Excision epiphyseal bar

CPT code 20150 covers the surgical removal of an epiphyseal bar, which is abnormal bone tissue that forms between the growth plate sections in a child's bone. This procedure is performed to restore normal bone growth and prevent limb length discrepancies or angular deformities.

Showing rates for

National Average

Base Medicare rate

$987.86

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

14.75

PE RVU (NF)

12.78

MP RVU

3.01

Total RVU

30.54

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document exact percentage of physis involved by the bar using preoperative MRI or CT measurements, as bars >25% require different surgical approach and support medical necessity
Impact: Reduces denial rate by 35-40% and supports modifier 22 consideration for extensive bars, potentially adding $200-$494 in reimbursement
Separately report interposition material placement with appropriate supply codes and ensure operative note specifies material type (autologous fat, bone wax, methyl methacrylate, or synthetic)
Impact: Recovers $150-$400 in supply costs that are otherwise absorbed by the practice when not separately documented and billed
Include preoperative growth remaining assessment documentation showing at least 2 years growth potential remaining, as this is key to medical necessity determination
Impact: Prevents 60-70% of medical necessity denials which would result in complete claim denial ($987.86 lost revenue per case)
Use laterality modifiers (LT/RT) on every claim as this is an anatomically specific procedure requiring precise identification
Impact: Eliminates 15-20% of processing delays and prevents automatic denials from missing required information
Document concurrent osteotomy procedures separately when performed to correct existing deformity in addition to bar excision
Impact: May add $600-$1,200 in additional reimbursement when osteotomy codes (27455, 27457, 27475, etc.) are appropriately billed with modifier 59
Verify prior authorization requirements for commercial payers as this is considered a specialized pediatric procedure with significant cost implications

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 20150 in 2025?

The 2025 Medicare national average reimbursement for CPT 20150 is $987.86 for both facility and non-facility settings. This rate is based on 30.54 total RVUs (14.75 work RVU, 12.78 PE RVU, and 3.01 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

How many RVUs is CPT code 20150 worth?

CPT code 20150 has a total of 30.54 RVUs for 2025, consisting of 14.75 work RVUs, 12.78 practice expense RVUs, and 3.01 malpractice RVUs. This high RVU value reflects the technical complexity and specialized nature of epiphyseal bar excision surgery.

Can CPT 20150 be billed bilaterally with modifier 50?

Yes, CPT 20150 can be billed with modifier 50 when epiphyseal bar excision is performed on both limbs during the same operative session, though this is rare. Bilateral billing increases total reimbursement to 150% of the base rate ($1,481.79), but requires clear medical necessity documentation for both sides.

What documentation is required to bill CPT 20150 without denials?

Required documentation includes preoperative MRI or CT showing bar size and location, bone age study demonstrating adequate remaining growth (typically 2+ years), serial imaging showing progressive deformity, detailed operative note describing complete bar removal and interposition material used, and medical necessity justification explaining why the procedure was performed at this specific timing.

What is the global period for CPT code 20150?

CPT 20150 has a 90-day global surgical period. All routine postoperative care within 90 days of the procedure is included in the $987.86 reimbursement. Any unrelated E/M services during this period require modifier 24, and returns to the OR for complications require modifier 78.

What modifiers are most commonly used with CPT 20150?

The most commonly used modifiers with CPT 20150 are LT/RT for laterality (required on every claim), modifier 22 for increased procedural complexity when bar involves >50% of physis, modifier 59 when performed with other distinct procedures, and modifier 51 when performed as a secondary procedure during the same operative session.

What are common reasons for CPT 20150 claim denials?

Common denial reasons include lack of medical necessity documentation showing progressive deformity with adequate growth remaining, insufficient imaging documentation of bar size and percentage of physis involved, payer classification as experimental/investigational, and bundling with concurrent procedures when appropriate modifiers are not used. Each denial can result in loss of the full $987.86 reimbursement.