Billing code 20827: Thumb replantationMedicare rate & RVUs in Florida
Reports microsurgical reattachment of a completely amputated thumb, including operative work to restore circulation and reconstruct injured structures.
CMS doesn’t publish an office rate for 20827 in Florida.
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 9 sections
What 20827 covers
This service covers surgery to reattach a thumb that has been completely severed. A hand surgeon or other surgeon with microsurgical expertise typically performs the urgent procedure in an operating room, using techniques to reconnect blood vessels and repair injured structures needed for thumb function. The code is specific to the thumb; a completely amputated nonthumb digit or a larger part of the hand has a different code in the replantation family.
Choose this code when the thumb was fully separated, rather than incompletely amputated with circulation requiring restoration. The operative report should establish the thumb as the replantation site, document complete separation, and describe the reconstruction performed. 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 the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. For bilateral service, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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 20827 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,805.02 |
| Miami | Unavailable | $1,958.15 |
| Rest Of Florida | Unavailable | $1,715.03 |
How the 20827 rate is calculated
Each of 20827’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 · 20827
RVUs × geographic indexes × conversion factor
Work26.79
26.79 RVUs× 1.000 GPCI
Practice expense16.71
16.71 RVUs× 1.000 GPCI
Malpractice5.71
5.71 RVUs× 1.000 GPCI
Adjusted RVUs
49.2100
Conversion factor
$33.4009
Medicare rate
$1,643.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20827
20827 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20827
Thumb replantation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 20827
Thumb replantation
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
20827 without 50 · national facility
$1,643.66
Thumb replantation
20827-50 · Bilateral: 150%
$2,465.49
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).
20827 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20824Thumb replantation
- Choose 20827 for a completely severed thumb. Code 20824 describes revascularization after an incomplete thumb amputation.
- 20816Digit replantation
- Code 20816 is for complete replantation of a nonthumb digit; 20827 is specific to the thumb.
- 20808Hand replantation
- Code 20808 applies when the replantation site is the hand. Code 20827 identifies a completely amputated thumb.
20827 billing questions
How is this code distinguished from 20824?
Use 20827 when the thumb was completely severed before replantation. Code 20824 is for an incompletely amputated thumb requiring revascularization.
When is 20816 more appropriate?
Code 20816 is for complete replantation of a nonthumb digit. The thumb is reported with 20827 when completely amputated.
Are the preoperative visit and postoperative care separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral thumb replantation reported?
For bilateral service, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
What happens when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures 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
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