No office rate
Choose 20660 for cranial tongs, calipers, or comparable traction hardware. Choose 20661 for application of a cranial halo.
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CMS RVU26D · Effective 2026-10-01
20660 Cranial traction Medicare reimbursement rates in Alabama
Reports application and removal of cranial tongs, calipers, or similar fixation hardware to provide skeletal traction, commonly for cervical spine injuries. Compare 20660 office and facility rates across CMS payment localities in Alabama.
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 20660 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$191.20
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
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 Alabama, 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.
$107.58
20660 includes application and removal of cranial traction hardware. 20665 is for removal of a cranial device as a separate service.
Compare 20660 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$191.20
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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 Alabama.
PPRRVU2026_Oct_nonQPP.csv
1,776
- Code
- 20660
- Physician work
- 3.90
- Practice expense
- 1.27
- Malpractice
- 1.26
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.90 | × 1.000 | 3.9000 |
| Practice expense | 1.27 | × 0.875 | 1.1113 |
| Malpractice | 1.26 | × 0.566 | 0.7132 |
| Total RVUs | 5.7244 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$191.20
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.9 | 1 |
| Practice expense | 1.27 | 0.875 |
| Malpractice | 1.26 | 0.566 |
(3.9 × 1 + 1.27 × 0.875 + 1.26 × 0.566) × $33.4009 = $191.20
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.
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
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515