Billing code 20694: Fixator removalMedicare rate & RVUs in Utah

Removal of an external fixation frame under anesthesia, typically after fracture healing or completion of staged bone correction.

CMS RVU26DEffective Oct 1, 20261 payment locality5.2K Medicare services in 2024

Medicare pays $441.47 for 20694 in the office in Utah (Utah). Which amount applies depends on the service address.

$441.47Office (non-facility)
$315.88Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 20694 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 20694 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 20694 covers

An orthopedic surgeon removes an external fixation system while the patient is under anesthesia. The device may stabilize a fracture, support an osteotomy, or maintain alignment during limb-lengthening or deformity correction. This service is commonly performed in an operating room or another setting where anesthesia is provided. It concerns removal of the external frame and its fixation elements, rather than removal of buried internal plates, screws, or other implants.

Report this code when the external fixation system is removed under anesthesia; documentation should identify the device, the reason for removal, and the work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery billing 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.

20694 in Utah

20694 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$441.47$315.88

How the 20694 rate is calculated

Each of 20694’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 · 20694

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.17Practice expense 8.87Malpractice 0.79

13.8300 adjusted RVUs×$33.4009 conversion factor=$461.93

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 20694

20694 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20694

Fixator removal

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 20694

Fixator removal

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

20694 without 51 · national office

$461.93

Fixator removal

20694-51 · Second procedure: 50%

$230.97

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%).

When to use modifier 51

20694 compared with similar codes

Compare codes

20694 vs 20693 vs 20665 vs 20670 vs 20680: national Medicare rates

Swap in your local Medicare rate.

  • 20694
    Fixator removal · 4.17 wRVU
    $461.93
  • 20693
    Fixator adjustment · 5.91 wRVU
    —
  • 20665
    Cranial device removal · 1.33 wRVU
    $117.91−$344.02
  • 20670
    Implant removal · 1.75 wRVU
    $370.42−$91.51
  • 20680
    Implant removal · 5.81 wRVU
    $631.95+$170.02

How to choose

20693Fixator adjustment
20694 is for taking off the external fixation system under anesthesia. Choose 20693 when the system is adjusted or revised and remains in place.
20665Cranial device removal
20665 identifies removal of cranial tongs or a halo. Use 20694 for removal of an external fixation system.
20670Implant removal
20670 concerns superficial internal implant removal, such as accessible buried fixation material. It is not the code for removal of an external frame.
20680Implant removal
20680 concerns deep internal implant removal, such as buried plates or screws; 20694 concerns an external fixation system removed under anesthesia.

20694 billing questions

When should this code be chosen instead of 20693?

Use 20694 when the external fixation system is removed under anesthesia. Code 20693 describes adjustment or revision of the system under anesthesia when it remains in place.

Is this the code for removing buried plates or screws?

No. It covers removal of an external fixation system. Codes 20670 and 20680 concern removal of superficial and deep internal implants, respectively.

Can modifier 50 be used when fixators are removed on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the documented procedure rather than appending modifier 50.

What documentation supports reporting 20694?

Document the external fixation device, the clinical reason for removal, that removal was performed under anesthesia, and the operative work completed.

How does the 90-day global period affect follow-up billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant surgeon or co-surgeon be reported?

CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.

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
RVUs for 20694PPRRVU2026_Oct_nonQPP.csv, line 1,787 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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