20150

Surgical removal of an epiphyseal bar (physeal bar) from a long bone, with or without autogenous soft tissue graft harvested through the same fascial incision.

Verified May 8, 2026 · 6 sources ↓

Medicare: $920.86
Total RVUs: 27.57
Global, days: 90
Region: Other

Drawn from CMSNIHEmednyAAPCAAOS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Preoperative imaging (MRI or CT physeal mapping) documenting the bar's location, size, and estimated percentage of physis involved
Operative note identifying the specific bone and physeal location (e.g., distal femur, distal radius) and confirming open surgical approach
Documentation confirming autogenous soft tissue graft harvest through the same fascial incision, if graft was used
Patient age and skeletal maturity status establishing clinical indication for physeal bar resection
Pathology or intraoperative findings confirming excision of bony bridge tissue
Postoperative plan addressing expected growth resumption or need for staged correction

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

20150 covers open excision of a bony bridge — the epiphyseal bar — that has formed across a growth plate following fracture, infection, or other injury to the physis. The bar tethers the epiphysis to the metaphysis, causing partial or complete premature growth arrest and progressive angular deformity. Excision removes the offending osseous bridge; the resulting void is filled with autogenous fat or other soft tissue graft taken through the same incision, with the graft harvest included in the code and not separately billable.

This procedure is almost exclusively performed in skeletally immature patients — children and adolescents with sufficient remaining growth to warrant physeal bar resection. The clinical goal is to restore or permit resumption of differential growth across the affected physis. Imaging workup (MRI or CT with physeal mapping) is required preoperatively to characterize the bar's location, extent, and percentage of physeal involvement before surgical planning.

20150 carries a 90-day global period. All routine postoperative visits, cast checks, wound care, and stitch removal through day 90 are bundled. Bill separately within that window only for unrelated E/M services (modifier 24), significant separately identifiable E/M on the day of surgery (modifier 25), or a staged or unplanned return to the OR using modifier 58 or 78 as appropriate.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	14.38
Practice expense RVU	10.14
Malpractice RVU	3.05
Total RVU	27.57
Medicare national rate	$920.86
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$920.86
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI G2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 20150 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Medical necessity not established — payer requires preoperative imaging with physeal mapping to confirm bar presence and growth potential
Graft harvest billed separately when taken through the same fascial incision — that work is included in 20150
Missing or vague operative note that fails to identify the specific bone, physeal location, or confirmation that a bony bridge was excised
Bilateral modifier 50 applied without documentation that bars were excised on contralateral limbs in the same operative session
Modifier 22 appended without supporting documentation of unusual complexity (e.g., large bar percentage, prior failed resection, scarring from infection)

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Is autogenous graft harvest billed separately when performed with 20150?

No. The code descriptor explicitly includes autogenous soft tissue graft obtained through the same fascial incision. Billing a separate graft-harvest code will be denied as unbundling.

02What modifier applies when 20150 is performed on both limbs in the same session?

Append modifier 50 for a bilateral procedure performed in the same session. Alternatively, some payers require LT and RT on separate line items — confirm your MAC's preference before submitting.

03Can 20150 be billed for an adult patient?

The clinical indication is physeal bar resection in skeletally immature patients. Performing this procedure in a patient with a closed physis is unlikely to survive medical necessity review; document remaining growth potential explicitly if a borderline-age patient is treated.

04What is the global period for 20150?

90 days. Routine postoperative care, cast management, and wound checks within that window are bundled. Use modifier 24 for unrelated E/M visits and modifier 78 for an unplanned related return to the OR during the global period.

05When is modifier 22 appropriate for 20150?

Use modifier 22 when the procedure required substantially more work than typical — for example, a large-percentage physeal bar, significant scar tissue from prior infection, or a revision resection after failed prior bar excision. The operative note must explicitly describe the added complexity and time; a bare modifier 22 without supporting documentation will be reduced or denied.

06How does site of service affect reimbursement for 20150?

HOPD and ASC payments differ meaningfully from the physician fee schedule rate. The facility captures the technical component payment; the surgeon bills the professional component regardless of setting. See the Site of Service comparison table on this page for current figures.

07What ICD-10 diagnoses most commonly support 20150?

Growth plate arrest codes (e.g., M89.2x series for physeal arrest) and post-traumatic physeal bridge codes are the primary supporting diagnoses. The specific bone and laterality must match the operative site exactly or the claim will reject on diagnosis-to-procedure mismatch.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the affected bone and physeal location, bar etiology (fracture, infection, or other), percentage of physis involved per preoperative imaging, whether autogenous graft was harvested through the same incision, and intraoperative confirmation of bony bridge removal. That detail prevents denials tied to missing medical necessity documentation and eliminates separate graft-harvest billing errors before the claim is submitted.

See how Mira captures CPT 20150 documentation