No office rate
Choose 20696 for initial placement of a multiplane frame with stereotactic computer-assisted adjustment; 20692 describes multiplane fixation without that feature.
On this page
CMS RVU26D · Effective 2026-10-01
20696 External fixation Medicare reimbursement rates in Iowa
Reports initial placement of a unilateral multiplane external fixation system that uses computer-assisted adjustment, such as a spatial frame for fracture or deformity treatment. Compare 20696 office and facility rates across CMS payment localities in Iowa.
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 20696 in Iowa?
Iowa 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
$968.09
1 of 1 localities have a supported rate.
Payment area: Iowa
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 20696: Initial computer-adjusted external fixation
Reports initial placement of a unilateral multiplane external fixation system that uses computer-assisted adjustment, such as a spatial frame for fracture or deformity treatment.
An orthopedic surgeon or other qualified surgeon uses this code for initial placement of a unilateral external fixation system with pins or wires positioned in more than one plane and stereotactic computer-assisted adjustment. A spatial or hexapod frame may be used to manage a complex fracture or gradually correct a bone deformity. The service is generally performed in an operating room or another surgical setting, with the frame applied to the affected limb.
Documentation should identify the treated bone or segment, the multiplane fixation construct, the computer-assisted adjustment capability, and that this is the initial application. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 20696
- 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 RVU17.12 · 54%
- Practice expense (office) RVU11.66 · 37%
- Malpractice RVU3.01 · 9%
151
Medicare services in 2024 · #4558 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.
20696 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
20690 is for a unilateral frame with pins or wires in one plane. 20696 requires a multiplane construct and computer-assisted adjustment.
$1,747.62
20696 covers the initial segment of the computer-adjusted system; 20697 is used for each additional segment.
Compare 20696 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
Iowa →
Office / nonfacility
Unavailable
Facility
$968.09
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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 20696 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,788
- Code
- 20696
- Physician work
- 17.12
- Practice expense
- 11.66
- Malpractice
- 3.01
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.12 | × 1.000 | 17.1200 |
| Practice expense | 11.66 | × 0.915 | 10.6689 |
| Malpractice | 3.01 | × 0.397 | 1.1950 |
| Total RVUs | 28.9839 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$968.09
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.12 | 1 |
| Practice expense | 11.66 | 0.915 |
| Malpractice | 3.01 | 0.397 |
(17.12 × 1 + 11.66 × 0.915 + 3.01 × 0.397) × $33.4009 = $968.09
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.
20696 billing questions
How does 20696 differ from 20692?
20696 is for initial application of a multiplane frame with stereotactic computer-assisted adjustment. Use 20692 for a multiplane external fixation system without that computer-assisted adjustment.
When is 20697 reported with 20696?
20697 describes each additional segment when the computer-adjusted multiplane system extends beyond the initial segment. Document the additional segment separately.
Can modifier 50 be used for bilateral application?
No. CMS identifies bilateral adjustment as inappropriate for this code; its descriptor and anatomy make modifier 50 inappropriate.
Is an assistant at surgery payable?
Assistant-at-surgery payment may be made for 20696. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
1,78520692,,Appl mltpln uni ext fixj sys,A,,15.86,12.56,NA,12.56,,2.93,31.35,31.35,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78620693,,Adjmt/revj ext fixj sys anes,A,,5.91,5.91,NA,5.91,,1.05,12.87,12.87,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78720694,,Rmvl ext fixj sys under anes,A,,4.17,8.87,,4.87,,0.79,13.83,9.83,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78820696,,App mltpln uni xtrnl fix 1st,A,,17.12,11.66,NA,11.66,,3.01,31.79,31.79,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78920697,,App mltpln uni xtrnl fix xch,A,,0.00,57.17,,57.17,NA,0.03,57.20,57.20,3,000,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,79020700,,Mnl prep&insj dp rx dlvr dev,A,,1.46,0.82,,0.40,,0.26,2.54,2.12,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,79120701,,Rmvl deep rx delivery device,A,,1.10,0.66,,0.33,,0.21,1.97,1.64,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136