CPT 20692
Global 090 ActiveAppl mltpln uni ext fixj sys
CPT 20692 Billing & Documentation Guide
CPT code 20692 (Appl mltpln uni ext fixj sys) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 15.86, a non-facility practice expense RVU of 12.56, and a malpractice RVU of 2.93, a total non-facility RVU of 31.35 and facility RVU of 31.35. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1062.15, though rates vary from $940.5 to $1295.31 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 20692, 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 20692 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 20692 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 20692
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 15.86 | 15.86 |
| Practice Expense RVU | 12.56 | 12.56 |
| Malpractice RVU | 2.93 | 2.93 |
| Total RVU | 31.35 | 31.35 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 20692
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 | $1098.2 | $1098.2 | $1050.99 - $1245.41 | 29 |
| Florida | $1141.16 | $1141.16 | $1077.89 - $1213.95 | 3 |
| Georgia | $1047.85 | $1047.85 | $1020.6 - $1075.09 | 2 |
| Illinois | $1123.97 | $1123.97 | $1065.72 - $1179.66 | 4 |
| Michigan | $1061.41 | $1061.41 | $1023.24 - $1099.57 | 2 |
| North Carolina | $983.68 | $983.68 | $983.68 - $983.68 | 1 |
| New York | $1155.92 | $1155.92 | $997.08 - $1244.18 | 5 |
| Ohio | $1011.4 | $1011.4 | $1011.4 - $1011.4 | 1 |
| Pennsylvania | $1050.04 | $1050.04 | $1007.34 - $1092.74 | 2 |
| Texas | $1036.57 | $1036.57 | $1002.41 - $1085.22 | 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 20692
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 20692 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 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 |
| 0594T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 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 |
| 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 20692
What does CPT code 20692 mean? +
CPT code 20692 represents: Appl mltpln uni ext fixj sys. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 20692? +
The 2026 Medicare national average non-facility payment for CPT 20692 is $1062.15. Rates range from $940.5 to $1295.31 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 20692? +
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 20692? +
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 July 16, 2026.
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