Billing code 20970: Bone and skin graftMedicare rate & RVUs in Oklahoma
Reports transfer of vascularized iliac crest bone with a skin component and microvascular connection, commonly for complex mandibular or other skeletal reconstruction.
CMS doesn’t publish an office rate for 20970 in Oklahoma.
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 20970 covers
This code describes transfer of a vascularized graft containing iliac crest bone and skin, with microsurgical connection of its blood supply at the recipient site. It is used when reconstruction requires both a living bone segment and a skin paddle, such as rebuilding a mandibular defect after tumor removal or major trauma. The reconstructive surgeon harvests and transfers the graft; the work includes obtaining the graft and its microvascular transfer.
Select this code when the graft comes from the iliac crest and includes both bone and skin with microvascular anastomosis; a vascularized bone-only graft or a graft from another listed donor site points to a different code. The operative report should identify the donor site, bone and skin components, recipient defect, and microvascular work. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; 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.
20970 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $2,388.34 |
How the 20970 rate is calculated
Each of 20970’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 · 20970
RVUs × geographic indexes × conversion factor
Work43.47
43.47 RVUs× 1.000 GPCI
Practice expense23.32
23.32 RVUs× 1.000 GPCI
Malpractice9.28
9.28 RVUs× 1.000 GPCI
Adjusted RVUs
76.0700
Conversion factor
$33.4009
Medicare rate
$2,540.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20970
20970 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20970
Bone and skin 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 · 20970
Bone and skin 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
20970 without 51 · national facility
$2,540.81
Bone and skin graft
20970-51 · Second procedure: 50%
$1,270.41
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%).
20970 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20956Bone graft
- Use 20970 when the vascularized iliac crest graft includes skin as well as bone. Use 20956 for the iliac crest bone graft without a skin component.
- 20969Bone-skin graft
- Both describe vascularized grafts containing bone and skin, but 20970 specifies the iliac crest donor site; 20969 is the other-site option.
- 20972Free flap
- Both describe vascularized bone-and-skin grafts, but 20972 specifies a metatarsal donor site rather than the iliac crest.
20970 billing questions
How is this different from 20956?
20970 describes a vascularized iliac crest graft that includes skin. 20956 is the iliac crest option when the graft is bone without a skin component.
Is graft harvest separately reported?
Obtaining the iliac crest graft is included in this service. The operative documentation should show the donor site and the transferred bone and skin components.
What should the operative report document?
Identify the iliac crest as the donor site, the skin component, the recipient defect, and the microvascular transfer. Those details distinguish this service from bone-only or other-site graft codes.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when this is performed with other procedures?
Under the standard multiple procedure rule, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%.
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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