20934 Intercalary algrft compl
What 20934 is
CMS fee schedule short descriptor: Intercalary algrft compl.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 20934 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 12.68 | 4.04 | 2.70 | 19.42 | $648.65 |
| Facility (hospital, ASC) | 12.68 | 4.04 | 2.70 | 19.42 | $648.65 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.
Medically Unlikely Edit (MUE)
Medicare caps 20934 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: CMS Workgroup. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 20934? These codes are bundled into it
20934 is a Column 1 code in 251 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0333T | Visual ep scr acuity auto | 0 - no modifier bypass | Check pair |
0464T | Visual ep test for glaucoma | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11010 | Debride skin at fx site | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
12015 | Rpr f/e/e/n/l/m 7.6-12.5 cm | 1 - modifier may bypass | Check pair |
12016 | Rpr fe/e/en/l/m 12.6-20.0 cm | 1 - modifier may bypass | Check pair |
12017 | Rpr fe/e/en/l/m 20.1-30.0 cm | 1 - modifier may bypass | Check pair |
Showing 30 of 251 column 2 codes. Use the pair checker for any specific combination.
20934 is bundled into these codes
20934 appears as a Column 2 code in 15 active edits. Reported with one of these Column 1 codes on the same date of service, 20934 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0219T | Plmt post facet implt cerv | 1 | Check pair |
0220T | Plmt post facet implt thor | 1 | Check pair |
0221T | Plmt post facet implt lumb | 1 | Check pair |
20932 | Osteoart algrft w/surf & b1 | 1 | Check pair |
22318 | Treat odontoid fx w/o graft | 1 | Check pair |
22586 | Arthrd pre-sac ntrbdy l5-s1 | 1 | Check pair |
23200 | Radical rescj tumor clavicle | 1 | Check pair |
24152 | Rad resection tum radial h/n | 1 | Check pair |
27078 | Rsect hip tum incl femur | 1 | Check pair |
27090 | Removal of hip prosthesis | 1 | Check pair |
27091 | Removal of hip prosthesis | 1 | Check pair |
27448 | Incision of thigh | 1 | Check pair |
27646 | Resect fibula tumor | 1 | Check pair |
27647 | Resect talus/calcaneus tum | 1 | Check pair |
27648 | Injection for ankle x-ray | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.