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CMS RVU26D · Effective 2026-10-01

20931 Spinal bone graft Medicare reimbursement rates in Missouri

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 Missouri.

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 Missouri?

Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$94.97–$97.29

3 of 3 localities have a supported rate.

Lowest: Rest Of Missouri

Highest: Metropolitan St. Louis

A spread of $2.32 per service.

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.

Find 20931 in your payment locality →

Where 20931 pays more and less in Missouri

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 Missouri, from the same CMS release.

20930

Sp bone algrft morsel add-on

No office rate

Choose 20931 for structural donor bone used as support; choose 20930 for morselized donor bone used as graft material.

20938

Spinal bone graft

Structural autograft, separate incision

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

Sp bone agrft local add-on

No office rate

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.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

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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.

RVUs for 20931PPRRVU2026_Oct_nonQPP.csv, line 1,812 (RVU26D)