20930
No office rateSp bone algrft morsel add-on
Choose 20931 for structural donor bone used as support; choose 20930 for morselized donor bone used as graft material.
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CMS RVU26D · Effective 2026-10-01
20931 Spinal bone graft Medicare reimbursement rates in Kentucky
Report 20931 with spine surgery when a surgeon implants structural donor bone as support, rather than morselized graft material. Compare 20931 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 20931 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
$94.34
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.
Spinal surgery
About 20931: Structural donor bone graft for spine surgery
Report 20931 with spine surgery when a surgeon implants structural donor bone as support, rather than morselized graft material.
CPT 20931 captures placement of a shaped, donor-derived bone graft that provides structural support during spinal reconstruction or fusion. Unlike chips or granules used to fill a fusion bed, this graft retains a block or strut form and may help maintain spacing or support between vertebrae. A spine surgeon typically places it during an operative spinal fusion, such as an interbody fusion, in a hospital or ambulatory surgical setting. The graft is allograft tissue, not bone harvested from the patient during the operation.
Report 20931 only alongside an eligible primary spine procedure; it is an add-on, not a stand-alone service. The operative report should identify the structural allograft and its role in the spinal reconstruction, distinguishing it from morselized allograft and structural autograft. CMS pays this add-on within the primary procedure’s global period.
CMS billing rules for 20931
- 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 RVU1.76 · 60%
- Practice expense (office) RVU0.59 · 20%
- Malpractice RVU0.59 · 20%
7.8K
Medicare services in 2024 · #1602 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.
20931 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
Both involve structural grafting during spine surgery. The source differs: 20931 is donor bone, while 20938 is bone harvested from the patient.
20936
No office rateSp bone agrft local add-on
20936 describes local bone from the operative site used as graft material. It is not the structural donor-bone service reported with 20931.
Compare 20931 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
$94.34
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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 20931 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
1,812
- Code
- 20931
- Physician work
- 1.76
- Practice expense
- 0.59
- Malpractice
- 0.59
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.76 | × 1.000 | 1.7600 |
| Practice expense | 0.59 | × 0.889 | 0.5245 |
| Malpractice | 0.59 | × 0.915 | 0.5398 |
| Total RVUs | 2.8244 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$94.34
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.76 | 1 |
| Practice expense | 0.59 | 0.889 |
| Malpractice | 0.59 | 0.915 |
(1.76 × 1 + 0.59 × 0.889 + 0.59 × 0.915) × $33.4009 = $94.34
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.
20931 billing questions
Can 20931 be reported without a primary spine procedure?
No. It is an add-on code and must be reported with a primary procedure.
How does 20931 differ from 20930?
20931 represents structural donor bone used as a supporting graft. Code 20930 is for morselized donor bone, such as chips or granules used to fill a fusion bed.
How does 20931 differ from 20938?
Both describe structural grafting for spine surgery, but 20931 is for donor bone and 20938 is for bone graft taken from the patient.
What documentation supports reporting 20931?
The operative report should identify the donor-derived graft as structural and describe its placement and role in the spinal reconstruction.
How does CMS treat payment for 20931?
CMS treats it as an add-on paid within the primary procedure’s global period.
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.
1,80920922,,Removal of fascia for graft,A,,6.76,11.41,,5.82,,1.51,19.68,14.09,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81020924,,Removal of tendon for graft,A,,6.51,6.33,NA,6.33,,1.23,14.07,14.07,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,81120930,,Sp bone algrft morsel 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
1,81220931,,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
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