Billing code 20962: Bone graftMedicare rate & RVUs in Kansas
Reports a vascularized bone graft transferred from a donor site other than the fibula, iliac crest, or metatarsal for complex reconstruction.
CMS doesn’t publish an office rate for 20962 in Kansas.
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 20962 covers
This code covers harvesting and transferring a vascularized bone graft from a donor site outside the specifically named fibula, iliac crest, and metatarsal options. The graft’s blood supply is restored through microsurgical vessel connections. Reconstructive, orthopedic, and oral and maxillofacial surgeons may use this technique to address a segmental bone defect or a difficult nonunion when vascularized bone is needed. These cases are generally performed in a hospital or other facility setting.
Select the code according to the graft source and the work documented, including the bone harvested and the microvascular transfer. The operative report should identify the donor site, recipient defect, graft transfer, and vascular anastomosis. This major procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this descriptor. Assistant-at-surgery payment may be available; 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.
20962 in Kansas
| Payment locality | Office | Facility |
|---|---|---|
| Kansas | Unavailable | $2,208.83 |
How the 20962 rate is calculated
Each of 20962’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 · 20962
RVUs × geographic indexes × conversion factor
Work38.23
38.23 RVUs× 1.000 GPCI
Practice expense26.32
26.32 RVUs× 1.000 GPCI
Malpractice8.15
8.15 RVUs× 1.000 GPCI
Adjusted RVUs
72.7000
Conversion factor
$33.4009
Medicare rate
$2,428.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20962
20962 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20962
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 · 20962
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
20962 without 51 · national facility
$2,428.25
Bone graft
20962-51 · Second procedure: 50%
$1,214.13
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%).
20962 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 20955Bone graft
- Use 20955 for a vascularized fibular graft. Use 20962 when the bone comes from another donor site.
- 20956Bone graft
- Use 20956 for a vascularized iliac crest graft; 20962 identifies another bone donor site.
- 20957Bone graft
- Use 20957 for a vascularized metatarsal graft. 20962 is for a different donor site.
- 20969Bone-skin graft
- 20969 describes a microvascular graft that includes bone and skin. 20962 is the other-donor-site choice for a bone graft without that bone-and-skin distinction.
20962 billing questions
How is 20962 distinguished from 20955, 20956, and 20957?
Choose 20962 when the vascularized bone graft comes from another donor site. The neighboring codes identify grafts from the fibula, iliac crest, or metatarsal.
What documentation supports reporting 20962?
The operative report should name the donor site and recipient defect and describe the graft transfer and microvascular vessel connections.
Is modifier 50 appropriate?
No. The descriptor and anatomy make modifier 50 inappropriate for this service.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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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