No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
20970 Bone and skin graft Medicare reimbursement rates in Pennsylvania
Reports transfer of vascularized iliac crest bone with a skin component and microvascular connection, commonly for complex mandibular or other skeletal reconstruction. Compare 20970 office and facility rates across CMS payment localities in Pennsylvania.
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 20970 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2459.89–$2658.70
2 of 2 localities have a supported rate.
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.
Reconstructive surgery
About 20970: Vascularized iliac crest bone and skin graft
Reports transfer of vascularized iliac crest bone with a skin component and microvascular connection, commonly for complex mandibular or other skeletal reconstruction.
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.
CMS billing rules for 20970
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU43.47 · 57%
- Practice expense (office) RVU23.32 · 31%
- Malpractice RVU9.28 · 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.
20970 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Both describe vascularized grafts containing bone and skin, but 20970 specifies the iliac crest donor site; 20969 is the other-site option.
No office rate
Both describe vascularized bone-and-skin grafts, but 20972 specifies a metatarsal donor site rather than the iliac crest.
Compare 20970 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$2658.70
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$2459.89
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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 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.
1,82320957,,Mt bone graft microvasc,A,,41.54,23.14,NA,23.14,,8.86,73.54,73.54,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82420962,,Other bone graft microvasc,A,,38.23,26.32,NA,26.32,,8.15,72.70,72.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82520969,,Bone/skin graft microvasc,A,,44.29,18.42,NA,18.42,,6.82,69.53,69.53,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82620970,,Bone/skin graft iliac crest,A,,43.47,23.32,NA,23.32,,9.28,76.07,76.07,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82720972,,Bone/skin graft metatarsal,A,,43.40,23.14,NA,23.14,,9.26,75.80,75.80,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82820973,,Bone/skin graft great toe,A,,46.09,24.00,NA,24.00,,9.86,79.95,79.95,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82920974,,Estim aid bone healg n-invas,A,,0.60,2.09,,0.76,,0.16,2.85,1.52,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00