CPT code 20693: Fixator adjustment2026 Medicare rate & RVUs in Nevada
Report this service when a surgeon adjusts or revises an existing external fixation system and the work requires anesthesia, rather than initial device placement or removal.
CMS doesn’t publish an office rate for 20693 in Nevada.
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 20693 covers
An orthopedic surgeon reports this service for adjustment or revision of an external fixation system when anesthesia is required. The work may address fracture alignment or correct a deformity using an existing frame. It is distinct from applying a new external fixator or removing the system. These procedures are commonly performed in an operating room or another setting equipped to provide anesthesia and manage the fixation device.
Select the code based on the documented adjustment or revision and the need for anesthesia. The operative record should identify the existing fixation system, the change made, the clinical purpose, and the anesthesia requirement. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are 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.
20693 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $424.21 |
How the 20693 rate is calculated
Each of 20693’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 · 20693
RVUs × geographic indexes × conversion factor
Work5.91
5.91 RVUs× 1.000 GPCI
Practice expense5.91
5.91 RVUs× 1.000 GPCI
Malpractice1.05
1.05 RVUs× 1.000 GPCI
Adjusted RVUs
12.8700
Conversion factor
$33.4009
Medicare rate
$429.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20693
20693 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20693
Fixator adjustment
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 20693
Fixator adjustment
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
20693 without 51 · national facility
$429.87
Fixator adjustment
20693-51 · Second procedure: 50%
$214.94
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%).
20693 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 20690External fixation
- Use 20690 for initial application of a uniplane external fixation system. Use 20693 for adjustment or revision of an existing system requiring anesthesia.
- 20692External fixation
- Use 20692 for initial application of a multiplane external fixation system. It does not describe adjustment or revision of an existing system.
- 20694Fixator removal
- Use 20694 when the external fixation system is removed under anesthesia. Use 20693 when the service adjusts or revises the system instead.
- 20696External fixation
- 20696 describes initial application of a multiplane system with stereotactic computer-assisted adjustment; 20693 describes adjustment or revision of an existing system requiring anesthesia.
20693 billing questions
How does this differ from applying an external fixator?
This code is for adjustment or revision of an existing system requiring anesthesia. Codes 20690 and 20692 describe initial application of specified external fixation systems.
Can this code be used for removal of the frame?
No. Removal of an external fixation system under anesthesia is described by 20694. Report 20693 when the service is an adjustment or revision.
What documentation supports reporting 20693?
Document the existing external fixation system, the adjustment or revision performed, its clinical purpose, and that the service required anesthesia.
Can modifier 50 be reported for adjustment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor, so modifier 50 should not be used.
How does the 90-day global period affect postoperative care?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. The service is treated as major surgery for this purpose.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted under the CMS rules provided.
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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