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    v1.0.31
    OpenPayerBilling CodesOther Procedures on the Musculoskeletal SystemCPT cpt-20985-computer-assisted-navigation-for-joint-replacement
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    CPT 20985: Computer Assisted Navigation for Musculoskeletal Procedures

    Medicare pays $125 on average nationally for this procedure.

    CPT code 20985 describes the use of a computer assisted navigation system (CANS) to perform musculoskeletal surgical procedures, such as joint replacement, where a provider uses a three-dimensional digital representation of the patient’s anatomy to guide implant placement; this is a surgical image-guidance service typically performed in an inpatient or outpatient hospital operating room or an ambulatory surgery center and may be provided with an imageless workflow that does not require preoperative CT imaging.

    For related coverage guidance, see recent payer policy updates: Implants for Joint Pain, Bone Lengthening (Distraction Osteogenesis), Orthopedic Applications of Stem Cell Therapy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with end-stage osteoarthritis of the right knee presents for a total knee arthroplasty. Preoperative evaluation confirms joint space loss, pain with ambulation, and failed conservative management including physical therapy and intra-articular injections. The orthopedic surgeon elects to perform a primary right total knee replacement using an imageless computer assisted navigation system (CANS) to optimize component alignment and sizing. The clinical workflow includes preoperative consent and marking, administration of anesthesia in the operating room (typical site of service: hospital inpatient or ambulatory surgery center), registration of anatomical landmarks into the CANS intraoperatively, real-time three-dimensional guidance during bone preparation and component placement, verification of implant position and limb alignment on the navigation monitor, implant fixation, and standard wound closure. Postoperative recovery occurs in the PACU with routine neurovascular checks and pain management, followed by inpatient admission or same-day discharge per facility and patient factors. Documentation includes selection of 20985 for the use of CANS, operative report describing navigation steps and verification, and standard arthroplasty operative details including implants, laterality, and estimated blood loss.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patellar resurfacing (total knee arthroplasty)Primary surgical procedure for which 20985 is commonly reported when CANS is used to assist component placement.
    33533Replacement, aortic valve, with cardiopulmonary bypass (for example)Data not available in the input.
    20985Use of computer assisted navigation, musculoskeletal proceduresThe navigation add-on code describing use of a computer assisted navigation system during the musculoskeletal procedure.
    27486Revision of total knee arthroplasty, with or without allograft; femoral and tibial componentNavigation may be used for complex revisions; billed alongside revision arthroplasty procedure codes when applicable.
    20690Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee)Preoperative or diagnostic joint aspiration/injection services performed prior to definitive arthroplasty in some workflows.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    207P00000X
    207K00000X
    207RI0200X
    2080P0207X
    235Z00000X
    332BC3200X
    103TP2700X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    M00.061Staphylococcal arthritis, right knee
    M12.561Traumatic arthropathy, right knee
    M16.11Unilateral primary osteoarthritis, right hip
    M16.12Unilateral primary osteoarthritis, left hip
    M17.0Bilateral primary osteoarthritis of knee
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M17.9Osteoarthritis of knee, unspecified
    M18.11Unilateral primary osteoarthritis of first carpometacarpal joint, right hand
    M19.011Primary osteoarthritis, right shoulder

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    10 rows

    PolicyPayerEffective Date
    Implants for Joint PainBlue Cross Blue Shield - Rhode Island2027-03-01
    Bone Lengthening (Distraction Osteogenesis)regence2027-01-01
    Orthopedic Applications of Stem Cell TherapyBlue Cross Blue Shield - Rhode Island2027-01-01
    Bone Lengthening (Distraction Osteogenesis)Blue Cross Blue Shield - North Dakota2027-01-01
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Sacroiliac Joint Fusion for the Treatment of Adult Low-Back Pain Medical PolicyHealth-New-England2026-12-01
    Bone Grafts and Stabilization Devices for Spinal Defects - Medical PolicyHealth-New-England2026-12-01
    Implantable Shock Absorbers for Treatment of Knee Osteoarthritisblue cross blue shield - louisiana2026-12-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06

    Related Codes

    CPT-20950-COMPARTMENT-PRESSURE-MEASUREMENT

    CPT 20950: Measurement of Interstitial Fluid Pressure for Compartment Syndrome

    CPT-20955-VASCULARIZED-FIBULA-BONE-GRAFT-MAJOR-DEFECT-RECONSTRUCTION

    CPT 20955: Vascularized Fibular Bone Graft with Microvascular Anastomosis

    CPT-20956-VASCULARIZED-ILIAC-CREST-BONE-GRAFT-MICROVASCULAR

    CPT 20956: Vascularized Iliac Crest Bone Graft with Microvascular Anastomosis

    CPT-20957-VASCULARIZED-METATARSAL-BONE-GRAFT-RECONSTRUCTION

    CPT 20957: Vascularized Metatarsal Bone Graft for Major Bone Defect

    CPT-20962-VASCULARIZED-BONE-GRAFT-MAJOR-DEFECT

    CPT 20962: Vascularized Autologous Bone Graft from Non-Iliac/Fibula Donor Site

    CPT-20969-VASCULARIZED-BONE-GRAFT-WITH-CUTANEOUS-FLAP

    CPT 20969: Vascularized Bone Graft with Cutaneous Tissue

    CPT-20970-VASCULARIZED-ILIAC-CREST-BONE-AND-CUTANEOUS-GRAFT

    CPT 20970: Iliac Crest Vascularized Bone Graft with Skin Paddle

    CPT-20972-METATARSAL-VASCULARIZED-BONE-GRAFT-WITH-CUTANEOUS-FLAP

    CPT 20972: Metatarsal Vascularized Bone Graft with Skin Paddle

    CPT-20973-GREAT-TOE-VASCULARIZED-BONE-AND-CUTANEOUS-GRAFT

    CPT 20973: Vascularized Great Toe Bone Graft with Skin Paddle

    CPT-20974-ELECTRICAL-BONE-GROWTH-STIMULATION-DEVICE-PLACEMENT

    CPT 20974: Electrical Bone Stimulation for Fracture Healing

    Showing 1–10 of 15

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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