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CPT 20933: Allograft for Cortical Defect of Long Bone
CPT code 20933 covers an add-on surgical procedure in which a provider uses an allograft to reconstruct a cortical defect of a long bone. The service includes designing a template, cutting and shaping donor tissue to fit the defect, placing the graft, and fixing it to the host bone. This procedure is clinically important for orthopedic reconstructions where structural support of the cortical bone is required and can affect operative planning, supplies, and post-operative care.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, benchmarks where available, common billing modifiers and coding considerations, and links to related surgical codes. The publication highlights national relevance by focusing on how the code defines scope of service for grafting of cortical defects and how payers commonly classify and adjudicate add-on orthopedic graft procedures.
The report provides practical content for billing and compliance teams, clinical coders, and policy analysts: a description of what CPT code 20933 represents, typical sites of service, payer coverage considerations, and pointers to supporting documentation practices. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 20933 describes the use of an allograft to fill a cortical defect in a long bone. The procedure involves designing a template, cutting and shaping donor tissue to fit the template, placing the graft into a portion of the cortex (the outer covering) of a long bone between joints, and securing the graft to the bone. This entry is an add-on surgical procedure and represents reconstruction of a cortical defect rather than primary joint procedures.
Service type: Surgical, musculoskeletal reconstructive procedure
Typical site of service: Hospital operating room or ambulatory surgical center, where orthopedic grafting and reconstructive procedures are performed.