CPT 20957
Global 090 ActiveMt bone graft microvasc
CPT 20957 Billing & Documentation Guide
CPT code 20957 (Mt bone graft microvasc) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 41.54, a non-facility practice expense RVU of 23.14, and a malpractice RVU of 8.86, a total non-facility RVU of 73.54 and facility RVU of 73.54. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2475.75, though rates vary from $2203.8 to $3067.4 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 20957, 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 20957 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 1 units of 20957 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 20957
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 41.54 | 41.54 |
| Practice Expense RVU | 23.14 | 23.14 |
| Malpractice RVU | 8.86 | 8.86 |
| Total RVU | 73.54 | 73.54 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 20957
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 | $2512.23 | $2512.23 | $2416.77 - $2813.23 | 29 |
| Florida | $2739.03 | $2739.03 | $2571.15 - $2940.47 | 3 |
| Georgia | $2480.98 | $2480.98 | $2429.65 - $2532.31 | 2 |
| Illinois | $2704.67 | $2704.67 | $2555.67 - $2853.11 | 4 |
| Michigan | $2529.75 | $2529.75 | $2427.24 - $2632.26 | 2 |
| North Carolina | $2297.69 | $2297.69 | $2297.69 - $2297.69 | 1 |
| New York | $2717.83 | $2717.83 | $2329.77 - $2944.79 | 5 |
| Ohio | $2391.43 | $2391.43 | $2391.43 - $2391.43 | 1 |
| Pennsylvania | $2473.37 | $2473.37 | $2376.65 - $2570.08 | 2 |
| Texas | $2430.91 | $2430.91 | $2365.73 - $2573.26 | 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 20957
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 20957 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 |
| 0282T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0283T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0284T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0588T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 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 |
Frequently Asked Questions, CPT 20957
What does CPT code 20957 mean? +
CPT code 20957 represents: Mt bone graft microvasc. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 20957? +
The 2026 Medicare national average non-facility payment for CPT 20957 is $2475.75. Rates range from $2203.8 to $3067.4 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 20957? +
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 20957? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 17, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team