Billing code 20816: Digit replantationMedicare rate & RVUs in Washington
Reports microsurgical reattachment of a completely severed finger other than the thumb, including operative repair to restore circulation and function.
CMS doesn’t publish an office rate for 20816 in Washington.
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 20816 covers
This service covers reattachment of a completely severed finger other than the thumb after traumatic amputation. A hand surgeon, often with microsurgical expertise, performs the operation in a surgical setting. The work commonly includes restoring blood flow through vessel repair, stabilizing bone, and repairing tendons, nerves, and soft tissue as indicated by the injury. It is distinct from replantation of a thumb, an entire hand, or a digit that remains partially attached.
Select the code based on the injured body part and whether the digit was completely severed; document the amputation level, structures treated, and operative work. The 90-day global period includes 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 for this digit-specific service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
Where 20816 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,826.73 |
| Seattle (King Cnty) | Unavailable | $1,977.47 |
How the 20816 rate is calculated
Each of 20816’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 · 20816
RVUs × geographic indexes × conversion factor
Work31.15
31.15 RVUs× 1.000 GPCI
Practice expense17.18
17.18 RVUs× 1.000 GPCI
Malpractice6.63
6.63 RVUs× 1.000 GPCI
Adjusted RVUs
54.9600
Conversion factor
$33.4009
Medicare rate
$1,835.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20816
20816 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20816
Digit replantation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 20816
Digit replantation
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20816 without 51 · national facility
$1,835.71
Digit replantation
20816-51 · Second procedure: 50%
$917.86
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%).
20816 compared with similar codes
Compare codes · National
20816 vs 20822 vs 20808: Medicare rates
How to choose
20816 billing questions
When is this code selected instead of the incomplete replantation code?
Use this code when the non-thumb digit was completely severed. A digit that remains partially attached is distinguished as an incomplete injury.
How is a thumb replantation distinguished?
This code is for a finger other than the thumb. Use the thumb-specific replantation code when the amputated part is the thumb.
Does this code describe replantation of an entire hand?
No. It describes reattachment of an individual non-thumb digit; replantation of an entire hand is reported with the hand-level code.
What documentation supports reporting this service?
The operative record should identify the digit and amputation level, establish that it was completely severed, and describe the replantation and repairs performed.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 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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