Billing code 20955: Bone graftMedicare rate & RVUs in Georgia
Reports transfer of vascularized fibular bone using microvascular anastomosis, commonly to reconstruct a major mandibular or skeletal defect.
CMS doesn’t publish an office rate for 20955 in Georgia.
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 20955 covers
This service transfers vascularized bone from the fibula to repair a substantial bone defect. The surgeon harvests the fibular graft and uses microsurgical techniques to connect its blood supply at the recipient site. It is commonly performed by reconstructive, oral and maxillofacial, or orthopedic surgeons, including during reconstruction after head and neck tumor removal, major trauma, or bone loss. A fibular graft can provide a long segment of living bone for reconstruction, such as for a mandibular defect.
Report this code when the donor bone is fibula and the graft is transferred with microvascular anastomosis; the operative note should identify the donor bone and document the vascularized transfer. 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 procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate for this code.
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 20955 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $2,332.27 |
| Rest Of Georgia | Unavailable | $2,237.72 |
How the 20955 rate is calculated
Each of 20955’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 · 20955
RVUs × geographic indexes × conversion factor
Work39.25
39.25 RVUs× 1.000 GPCI
Practice expense21.35
21.35 RVUs× 1.000 GPCI
Malpractice7.30
7.30 RVUs× 1.000 GPCI
Adjusted RVUs
67.9000
Conversion factor
$33.4009
Medicare rate
$2,267.92
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20955
20955 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20955
Bone graft
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 20955
Bone graft
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 51 · payment effect
With and without the modifier
20955 without 51 · national facility
$2,267.92
Bone graft
20955-51 · Second procedure: 50%
$1,133.96
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
20955 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20956Bone graft
- Both are microvascular bone grafts, but 20956 identifies iliac bone as the donor source; 20955 identifies fibula.
- 20962Bone graft
- 20955 is specific to a fibular graft. Consider 20962 when the microvascular bone graft comes from another source covered by that code.
- 20969Bone-skin graft
- 20969 describes a microvascular bone-and-skin graft. 20955 identifies a fibular bone graft without that bone-and-skin distinction.
20955 billing questions
How is this code different from 20956?
Both describe microvascular transfer of bone, but 20955 identifies fibula as the donor bone and 20956 identifies iliac bone.
When should 20955 be selected instead of 20962?
Use 20955 for a fibular graft. Code 20962 is for a microvascular bone graft from another source covered by that code.
What operative details support reporting 20955?
Document the fibula as the donor site and the microvascular transfer, including the vascular anastomosis. The record should also describe the defect being reconstructed.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the global period affect postoperative billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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