounts different?

For 20650 in Redding, the physician’s office rate is $260.49 and the facility-setting rate is $162.38: a difference of $98.11.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 20650 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$286.54

$260.49 × 110% = $286.54

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.

Compare your contract offer →

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 20650 in Redding.

PPRRVU2026_Oct_nonQPP.csv

1,775

Code
20650
Physician work
2.22
Practice expense
4.87
Malpractice
0.38

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 20650 in Redding
ComponentRVULocality factorAdjusted
Physician work2.22× 1.0172.2577
Practice expense4.87× 1.0965.3375
Malpractice0.38× 0.5360.2037
Total RVUs7.7989
Conversion factor× 33.4009

Office / nonfacility rate, Redding$260.49

Open 20650 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.221.017
Practice expense4.871.096
Malpractice0.380.536

(2.22 × 1.017 + 4.87 × 1.096 + 0.38 × 0.536) × $33.4009 = $260.49

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.221.017
Practice expense2.191.096
Malpractice0.380.536

(2.22 × 1.017 + 2.19 × 1.096 + 0.38 × 0.536) × $33.4009 = $162.38

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

20650 · Office / nonfacility

$260.49

Effective 2026-10-01

The base rate is $22.56 higher than on 2025-10-01, moving from $237.93 to $260.49 (9.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $237.93changed to$260.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.28 changed to 2.22
    • Practice expense RVU 4.42 changed to 4.87
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $237.93

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$260.49$162.38RVU26D
2026-07-01$260.49$162.38RVU26C
2026-04-01$260.49$162.38RVU26B
2026-01-01$260.49$162.38RVU26A
2025-10-01$237.93$169.35RVU25D
2025-07-01$237.93$169.35RVU25C
2025-04-01$237.93$169.35RVU25B
2025-01-01$237.93$169.35RVU25A

20650 billing questions

How is 20650 different from cranial tongs or a halo?

20650 describes skeletal traction established with a wire or pin inserted into bone. Cranial tongs and halo services use different fixation devices and are reported with their respective codes.

Can pin removal be billed separately?

Removal of the traction wire or pin is included when performed as part of this service. The code does not describe removal of a separate, previously placed implant.

Should modifier 50 be appended for pins on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

What documentation supports reporting 20650?

Record the indication for skeletal traction, the bone and insertion site, the wire or pin placement, and the traction applied. Document removal when it is performed.

How are other procedures in the same session paid?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures in that session are subject to the reduction. Related postoperative visits are included for 10 days.

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.

RVUs for 20650PPRRVU2026_Oct_nonQPP.csv, line 1,775 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)