No office rate
20933 describes a partial hemicortical intercalary graft. Choose 20934 when the reconstruction uses a complete intercalary segment.
On this page
CMS RVU26D · Effective 2026-10-01
20934 Bone allograft Medicare reimbursement rates in Guam
Reports placement of a complete intercalary bone allograft, typically reconstructing a long-bone segment removed during tumor surgery. Compare 20934 office and facility rates across CMS payment localities in Guam.
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 20934 in Guam?
Guam 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
$629.17
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 surgery
About 20934: Complete intercalary allograft reconstruction
Reports placement of a complete intercalary bone allograft, typically reconstructing a long-bone segment removed during tumor surgery.
This add-on service represents reconstruction of a long-bone gap with a complete intercalary segment of donor bone. Orthopedic surgeons, often orthopedic oncologists, use this approach after removing a segment of bone, such as during surgery for a primary bone tumor. The graft spans the defect between the remaining bone ends and is secured as part of the reconstruction. The code includes obtaining the allograft; it is not for a graft harvested from the patient.
Report 20934 only with a primary procedure, such as the operation that removes the diseased bone and reconstructs the resulting defect. Documentation should identify the bone and defect, support use of a complete intercalary rather than partial or joint-surface graft, and describe placement and fixation. CMS treats payment for this add-on as part of the primary procedure's global period. It is not separately reported as a stand-alone service.
CMS billing rules for 20934
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU12.68 · 65%
- Practice expense (office) RVU4.04 · 21%
- Malpractice RVU2.70 · 14%
15
Medicare services in 2024 · #6056 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.
20934 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
20932 is for an allograft reconstruction that includes an articular surface and bone; 20934 is for a complete intercalary bone segment.
No office rate
20931 describes structural allograft use in spine surgery. 20934 is for complete intercalary allograft reconstruction of a long-bone defect.
Compare 20934 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$629.17
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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 20934 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,815
- Code
- 20934
- Physician work
- 12.68
- Practice expense
- 4.04
- Malpractice
- 2.70
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.68 | × 1.000 | 12.6800 |
| Practice expense | 4.04 | × 1.137 | 4.5935 |
| Malpractice | 2.70 | × 0.579 | 1.5633 |
| Total RVUs | 18.8368 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$629.17
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.68 | 1 |
| Practice expense | 4.04 | 1.137 |
| Malpractice | 2.7 | 0.579 |
(12.68 × 1 + 4.04 × 1.137 + 2.7 × 0.579) × $33.4009 = $629.17
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.
20934 billing questions
When is 20934 preferable to 20933?
Use 20934 for a complete intercalary allograft reconstruction. Code 20933 describes a partial hemicortical intercalary graft.
Can 20934 be reported by itself?
No. CMS identifies it as an add-on code, so it must be reported with a primary procedure.
Does the code include obtaining the donor graft?
Yes. The service includes obtaining the allograft; it does not describe harvesting autologous bone from the patient.
What documentation supports the complete graft selection?
Document the bone and defect being reconstructed, the complete intercalary graft used, and how it was placed and secured.
How does CMS treat payment for this add-on?
Payment is within the primary procedure's global period, rather than as a stand-alone service.
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.
1,81220931,,Sp bone algrft struct add-on,A,,1.76,0.59,NA,0.59,,0.59,2.94,2.94,0,ZZZ,0.00,0.00,0.00,0,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81320932,,Osteoart algrft w/surf & b1,A,,12.68,4.04,NA,4.04,,2.70,19.42,19.42,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81420933,,Hemicrt intrclry algrft prtl,A,,11.64,3.71,NA,3.71,,2.48,17.83,17.83,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81520934,,Intercalary algrft compl,A,,12.68,4.04,NA,4.04,,2.70,19.42,19.42,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81620936,,Sp bone agrft local add-on,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81720937,,Sp bone agrft morsel add-on,A,,2.72,0.90,NA,0.90,,0.79,4.41,4.41,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81820938,,Sp bone agrft struct add-on,A,,2.94,0.99,NA,0.99,,0.96,4.89,4.89,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014