Billing code 20933: Bone allograftMedicare rate & RVUs in Virginia
Reports partial hemicortical allograft reconstruction of a bone defect, commonly after tumor resection, when part of the host bone’s cortex is replaced.
CMS doesn’t publish an office rate for 20933 in Virginia.
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 20933 covers
This add-on describes reconstruction of a bone defect with a donor-derived graft that replaces part of the cortical circumference while retaining the remaining host bone. It is most often associated with orthopedic oncology, such as reconstruction after removal of a bone tumor in a long bone. The orthopedic surgeon shapes and secures the graft to restore structural continuity at the resection site.
Report it with the primary operation that created and reconstructs the defect; it is not submitted alone. The operative report should establish that a partial hemicortical allograft was used and identify the reconstructed bone and defect. Distinguish this from a graft replacing an entire intercalary segment or a joint-bearing surface. CMS classifies the service as an add-on paid within the primary procedure’s global period.
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.
Where 20933 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $647.95 |
| Virginia | Unavailable | $569.08 |
How the 20933 rate is calculated
Each of 20933’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 · 20933
RVUs × geographic indexes × conversion factor
Work11.64
11.64 RVUs× 1.000 GPCI
Practice expense3.71
3.71 RVUs× 1.000 GPCI
Malpractice2.48
2.48 RVUs× 1.000 GPCI
Adjusted RVUs
17.8300
Conversion factor
$33.4009
Medicare rate
$595.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20933
The CMS indicators that decide how 20933 is paid alongside other services.
CMS payment indicators · 20933
Bone allograft
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
20933 without 80 · national facility
$595.54
Bone allograft
20933-80 · Assistant: 16%
$95.29
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
20933 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20932Joint allograft
- Choose 20932 for an osteoarticular allograft involving a joint-bearing surface; 20933 is for partial hemicortical reconstruction.
- 20934Bone allograft
- 20934 describes a complete intercalary segment replacement. 20933 is for a partial hemicortical reconstruction, not replacement of the full segment.
- 20955Bone graft
- 20955 describes a microvascular fibula bone graft. It differs from the allograft reconstruction represented by 20933 in graft source and reconstructive method.
20933 billing questions
Can 20933 be reported without a primary procedure?
No. It is an add-on code and must be reported with the primary operation for the bone defect.
How is 20933 distinguished from 20934?
Use 20933 for partial hemicortical reconstruction. Code 20934 describes reconstruction with a complete intercalary segment.
When would 20932 be considered instead?
20932 applies to an osteoarticular allograft reconstruction involving a joint-bearing surface, rather than a partial cortical segment.
What documentation supports reporting 20933?
The operative report should identify the allograft, the bone and defect reconstructed, and that the reconstruction replaced only part of the cortical circumference.
How does the global period affect this add-on?
CMS payment for 20933 falls within the global period of the primary procedure. Report it with that procedure rather than as a stand-alone service.
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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