Billing code 20985: Surgical navigationMedicare rate & RVUs in Virginia
Reports intraoperative computer navigation without image-based planning during a musculoskeletal operation, commonly to guide alignment in joint replacement surgery.
CMS doesn’t publish an office rate for 20985 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 20985 covers
This add-on describes a surgeon’s use of computer navigation during a musculoskeletal operation without a preloaded CT or MRI image set. The system registers the patient’s anatomy during surgery and tracks instruments to help guide their position or alignment. Orthopedic surgeons commonly use this approach during joint replacement, including total knee arthroplasty, in hospital operating rooms and ambulatory surgical settings.
Report 20985 with the primary operation for which the navigation was used, not by itself. The operative record should identify the musculoskeletal procedure and support that image-less computer navigation was performed, such as intraoperative anatomy registration and instrument tracking. Medicare treats 20985 as an add-on: it is billed with a primary procedure and paid within that procedure’s global period. The navigation service supplements the operative work; the primary code still identifies the surgery performed.
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 20985 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $134.78 |
| Virginia | Unavailable | $118.57 |
How the 20985 rate is calculated
Each of 20985’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 · 20985
RVUs × geographic indexes × conversion factor
Work2.44
2.44 RVUs× 1.000 GPCI
Practice expense0.77
0.77 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
3.7100
Conversion factor
$33.4009
Medicare rate
$123.92
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20985
The CMS indicators that decide how 20985 is paid alongside other services.
CMS payment indicators · 20985
Surgical navigation
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
20985 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 0054TBone srgry cmptr fluor image
- 20985 describes image-less navigation using anatomy registered during surgery. 0054T is the image-guided navigation code, associated with preoperative imaging.
- 27447Total knee replacement
- 27447 reports the total knee replacement itself. Add 20985 only when image-less computer navigation is also used during that operation.
- 27130Hip replacement
- 27130 reports total hip arthroplasty, not navigation. 20985 is an add-on when image-less navigation is used during the hip procedure.
20985 billing questions
When should 20985 be chosen over image-guided navigation?
Use 20985 for image-less navigation, where the system registers anatomy during surgery rather than relying on a preloaded CT or MRI image set. Code 0054T describes the image-guided navigation approach.
Can 20985 be billed by itself?
No. It is an add-on code and must be reported with the primary musculoskeletal operation for which navigation was used.
What documentation supports 20985?
The operative record should identify the primary surgery and document the use of image-less computer navigation, including relevant registration or instrument-tracking activity.
Is 20985 the code for the joint replacement itself?
No. The primary code reports the replacement, such as 27447 for total knee arthroplasty; 20985 reports the image-less navigation used during that operation.
How does Medicare treat payment for 20985?
Medicare treats it as an add-on billed with a primary procedure, with payment made within that procedure’s global period.
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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