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CMS RVU26D · Effective 2026-10-01

20973 Bone/skin graft Medicare reimbursement rates in Connecticut

Report this vascularized bone-and-skin graft when tissue from the great toe is transferred to reconstruct a defect requiring both components. Compare 20973 office and facility rates across CMS payment localities in Connecticut.

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 20973 in Connecticut?

Connecticut 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

$2832.08

1 of 1 localities have a supported rate.

Payment area: Connecticut

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.

Find 20973 in your payment locality →

Reconstructive surgery

About 20973: Great toe bone-and-skin graft transfer

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

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.

CMS billing rules for 20973

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 RVU46.09 · 58%
  • Practice expense (office) RVU24.00 · 30%
  • Malpractice RVU9.86 · 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.

20973 compared with similar codes

Office rates for Connecticut, from the same CMS release.

20972

Free flap

Metatarsal bone and skin

No office rate

Use 20973 for a bone-and-skin graft from the great toe. Code 20972 identifies a metatarsal donor source.

20970

Bone and skin graft

Iliac crest, microvascular

No office rate

Both describe bone-and-skin grafts, but 20970 identifies the iliac crest as the donor site.

20955

Bone graft

Fibula, microvascular

No office rate

Code 20955 is a microvascular bone graft from the fibula; 20973 identifies a graft containing bone and skin from the great toe.

Compare 20973 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

Office and facility base rates · shared scale starting at $0

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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 20973 in Connecticut.

PPRRVU2026_Oct_nonQPP.csv

1,828

Code
20973
Physician work
46.09
Practice expense
24.00
Malpractice
9.86

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 20973 in Connecticut
ComponentRVULocality factorAdjusted
Physician work46.09× 1.02047.0118
Practice expense24.00× 1.07725.8480
Malpractice9.86× 1.21011.9306
Total RVUs84.7904
Conversion factor× 33.4009

Facility rate, Connecticut$2832.08

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work46.091.02
Practice expense241.077
Malpractice9.861.21

(46.09 × 1.02 + 24 × 1.077 + 9.86 × 1.21) × $33.4009 = $2832.08

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.

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 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 20973PPRRVU2026_Oct_nonQPP.csv, line 1,828 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)