Removal of bone for graft

CPT 20902 covers the surgical removal of bone tissue from one part of a patient's body to be used as a graft in another area. This is the donor site harvesting procedure, typically involving iliac crest, rib, or other bone sources.

Showing rates for

National Average

Base Medicare rate

$266.21

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

4.58

PE RVU (NF)

2.83

MP RVU

0.82

Total RVU

8.23

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Always document the specific donor site location, size of graft harvested, and technique used (e.g., 'harvested 4cc of cancellous bone from left posterior iliac crest through separate 3cm incision')
Impact: Prevents 60-70% of medical necessity denials and supports separate site coding
Bill 20902 in addition to the primary grafting procedure code (e.g., spinal fusion codes); do not use 20902 for local bone removed during the primary procedure
Impact: Ensures proper $266.21 reimbursement; local bone procurement is included in primary procedure
Use modifier 59 when necessary to override CCI edits, but ensure documentation supports a distinctly separate anatomical site or separate patient encounter
Impact: Critical for payment; improper use can trigger audit resulting in full recoupment
Verify payer-specific policies for 20902 as some commercial payers consider it bundled with certain primary procedures or require specific modifiers
Impact: Can prevent 30-40% of initial denials; some payers have different bundling policies than Medicare
For structural allograft or bone substitute materials, do not bill 20902; use appropriate supply codes or surgical procedure codes instead
Impact: Prevents upcoding allegations and potential $266.21 recoupment per occurrence
Document closure of donor site separately in operative note, including layered closure technique and any drains placed
Impact: Strengthens medical necessity and complexity justification during audits

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 20902?

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 Medicare reimbursement for CPT 20902 in 2025?

The 2025 Medicare national average payment for CPT 20902 is $266.21 for both facility and non-facility settings, based on 8.23 total RVUs and a conversion factor of 32.3465.

Can CPT 20902 be billed with spinal fusion codes?

Yes, 20902 can be billed with spinal fusion codes when bone is harvested from a separate donor site (typically iliac crest). However, it should not be billed when bone is obtained locally from the surgical field (e.g., spinous process removed during laminectomy), as this is included in the fusion procedure.

What modifier should I use when billing CPT 20902?

Modifier 59 is commonly required to indicate a distinct procedural service and override NCCI edits when billing 20902 with primary procedures. Modifier 50 is used for bilateral harvests, and RT/LT modifiers specify laterality. Always verify payer-specific modifier requirements.

What are the work RVUs for CPT code 20902?

CPT 20902 has 4.58 work RVUs, 2.83 practice expense RVUs, and 0.82 malpractice RVUs, totaling 8.23 RVUs for 2025 according to the CMS Physician Fee Schedule.

Is CPT 20902 bundled into other surgical procedures?

CPT 20902 is subject to NCCI edits with many primary procedures but can be separately reported when performed at a distinctly separate anatomical site with appropriate modifiers. Local bone procurement from the immediate surgical field is considered bundled into the primary procedure.

What documentation is required to bill CPT 20902?

Documentation must include the specific donor site location, a separate incision, type and quantity of bone harvested, harvest technique, donor site closure, and medical justification for autogenous graft. The operative note must clearly distinguish the harvest from any local bone obtained during the primary procedure.

Can CPT 20902 be billed bilaterally?

Yes, when bone is harvested from both sides (e.g., bilateral iliac crests), report 20902 with modifier 50 for bilateral procedure. Medicare typically reimburses bilateral procedures at 150% of the unilateral rate, which would be approximately $399.32 for 20902.