No office rate
Choose 20696 for initial application of the multiplane external fixation system. Choose 20697 for later adjustment or exchange of its struts.
On this page
CMS RVU26D · Effective 2026-10-01
20697 Fixator adjustment Medicare reimbursement rates in Washington
Reports adjustment or exchange of individual struts on a multiplane external fixation system, commonly during staged correction of a fracture or limb deformity. Compare 20697 office and facility rates across CMS payment localities in Washington.
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 20697 in Washington?
Washington 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
$2011.50–$2343.81
2 of 2 localities have a supported rate.
Facility setting
No 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.
Orthopedic procedure
About 20697: Multiplane external fixation strut adjustment
Reports adjustment or exchange of individual struts on a multiplane external fixation system, commonly during staged correction of a fracture or limb deformity.
This service covers changing or adjusting individual struts on a multiplane, or orthogonal, external fixation system. Orthopedic surgeons commonly perform it during staged treatment with a hexapod or similar frame, such as when correcting a fracture alignment or limb deformity. Unlike applying the frame, the work addresses its struts while the external fixation system remains in use.
Report the service for each strut adjusted or exchanged, and document the frame, the specific strut work, and the clinical reason for the change. CMS assigns this code a 0-day global period, so same-day preoperative and postoperative care is included. CMS classifies it as technical-component-only, with interpretation covered by a separate code. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 20697
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
- 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 RVU0.00 · 0%
- Practice expense (office) RVU57.17 · 100%
- Malpractice RVU0.03 · 0%
46
Medicare services in 2024 · #5397 by national volume
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.
20697 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
20693 describes adjustment or revision of an external fixation system requiring anesthesia. 20697 identifies strut work on a multiplane orthogonal system.
$473.14–$531.32
20694 is for removal of an external fixation system under anesthesia; 20697 covers strut adjustment or exchange while the frame remains in use.
Compare 20697 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
Rest Of Washington →
Office / nonfacility
$2011.50
Facility
Unavailable
Seattle (King Cnty) →
Office / nonfacility
$2343.81
Facility
Unavailable
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20697 billing questions
How does this differ from 20696?
20696 reports initial application of a multiplane external fixation system. Use 20697 for subsequent strut adjustment or exchange on the frame.
How does this differ from 20693?
20693 describes adjustment or revision of an external fixation system that requires anesthesia. Code 20697 is specific to strut adjustment or exchange on a multiplane orthogonal system.
How many units should be reported?
The code is reported for each strut adjusted or exchanged. Document which struts were changed and the work performed on each.
Is same-day postoperative care separately reported?
No. CMS assigns a 0-day global period, which includes same-day preoperative and postoperative care.
Can modifier 50 be used when struts on both sides are adjusted?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the struts treated, not with modifier 50.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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 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.
1,78620693,,Adjmt/revj ext fixj sys anes,A,,5.91,5.91,NA,5.91,,1.05,12.87,12.87,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78720694,,Rmvl ext fixj sys under anes,A,,4.17,8.87,,4.87,,0.79,13.83,9.83,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78820696,,App mltpln uni xtrnl fix 1st,A,,17.12,11.66,NA,11.66,,3.01,31.79,31.79,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78920697,,App mltpln uni xtrnl fix xch,A,,0.00,57.17,,57.17,NA,0.03,57.20,57.20,3,000,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,79020700,,Mnl prep&insj dp rx dlvr dev,A,,1.46,0.82,,0.40,,0.26,2.54,2.12,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,79120701,,Rmvl deep rx delivery device,A,,1.10,0.66,,0.33,,0.21,1.97,1.64,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,79220702,,Mnl prep&insj imed rx dev,A,,2.44,1.50,,0.75,,0.49,4.43,3.68,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00