CPT 20520
Global 010 ActiveRmvl fb musc/tdn simple
CPT 20520 Billing & Documentation Guide
CPT code 20520 (Rmvl fb musc/tdn simple) is classified under Surgery (Musculoskeletal) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.85, a non-facility practice expense RVU of 4.76, and a malpractice RVU of 0.27, a total non-facility RVU of 6.88 and facility RVU of 4.25. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $236.7, though rates vary from $203.01 to $302.68 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 20520, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 20520 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 20520 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 20520
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.85 | 1.85 |
| Practice Expense RVU | 4.76 | 2.13 |
| Malpractice RVU | 0.27 | 0.27 |
| Total RVU | 6.88 | 4.25 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 20520
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $257.02 | $153.08 | $241.93 - $302.68 | 29 |
| Florida | $238.87 | $150.73 | $227.34 - $250.11 | 3 |
| Georgia | $224.35 | $140.55 | $214.36 - $234.34 | 2 |
| Illinois | $232.86 | $147.98 | $221.04 - $242.7 | 4 |
| Michigan | $223.77 | $141.29 | $217.13 - $230.42 | 2 |
| North Carolina | $215.89 | $133.93 | $215.89 - $215.89 | 1 |
| New York | $254.35 | $156.35 | $219.17 - $271.53 | 5 |
| Ohio | $216.04 | $135.84 | $216.04 - $216.04 | 1 |
| Pennsylvania | $227.72 | $141.67 | $216.27 - $239.17 | 2 |
| Texas | $227.04 | $140.55 | $214.85 - $238.12 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 20520
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 20520 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0490T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0718T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 20520
What does CPT code 20520 mean? +
CPT code 20520 represents: Rmvl fb musc/tdn simple. It's in the Surgery (Musculoskeletal) category with a global period of 010.
What is the Medicare reimbursement for CPT 20520? +
The 2026 Medicare national average non-facility payment for CPT 20520 is $236.7. Rates range from $203.01 to $302.68 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 20520? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 20520? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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