How much does Medicare pay for CPT 20937?

Medicare allowed an average of $122.40 per service and paid $97.68 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $969.63, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 20937?

Harvest of bone fragment for spine bone graft. It was billed 4,796 times to 4,673 Medicare beneficiaries by 162 providers in 2024.

Does 20937 pay differently in an office than a hospital?

Yes. The allowed amount averaged $91.15 in an office setting and $122.70 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 20937 most?

Orthopedic Surgery, with 2,266 services from 78 clinicians. Next are Neurosurgery, Physician Assistant, Nurse Practitioner.

CPT 20937

Harvest of bone fragment for spine bone graft

$122.40Medicare-allowed amount per service, averaged across 4,796 services

Providers submitted

$969.63

Asking price, not received

Medicare allowed

$122.40

The fee schedule figure

Medicare paid

$97.68

Balance is patient coinsurance

Providers submitted an average of $969.63 for this code and Medicare allowed $122.40 — 7.9× 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 $97.68 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $91.15
Hospital / facility: $122.70

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 47 services were billed in an office setting and 4,749 in a facility.

Services: 4,796
Beneficiaries: 4,673
Providers billing it: 162
Total allowed: $587,030

What Medicare pays for CPT 20937

Across 4,796 services billed by 162 providers to 4,673 beneficiaries, Medicare allowed an average of $122.40 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 20937

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	2,266	2,199	$157.63	78
Neurosurgery	1,263	1,234	$157.44	42
Physician Assistant	934	914	$21.72	31
Nurse Practitioner	314	307	$22.05	10
General Surgery	19	19	$197.48	1

20937 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	1,202	$111.17	$88.18	26
Texas	487	$126.08	$103.81	21
Florida	390	$135.24	$97.58	11
Georgia	279	$99.29	$85.86	3
New York	196	$176.52	$120.48	10
Louisiana	195	$87.25	$74.97	4
Pennsylvania	187	$150.07	$115.31	6
Oregon	158	$108.64	$95.10	8
Utah	158	$100.35	$84.71	6
Colorado	157	$132.33	$107.02	5
Alabama	141	$94.82	$85.14	5
Maryland	133	$117.31	$81.95	3
Minnesota	122	$135.93	$119.84	4
Illinois	101	$172.23	$116.65	4
Massachusetts	83	$130.44	$99.90	4
Arkansas	81	$142.94	$128.63	3
Virginia	71	$138.68	$112.61	4
Washington	70	$95.85	$80.22	3
North Carolina	62	$124.56	$104.18	3
Michigan	61	$143.27	$104.73	3
Connecticut	55	$105.15	$78.22	2
Oklahoma	53	$152.75	$129.06	4
Nebraska	51	$70.57	$61.64	2
Tennessee	43	$137.82	$131.08	2
Wyoming	40	$155.99	$129.65	2
Nevada	39	$91.94	$75.14	2
Idaho	39	$94.74	$92.06	3
Indiana	33	$151.53	$131.68	2
Ohio	29	$161.08	$129.59	2
District of Columbia	21	$180.77	$129.47	1
Wisconsin	17	$161.38	$128.97	1
Missouri	16	$149.91	$131.33	1
Delaware	13	$150.04	$129.47	1
New Jersey	13	$169.60	$129.64	1

Related codes

20985Computer-assisted surgery for muscle and bone procedure$132.15
20939Aspiration of bone marrow for spine bone graft$60.92
20931Graft of donor bone to spine$106.13
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.