No office rate
This code is for replanting a completely separated arm. Choose 20838 when the replanted part is the foot.
On this page
CMS RVU26D · Effective 2026-10-01
20838 Foot replantation Medicare reimbursement rates in Kentucky
Reports surgical reattachment of a completely separated foot after traumatic amputation, with the operative service directed at restoring the foot’s continuity. Compare 20838 office and facility rates across CMS payment localities in Kentucky.
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 20838 in Kentucky?
Kentucky 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
$2379.97
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Replantation surgery
About 20838: Complete foot replantation surgery
Reports surgical reattachment of a completely separated foot after traumatic amputation, with the operative service directed at restoring the foot’s continuity.
This service covers reattachment of a foot that has been completely separated, most often after a severe traumatic injury. It is performed in the operating room by a surgeon with replantation experience, commonly an orthopedic or plastic surgeon with microsurgical expertise. The operation may involve restoring the foot’s structural and soft-tissue continuity and blood supply so the replanted part can be assessed for viability.
Select this code when the entire foot was detached and the surgeon performs replantation; document the injury, the anatomical level, complete separation, and the reattachment performed. It has a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. In a same-session group of procedures, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 identifies bilateral surgery, which is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 20838
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU41.81 · 56%
- Practice expense (office) RVU23.93 · 32%
- Malpractice RVU8.93 · 12%
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.
20838 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
This code addresses replantation at the forearm; 20838 describes replantation of a completely separated foot.
No office rate
This code is for a completely separated hand. The anatomical part being replanted, not the presence of microsurgical work, distinguishes it from 20838.
No office rate
This code concerns replantation of a digit, not the entire foot. Select by the part that was detached and replanted.
Compare 20838 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$2379.97
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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 20838 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
1,803
- Code
- 20838
- Physician work
- 41.81
- Practice expense
- 23.93
- Malpractice
- 8.93
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 41.81 | × 1.000 | 41.8100 |
| Practice expense | 23.93 | × 0.889 | 21.2738 |
| Malpractice | 8.93 | × 0.915 | 8.1709 |
| Total RVUs | 71.2547 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$2379.97
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 41.81 | 1 |
| Practice expense | 23.93 | 0.889 |
| Malpractice | 8.93 | 0.915 |
(41.81 × 1 + 23.93 × 0.889 + 8.93 × 0.915) × $33.4009 = $2379.97
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.
20838 billing questions
How do I distinguish this code from a hand or digit replantation code?
Use this code when the completely separated part being replanted is the foot. Codes for the hand, thumb, or a digit describe replantation at those different anatomical sites.
What documentation supports complete foot replantation?
Document the traumatic amputation, the level of separation, that the foot was completely detached, and the surgeon’s reattachment work.
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.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are paid at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
How is bilateral replantation reported under the CMS facts?
Modifier 50 identifies a bilateral procedure, which is paid at 150%.
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.
1,80020822,,Replantation digit complete,A,,25.99,16.45,NA,16.45,,5.54,47.98,47.98,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80120824,,Replantation thumb complete,A,,31.15,17.34,NA,17.34,,6.63,55.12,55.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80220827,,Replantation thumb complete,A,,26.79,16.71,NA,16.71,,5.71,49.21,49.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80320838,,Replantation foot complete,A,,41.81,23.93,NA,23.93,,8.93,74.67,74.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80420900,,Removal of bone for graft,A,,2.93,8.51,,1.40,,0.48,11.92,4.81,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80520902,,Removal of bone for graft,A,,4.47,1.94,NA,1.94,,0.83,7.24,7.24,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,80620910,,Remove cartilage for graft,A,,5.39,7.35,NA,7.35,,1.15,13.89,13.89,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631