How much does Medicare pay for CPT 20931?

Medicare allowed an average of $106.13 per service and paid $84.55 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $633.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 20931?

Graft of donor bone to spine. It was billed 3,812 times to 3,742 Medicare beneficiaries by 188 providers in 2024.

Which specialty bills 20931 most?

Neurosurgery, with 2,316 services from 115 clinicians. Next are Orthopedic Surgery, Anesthesiology, Neurology.

CPT 20931

Graft of donor bone to spine

$106.13Medicare-allowed amount per service, averaged across 3,812 services

Providers submitted

$633.56

Asking price, not received

Medicare allowed

$106.13

The fee schedule figure

Medicare paid

$84.55

Balance is patient coinsurance

Providers submitted an average of $633.56 for this code and Medicare allowed $106.13 — 6.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $84.55 (80%); the rest is the patient’s coinsurance and deductible.

Services: 3,812
Beneficiaries: 3,742
Providers billing it: 188
Total allowed: $404,568

What Medicare pays for CPT 20931

Across 3,812 services billed by 188 providers to 3,742 beneficiaries, Medicare allowed an average of $106.13 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 20931

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	2,316	2,271	$105.00	115
Orthopedic Surgery	1,448	1,424	$107.66	71
Anesthesiology	35	34	$116.53	1
Neurology	13	13	$107.48	1

20931 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	694	$106.48	$85.63	26
Texas	390	$108.26	$85.96	15
Delaware	209	$104.29	$85.96	6
Florida	188	$119.39	$85.86	10
Ohio	163	$106.40	$85.68	10
Pennsylvania	151	$111.00	$86.00	10
New York	140	$110.87	$84.11	7
Illinois	135	$117.73	$86.08	7
Maryland	132	$114.34	$86.38	7
Kansas	127	$95.42	$86.37	5
Michigan	121	$111.92	$86.15	6
North Carolina	112	$100.19	$85.96	4
Washington	109	$116.84	$86.03	6
Indiana	109	$95.05	$86.19	7
Nebraska	92	$91.88	$85.83	3
South Carolina	83	$102.45	$86.11	6
Georgia	74	$107.19	$85.87	4
Tennessee	67	$98.04	$86.74	4
Missouri	66	$104.46	$86.23	5
Oklahoma	59	$98.49	$86.54	3
Kentucky	57	$100.21	$85.85	4
Colorado	55	$105.08	$86.08	3
Virginia	53	$98.04	$86.92	3
Arkansas	51	$91.27	$86.74	3
Louisiana	48	$97.42	$86.90	3
Arizona	48	$104.11	$85.71	4
Mississippi	46	$97.82	$86.28	3
Massachusetts	44	$102.33	$86.65	3
Alabama	38	$94.77	$85.90	1
Connecticut	31	$116.12	$85.94	1
Idaho	25	$94.60	$85.78	2
Iowa	24	$94.97	$86.06	2
Oregon	19	$110.00	$85.82	1
Wyoming	15	$101.88	$85.93	1
New Jersey	15	$114.66	$85.84	1
Nevada	11	$106.58	$85.36	1
Utah	11	$96.88	$87.95	1

Related codes

20985Computer-assisted surgery for muscle and bone procedure$132.15
20939Aspiration of bone marrow for spine bone graft$60.92
20937Harvest of bone fragment for spine bone graft$122.40
20902Harvest of graft from large bone$280.05
20900Harvest of graft from small bone$707.38

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.