jtrurner40 there may not be an edit between the codes, but that does not mean that all can be billed either. Without seeing the op note my guess would be that 20680 is part of the ACL. If the hardware is in the same anatomical location 20680 would not be billed. CMS clarifies this in the 2017 surgical policy manual. As far as the -51 modifier goes, it would be used unless the patient is on a Medicare policy. -59 would not be used since there is no edit.