Remove cartilage for graft

CPT code 20910 covers the surgical removal of cartilage from one part of the body to be used as a graft in another area, such as taking cartilage from a rib to repair a nose or ear.

Showing rates for

National Average

Base Medicare rate

$475.17

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

5.53

PE RVU (NF)

8.01

MP RVU

1.15

Total RVU

14.69

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Bill 20910 separately from the primary reconstruction code (e.g., rhinoplasty 30400-30420) and ensure operative report clearly documents both donor and recipient sites with separate time allocation
Impact: Prevents bundling denials that would result in loss of $475.17 reimbursement; approximately 30-40% of claims denied when documentation doesn't clearly separate procedures
Document the specific anatomic donor site (costal cartilage ribs 6-8, auricular concha, nasal septum) and dimensions of cartilage harvested to support medical necessity
Impact: Reduces medical necessity denials by 60-70%; clear anatomic documentation supports both 20910 and prevents downcoding to simpler tissue harvest codes
When harvesting rib cartilage, photograph or document chest wall closure separately and note any intercostal dissection to justify work RVU of 5.53
Impact: Supports modifier 22 appeals when appropriate, potentially increasing reimbursement by $95-$237 for unusually complex harvests
Verify that 20910 is not bundled with specific reconstruction codes in NCCI edits before billing; check quarterly updates as edits change
Impact: Prevents automatic denials; NCCI violations result in immediate claim rejection and delayed payment cycles of 30-60 days for resubmission
For ASC settings, confirm facility and professional components are billed correctly as both facility and non-facility rates are identical at $475.17 for 2025
Impact: While rates are equal for 20910, proper place of service coding ensures clean claims processing and avoids MAC audits
When billing with modifier 51, ensure 20910 is sequenced after the primary procedure code to maximize total reimbursement under multiple procedure payment reduction rules

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 20910?

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 rate for CPT 20910 in 2025?

The 2025 Medicare national average reimbursement for CPT 20910 is $475.17 for both facility and non-facility settings. This rate is based on 14.69 total RVUs (5.53 work RVU, 8.01 PE RVU, 1.15 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 20910 be billed with rhinoplasty codes?

Yes, CPT 20910 can be billed separately with rhinoplasty codes (30400-30420, 30430-30450) when cartilage is harvested from a separate donor site such as rib or ear. However, you must use modifier 59 to indicate a distinct procedural service and document both donor and recipient sites separately in the operative report to avoid bundling denials.

What documentation is required to bill CPT 20910 separately?

Documentation must clearly describe the donor site location, incision and dissection technique, dimensions of cartilage harvested, closure of donor site, medical necessity for autologous graft, and separate time allocation. The operative report should distinctly separate the cartilage harvest from the reconstruction procedure with individual headings or sections.

Is CPT 20910 subject to multiple procedure payment reduction?

Yes, when billed with modifier 51 as a secondary procedure during the same operative session, CPT 20910 is typically subject to 50% payment reduction under Medicare's multiple procedure payment reduction rules, reducing reimbursement from $475.17 to approximately $237.59.

What are the most common donor sites for CPT 20910?

The most common donor sites for CPT 20910 are costal (rib) cartilage typically from ribs 6-8, auricular (ear) cartilage from the concha, and nasal septal cartilage. Rib cartilage provides the largest volume and is commonly used for major reconstructions, while ear and septal cartilage are used for smaller grafts.

When should modifier 59 be used with CPT 20910?

Modifier 59 should be used with CPT 20910 when the cartilage harvest is performed at a distinct anatomic site from the primary procedure and NCCI edits indicate bundling with the reconstruction code. This modifier indicates the harvest is a separate and medically necessary service, preventing automatic denial for bundling.

Does insurance cover CPT 20910 for cosmetic procedures?

Coverage for CPT 20910 depends on the medical necessity of the overall procedure. When performed as part of reconstructive surgery for trauma, congenital defects, or functional impairment, it is typically covered. For purely cosmetic procedures, both the reconstruction and cartilage harvest (20910) are usually patient responsibility and not covered by Medicare or most commercial insurance.