Removal of implant deep

CPT code 20680 covers the surgical removal of an implant that was placed deep within the body, such as a metal rod, plate, or screw used to stabilize a broken bone. This is typically performed after the bone has healed and the hardware is no longer needed.

Showing rates for

National Average

Base Medicare rate

$582.88

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

5.96

PE RVU (NF)

11.03

MP RVU

1.03

Total RVU

18.02

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Always verify and document the depth of the implant relative to the fascial layer; implants superficial to fascia should be coded 20670, which reimburses $168.84 less
Impact: Incorrect depth coding can result in $168.84 underpayment (29% reduction) if downgraded to 20670
Bill in the non-facility setting when performed in office-based surgical suite to capture the higher rate of $582.88 versus $414.04 facility rate
Impact: Strategic setting selection increases reimbursement by $168.84 per case (40.8% higher payment)
Document the number and type of implants removed (plates, screws, rods) but report 20680 only once per anatomical site regardless of the number of pieces removed
Impact: Prevents unbundling denials while supporting medical necessity; multiple units are not billable for same-site removal
When removing implants from multiple distinct anatomical sites during the same session, append modifier 59 to the second and subsequent codes to bypass CCI edits
Impact: Enables payment of full amount for each site rather than bundled denial, potentially capturing $582.88 per additional site
Separately bill for any bone grafting, debridement of infected tissue, or repair of complications using appropriate add-on codes with supporting documentation
Impact: Can add $200-$800 additional reimbursement when complications require additional procedures beyond simple removal
Check patient's global period status from prior surgeries; if within 90-day global, use modifier 79 for unrelated removal or coordinate timing to maximize reimbursement
Proper modifier use prevents automatic denials and can mean difference between $0 and $582.88 payment

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 20680?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the difference between CPT 20680 and 20670?

CPT 20680 is for removal of deep implants (below the fascial layer) and reimburses $582.88, while 20670 is for superficial implants (above the fascia) and pays $414.04. The key differentiator is the anatomical depth relative to the fascial plane, which must be clearly documented in the operative report.

How much does Medicare pay for CPT 20680 in 2025?

Medicare pays $582.88 for CPT 20680 in the non-facility setting and $414.04 in the facility setting based on the 2025 national average rates. Actual payment may vary slightly based on geographic locality adjustments.

Can I bill CPT 20680 multiple times for removing multiple screws and a plate?

No, CPT 20680 is billed once per anatomical site regardless of the number of implant components removed. Removing multiple screws and a plate from the same surgical site is considered a single procedure. However, if removing implants from distinctly separate anatomical sites, you may bill 20680 for each site with appropriate modifiers.

What RVU value does CPT 20680 have?

CPT 20680 has a total RVU of 18.02 for 2025, consisting of 5.96 work RVUs, 11.03 non-facility practice expense RVUs (5.81 facility), and 1.03 malpractice RVUs. This relatively high RVU reflects the surgical complexity of deep implant removal.

Does insurance require prior authorization for CPT 20680?

Prior authorization requirements vary by payer and plan. Many commercial insurers require prior authorization for elective hardware removal, while symptomatic or complication-related removals may have streamlined approval. Medicare typically does not require prior authorization but does require medical necessity documentation. Always verify with the specific payer before scheduling.

Can CPT 20680 be billed during the global period of the original fracture surgery?

Yes, but it requires careful modifier use. If the removal is planned/staged and unrelated to complications, use modifier 79 for full payment. If it's a return to OR for complications during the global period, use modifier 78, which will reduce payment to approximately 70% of the standard rate. Document the clinical justification clearly.

What diagnosis codes are typically used with CPT 20680?

Common ICD-10 codes include T84.xx codes for complications of internal orthopedic devices (pain, infection, mechanical complications), Z47.2 for encounter for removal of internal fixation device, or M96.69 for fracture of bone following insertion of orthopedic implant. The specific code should match the documented medical necessity for the removal.