Billing code 20973: Bone/skin graftMedicare rate & RVUs in Washington
Report this vascularized bone-and-skin graft when tissue from the great toe is transferred to reconstruct a defect requiring both components.
CMS doesn’t publish an office rate for 20973 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 20973 covers
The surgeon harvests bone and an attached skin component from the great toe while preserving its blood supply, then transfers the graft to a recipient site and connects its vessels microsurgically. This service is used in reconstructive surgery when the defect calls for vascularized bone together with skin; plastic, reconstructive, or orthopedic surgeons may perform it in an operating room. The great toe donor source distinguishes this graft from similar bone-and-skin grafts taken from the metatarsal or iliac crest.
Select the code based on the graft’s donor site, not the recipient location. The operative report should identify the great toe source, the bone and skin components transferred, the recipient site, and the microvascular work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 applies to bilateral procedures, paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 20973 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $2,654.19 |
| Seattle (King Cnty) | Unavailable | $2,869.07 |
How the 20973 rate is calculated
Each of 20973’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 · 20973
RVUs × geographic indexes × conversion factor
Work46.09
46.09 RVUs× 1.000 GPCI
Practice expense24.00
24.00 RVUs× 1.000 GPCI
Malpractice9.86
9.86 RVUs× 1.000 GPCI
Adjusted RVUs
79.9500
Conversion factor
$33.4009
Medicare rate
$2,670.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20973
20973 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20973
Bone/skin graft
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 20973
Bone/skin graft
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 50 · payment effect
With and without the modifier
20973 without 50 · national facility
$2,670.40
Bone/skin graft
20973-50 · Bilateral: 150%
$4,005.60
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
20973 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20972Free flap
- Use 20973 for a bone-and-skin graft from the great toe. Code 20972 identifies a metatarsal donor source.
- 20970Bone and skin graft
- Both describe bone-and-skin grafts, but 20970 identifies the iliac crest as the donor site.
- 20955Bone graft
- Code 20955 is a microvascular bone graft from the fibula; 20973 identifies a graft containing bone and skin from the great toe.
20973 billing questions
How is this code distinguished from the metatarsal bone-and-skin graft?
Choose this code when the transferred bone and skin come from the great toe. The metatarsal graft code is for tissue taken from the metatarsal.
Does the service include the microvascular transfer?
The code represents a vascularized bone-and-skin graft transfer, including the microsurgical connection of its vessels. Document the graft components, donor site, recipient site, and vascular work.
How does CMS apply the 90-day global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is modifier 50 handled for bilateral procedures?
CMS pays a bilateral procedure reported with modifier 50 at 150%. The operative documentation should support the bilateral service.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
What happens when this graft is performed with another procedure?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%.
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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