No office rate
Both are microvascular bone grafts, but 20956 identifies iliac bone as the donor source; 20955 identifies fibula.
On this page
CMS RVU26D · Effective 2026-10-01
20955 Bone graft Medicare reimbursement rates in Indiana
Reports transfer of vascularized fibular bone using microvascular anastomosis, commonly to reconstruct a major mandibular or skeletal defect. Compare 20955 office and facility rates across CMS payment localities in Indiana.
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 20955 in Indiana?
Indiana 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
$2090.54
1 of 1 localities have a supported rate.
Payment area: Indiana
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.
Reconstructive surgery
About 20955: Vascularized fibular bone graft
Reports transfer of vascularized fibular bone using microvascular anastomosis, commonly to reconstruct a major mandibular or skeletal defect.
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.
CMS billing rules for 20955
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU39.25 · 58%
- Practice expense (office) RVU21.35 · 31%
- Malpractice RVU7.30 · 11%
85
Medicare services in 2024 · #4996 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.
20955 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
20955 is specific to a fibular graft. Consider 20962 when the microvascular bone graft comes from another source covered by that code.
No office rate
20969 describes a microvascular bone-and-skin graft. 20955 identifies a fibular bone graft without that bone-and-skin distinction.
Compare 20955 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
Indiana →
Office / nonfacility
Unavailable
Facility
$2090.54
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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 20955 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
1,821
- Code
- 20955
- Physician work
- 39.25
- Practice expense
- 21.35
- Malpractice
- 7.30
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 39.25 | × 1.000 | 39.2500 |
| Practice expense | 21.35 | × 0.927 | 19.7915 |
| Malpractice | 7.30 | × 0.486 | 3.5478 |
| Total RVUs | 62.5892 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$2090.54
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 39.25 | 1 |
| Practice expense | 21.35 | 0.927 |
| Malpractice | 7.3 | 0.486 |
(39.25 × 1 + 21.35 × 0.927 + 7.3 × 0.486) × $33.4009 = $2090.54
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.
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 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.
1,81820938,,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
1,81920939,,Bone marrow aspir bone grfg,A,,1.13,0.37,NA,0.37,,0.34,1.84,1.84,0,ZZZ,0.00,0.00,0.00,0,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82020950,,Mntr intrstitial fluid press,A,,1.23,6.88,,1.05,,0.22,8.33,2.50,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82120955,,Fibula bone graft microvasc,A,,39.25,21.35,NA,21.35,,7.30,67.90,67.90,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82220956,,Iliac bone graft microvasc,A,,40.15,21.79,NA,21.79,,8.58,70.52,70.52,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82320957,,Mt bone graft microvasc,A,,41.54,23.14,NA,23.14,,8.86,73.54,73.54,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82420962,,Other bone graft microvasc,A,,38.23,26.32,NA,26.32,,8.15,72.70,72.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915