CPT 20938 Surgery - Musculoskeletal
Sp bone agrft struct add-on Cost
Body System: Musculoskeletal
Medicare Facility Rate
$163
CMS PFS CY2026
Medicare Non-Facility Rate
$163
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.94
Work RVU
0.99
Facility PE RVU
0.96
Malpractice RVU
4.89
Total RVU
Frequently Asked Questions
How much does Sp bone agrft struct add-on cost?
The Medicare facility rate is $163. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Sp bone agrft struct add-on cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $163.