Billing code 20934: Bone allograftMedicare rate & RVUs in Washington
Reports placement of a complete intercalary bone allograft, typically reconstructing a long-bone segment removed during tumor surgery.
CMS doesn’t publish an office rate for 20934 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 20934 covers
This add-on service represents reconstruction of a long-bone gap with a complete intercalary segment of donor bone. Orthopedic surgeons, often orthopedic oncologists, use this approach after removing a segment of bone, such as during surgery for a primary bone tumor. The graft spans the defect between the remaining bone ends and is secured as part of the reconstruction. The code includes obtaining the allograft; it is not for a graft harvested from the patient.
Report 20934 only with a primary procedure, such as the operation that removes the diseased bone and reconstructs the resulting defect. Documentation should identify the bone and defect, support use of a complete intercalary rather than partial or joint-surface graft, and describe placement and fixation. CMS treats payment for this add-on as part of the primary procedure's global period. It is not separately reported as a stand-alone service.
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 20934 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $639.75 |
| Seattle (King Cnty) | Unavailable | $683.95 |
How the 20934 rate is calculated
Each of 20934’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 · 20934
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.68Practice expense 4.04Malpractice 2.70
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 20934
The CMS indicators that decide how 20934 is paid alongside other services.
CMS payment indicators · 20934
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
20934 without 80 · national facility
$648.65
Bone allograft
20934-80 · Assistant: 16%
$103.78
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
20934 compared with similar codes
Compare codes
20934 vs 20933 vs 20932 vs 20931: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 20933Bone allograft
- 20933 describes a partial hemicortical intercalary graft. Choose 20934 when the reconstruction uses a complete intercalary segment.
- 20932Joint allograft
- 20932 is for an allograft reconstruction that includes an articular surface and bone; 20934 is for a complete intercalary bone segment.
- 20931Spinal bone graft
- 20931 describes structural allograft use in spine surgery. 20934 is for complete intercalary allograft reconstruction of a long-bone defect.
20934 billing questions
When is 20934 preferable to 20933?
Use 20934 for a complete intercalary allograft reconstruction. Code 20933 describes a partial hemicortical intercalary graft.
Can 20934 be reported by itself?
No. CMS identifies it as an add-on code, so it must be reported with a primary procedure.
Does the code include obtaining the donor graft?
Yes. The service includes obtaining the allograft; it does not describe harvesting autologous bone from the patient.
What documentation supports the complete graft selection?
Document the bone and defect being reconstructed, the complete intercalary graft used, and how it was placed and secured.
How does CMS treat payment for this add-on?
Payment is within the primary procedure's global period, 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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