Soft tissue repair · General

20920

Harvesting of fascia lata or other fascia from the patient for use as an autograft in a separate reconstructive procedure.

Verified May 8, 2026 · 5 sources ↓

Medicare
$357.72
Total RVUs
10.71
Global, days
90
Region
General
Drawn from CMS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

  • Identify the specific fascia harvested (e.g., fascia lata, tensor fascia lata) and its anatomic location.
  • Document the dimensions or length of the fascial strip removed.
  • Describe the donor-site closure method and any layered repair performed.
  • Identify the recipient site and confirm the harvested fascia was used as a functional graft.
  • Note the primary procedure code billed alongside the harvest to establish medical necessity for the graft.
  • Record the indication for autogenous fascia rather than allograft or synthetic material.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 59 Distinct service 79 Unrelated during global 80 Assistant surgeon XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 20920 covers surgical removal of fascia — most commonly fascia lata from the thigh — to be used as an autogenous graft at another site. The harvest itself is the billable work: the incision, dissection, and removal of the fascial strip. The primary reconstructive procedure (e.g., ligament reconstruction, eyelid repair under 67911, tendon augmentation) is billed separately under its own code.

This code carries a 90-day global period. When harvested in the same operative session as the primary procedure, 20920 is separately reportable — it is not bundled into most primary musculoskeletal or ophthalmologic procedures. CMS NCCI policy explicitly confirms that autogenous graft codes including 20920 may be reported separately when required for procedures such as lid retraction correction (CPT 67911). Modifier 59 or XS may be needed to bypass any NCCI edit that fires at the claim level.

Documentation must clearly establish that the fascia was harvested — not incidentally encountered — and that it served as a functional graft at the recipient site. Notes that describe only the primary procedure without narrating the harvest site, length of fascial strip obtained, and closure of the donor site are the most common audit failure points.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU5.37
Practice expense RVU4.55
Malpractice RVU0.79
Total RVU10.71
Medicare national rate$357.72
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$357.72
HOPD (APC 5054)
Hospital outpatient department
$2,107.97
ASC (PI A2)
Ambulatory surgical center (freestanding)
$1,128.57

Common denial reasons

The recurring reasons claims for CPT 20920 get rejected.

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

  • Bundling denial when payer treats the harvest as included in the primary procedure — requires modifier 59 or XS with supporting documentation.
  • Operative note describes only the primary procedure with no independent narrative of the fascia harvest, donor site, or graft dimensions.
  • Claim submitted without a primary reconstructive procedure code, making the standalone harvest appear medically unnecessary.
  • Missing donor-site closure documentation leads reviewers to question whether a true harvest occurred.
  • Global period conflict if billed as a subsequent encounter during an existing 90-day global without modifier 79.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Is 20920 always separately billable from the primary procedure?
Generally yes — fascia harvest is not included in most primary musculoskeletal or ophthalmologic procedure codes. CMS NCCI policy explicitly calls out 20920 as separately reportable alongside procedures like CPT 67911. Add modifier 59 or XS if an NCCI edit fires.
02When should I use modifier 59 versus XS on 20920?
Use XS when the harvest and the primary procedure occur at anatomically distinct sites — which is almost always the case (e.g., thigh harvest, knee reconstruction). Modifier 59 is the fallback if your payer doesn't accept X-modifiers, but XS is the more precise choice under CMS guidance.
03What is the global period for 20920 and how does it interact with the primary procedure's global?
20920 carries a 90-day global. When billed same-day as the primary procedure, only one global period clock typically governs post-op care. If a complication at the donor site requires a return visit outside the primary procedure's global but within 20920's global, routine follow-up is already covered — bill modifier 24 only for a clearly unrelated E/M.
04What is the difference between CPT 20920 and 20922?
20920 covers a fascia lata graft 2 cm or less in width (superficial harvest). CPT 20922 describes a deeper or larger strip requiring more extensive dissection. Select based on the actual dimensions harvested — don't default to 20920 when the operative note documents a larger harvest.
05Can 20920 be billed in an ASC setting?
Yes. The code has an assigned ASC payment rate under the CMS 2026 Physician Fee Schedule. Confirm that the ASC's covered procedures list includes 20920, as some facilities require the primary procedure to be on the ASC-approved list before add-on harvests are reimbursed.
06Does the 90-day global on 20920 mean I can't bill a post-op visit for donor-site wound issues?
Routine donor-site wound checks are included in the global. If the patient presents with a complication unrelated to the harvest — such as a new injury — use modifier 24 on the E/M. A donor-site infection or dehiscence requiring unplanned return to the OR for the same donor site would use modifier 78.

Sources & references

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

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/files/document/2025nccimedicarepolicymanualcompletepdf.pdf
  3. 03
    cms.gov
    https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf
  4. 04
    cms.gov
    https://www.cms.gov/files/document/medicare-ncci-policy-manual-2024-chapter-3.pdf
  5. 05
    cms.gov
    https://www.cms.gov/files/document/03-chapter3-ncci-medicare-policy-manual-2026-final.pdf

Mira AI Scribe

Mira's AI scribe captures the harvest site anatomy, fascial strip dimensions, donor-site closure technique, and the recipient-site procedure in a single dictation pass. That prevents the most common audit failure — an operative note that narrates the primary repair but never independently documents the harvest — which is the trigger for bundling denials and post-payment audits on 20920.

See how Mira captures CPT 20920 documentation

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