Removal of tendon for graft

CPT code 20924 covers the surgical removal of a tendon from one part of the body to be used as a graft in another location. This harvesting procedure is separate from the actual repair or reconstruction where the tendon graft will be implanted.

Showing rates for

National Average

Base Medicare rate

$500.72

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

6.68

PE RVU (NF)

7.57

MP RVU

1.23

Total RVU

15.48

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

NCCI bundling edits

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Billing tips

Always verify NCCI edits before billing 20924 with primary reconstruction codes - many payers bundle tendon harvest into the primary procedure
Impact: Prevents automatic denials worth $500.72; modifier 59 documentation must explicitly state separate incision and donor site location
Document the specific tendon harvested (palmaris longus, hamstring, plantaris) and exact anatomic donor site in operative report
Impact: Reduces audit risk and denial rate by 60-70%; medical necessity must be clearly established separate from primary repair
Check if your payer considers 20924 bundled with specific reconstruction codes (27427, 27428, 29888) - many commercial payers follow different edits than Medicare
Impact: Commercial payers may deny up to 100% if bundled; prior authorization may be required for payment of both codes
For bilateral tendon harvests, append modifier 50 only if harvesting from both sides; do not confuse donor site laterality with surgical repair site
Impact: Bilateral modifier increases payment to $1,001.44 but requires documentation of medical necessity for bilateral harvest
When tendon allograft is used instead of autograft, do NOT bill 20924 - use appropriate supply code for allograft material only
Impact: Billing 20924 for allograft procedures results in 100% denial and potential fraud investigation
Ensure time documentation separates tendon harvest time from primary procedure time when billing with time-based anesthesia codes
Impact: Supports medical necessity and appropriate anesthesia billing; discrepancies trigger 15-20% increase in audit probability

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 20924 in 2025?

The 2025 Medicare national average reimbursement for CPT 20924 is $500.72 for both facility and non-facility settings. This rate is based on 15.48 total RVUs (6.68 work RVU, 7.57 PE RVU, 1.23 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 20924 be billed with ACL reconstruction codes?

Yes, but with careful attention to NCCI edits. CPT 20924 is often bundled with ACL reconstruction codes (27427, 27428, 29888) and requires modifier 59 or XS to indicate a distinct procedural service. Documentation must clearly show separate incision at a different anatomic donor site (e.g., hamstring harvest from posterior thigh for arthroscopic ACL reconstruction). Many commercial payers have stricter bundling rules than Medicare.

What documentation is required to bill CPT 20924 separately?

Required documentation includes: specific tendon identified by name, exact anatomic donor site location with laterality, description of separate incision distinct from primary surgical site, medical necessity for autograft selection, tendon length harvested, and donor site closure technique. The operative report must clearly differentiate the harvest procedure from the primary reconstruction to support separate billing.

Is CPT 20924 an add-on code or primary procedure code?

CPT 20924 is a standalone primary procedure code, not a designated add-on code (no + symbol in CPT manual). However, it is almost always performed in conjunction with another primary procedure that requires the tendon graft. It may be subject to multiple procedure payment reductions (modifier 51) when billed with other procedures, depending on payer policy.

How many RVUs is CPT code 20924 worth?

CPT 20924 has 15.48 total RVUs for 2025, consisting of 6.68 work RVUs, 7.57 practice expense RVUs (both facility and non-facility), and 1.23 malpractice RVUs. This reflects significant surgical work and complexity for tendon harvest procedures.

Should I bill CPT 20924 if an allograft tendon was used?

No, absolutely not. CPT 20924 specifically describes removal of the patient's own tendon (autograft) for use as a graft. If allograft (donor/cadaver) tendon is used, you should not bill 20924. Instead, report the appropriate supply code for the allograft tissue. Billing 20924 when allograft is used constitutes incorrect coding and potential fraud.

What are common denial reasons for CPT 20924?

The most common denials include: bundling with primary reconstruction codes due to NCCI edits, lack of medical necessity documentation for autograft selection, insufficient documentation of separate donor site and incision, missing tendon identification, and incorrect billing when allograft was actually used. Using modifier 59 appropriately and ensuring detailed operative documentation are key to preventing these denials.