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CPT code 20200: Muscle biopsy, superficial, open approach2026 Medicare rate & RVUs in Delaware

Reports an open biopsy of an accessible superficial skeletal muscle when tissue is needed to investigate suspected muscle disease.

CMS RVU26DEffective Oct 1, 2026One payment locality505 Medicare services in 2024

In Delaware, Medicare pays $238.63 for 20200 in the office and $88.81 when it’s performed in a hospital or facility.

$238.63Office (non-facility)
$88.81Hospital or facility
−1.3%vs the national office rate ($241.82)

Check a contract rate as a % of Medicare · 20200 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 20200 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 20200 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 20200 covers

A physician obtains a small sample of accessible skeletal muscle through an open incision for diagnostic examination. Neurologists and surgeons may perform this procedure when evaluation of conditions such as inflammatory myopathy, muscular dystrophy, or metabolic muscle disease requires tissue. The specimen may be sent for histologic or other laboratory studies. This code describes a superficial muscle biopsy, not a needle sample or an open biopsy of a deeper muscle.

Select the code based on the muscle’s depth and the approach documented in the operative report. Documentation should identify the sampled muscle and site, the open approach, and the diagnostic reason for obtaining tissue. The 0-day global period includes same-day preoperative and postoperative care. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Delaware compares for 20200

Across 109 of 109 payment localities, the office rate for 20200 runs from $210.16 in Arkansas to $321.76 in San Benito County, CA. Delaware pays $238.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

20200 in Delaware vs other payment areas
  1. Delaware · this page$238.63
  2. Los Angeles, CA · California$272.93+$34.30
  3. Washington, DC area · District of Columbia$278.18+$39.55
  4. Miami, FL · Florida$268.18+$29.55
  5. Chicago, IL · Illinois$259.07+$20.44
  6. Manhattan, NY · New York$281.59+$42.96
  7. Alaska · Alaska$271.82+$33.19

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

20200 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$213.70$81.02
ArkansasArkansas$210.16$79.90
ArizonaArizona$234.40$87.46
Bakersfield, CACalifornia$255.37$89.17
Chico, CACalifornia$254.37$88.17
El Centro, CACalifornia$254.43$88.23
Fresno, CACalifornia$254.37$88.17
Hanford, CACalifornia$254.37$88.17

20200 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$210.16

$288.07

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
20200 office rate range by state
State / territoryOffice rate rangeLocalities
AK$271.821
AL$213.701
AR$210.161
AZ$234.401
CA$254.37–$321.7629
CO$251.341
CT$259.381
DC$278.181
DE$238.631
FL$240.03–$268.183
GA$224.54–$247.362
GU$261.561
HI$261.561
IA$218.901
ID$220.751
IL$232.94–$259.074
IN$222.181
KS$218.221
KY$220.571
LA$220.37–$232.762
MA$249.72–$277.722
MD$243.47–$278.183
ME$222.59–$235.622
MI$227.58–$243.932
MN$238.401
MO$216.38–$233.113
MS$213.291
MT$241.801
NC$225.161
ND$234.481
NE$220.121
NH$247.741
NJ$261.67–$274.782
NM$229.201
NV$239.941
NY$229.05–$289.855
OH$226.081
OK$219.591
OR$237.42–$259.622
PA$226.22–$252.522
PR$243.641
RI$247.401
SC$226.131
SD$233.621
TN$219.541
TX$224.56–$251.078
UT$229.641
VA$235.09–$278.182
VI$243.641
VT$233.901
WA$249.13–$283.252
WI$225.631
WV$223.301
WY$238.611

See 20200 in every payment locality

How the 20200 rate is calculated

Each of 20200’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 20200

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.42

1.42 RVUs× 1.000 GPCI

Practice expense5.45

5.45 RVUs× 1.000 GPCI

Malpractice0.37

0.37 RVUs× 1.000 GPCI

Adjusted RVUs

7.2400

Conversion factor

$33.4009

Medicare rate

$241.82

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,727

Code
20200
Physician work
1.42
Practice expense
5.45
Malpractice
0.37

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 20200 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.42× 1.0051.4271
Practice expense5.45× 0.9885.3846
Malpractice0.37× 0.8990.3326
Total RVUs7.1443
Conversion factor× 33.4009

Office rate, Delaware$238.63

Office: (1.42 × 1.005 + 5.45 × 0.988 + 0.37 × 0.899) × $33.4009 = $238.63

Facility: (1.42 × 1.005 + 0.91 × 0.988 + 0.37 × 0.899) × $33.4009 = $88.81

Open 20200 in the RVU calculator

Payment rules and modifiers for 20200

The CMS indicators that decide how 20200 is paid alongside other services.

CMS payment indicators · 20200

Muscle biopsy, superficial, open approach

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

20200 without 51 · national office

$241.82

Muscle biopsy, superficial, open approach

20200-51 · Second procedure: 50%

$120.91

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 20200

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 20200
CodeHow it relatesOffice range, Delaware
Same family
20205Muscle biopsy, open deep-muscle approachOpen muscle biopsy when the sampled muscle is deep rather than superficial.$333.99
Used instead
20206Muscle biopsy, percutaneous needle approachPercutaneous needle approach for obtaining a muscle biopsy specimen.$207.46
Often billed with
88305Tissue pathology exam, level IV specimenMay be reported by the laboratory for pathologic examination of the muscle specimen.$69.66

How 20200 has changed in Delaware

20200 · Office / nonfacility

$238.63

Effective 2026-10-01

The base rate is $32.35 higher than on 2025-10-01, moving from $206.28 to $238.63 (15.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $206.28changed to$238.63

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.46 changed to 1.42
    • Practice expense RVU 4.58 changed to 5.45
    • Malpractice RVU 0.38 changed to 0.37
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $214.93changed to$206.28

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.67 changed to 4.58
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $211.43changed to$214.93

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $223.33changed to$211.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.74 changed to 4.67
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $232.83changed to$223.33

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.83 changed to 4.74
    • Malpractice RVU 0.35 changed to 0.37
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $236.58changed to$232.83

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.89 changed to 4.83
    • Malpractice RVU 0.34 changed to 0.35

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $222.90changed to$236.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.26 changed to 4.89
    • Malpractice RVU 0.35 changed to 0.34
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $219.17changed to$222.90

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.13 changed to 4.26
    • Malpractice RVU 0.36 changed to 0.35
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $216.73changed to$219.17

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.07 changed to 4.13

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $217.26changed to$216.73

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.37 changed to 0.36
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $217.49changed to$217.26

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $218.64changed to$217.49

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.08 changed to 4.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $217.56changed to$218.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $213.22changed to$217.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.04 changed to 4.08
    • Malpractice RVU 0.32 changed to 0.37
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $217.65changed to$213.22

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.50 changed to 4.04
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $217.65

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$238.63$88.81RVU26D
2026-07-01$238.63$88.81RVU26C
2026-04-01$238.63$88.81RVU26B
2026-01-01$238.63$88.81RVU26A
2025-10-01$206.28$93.33RVU25D
2025-07-01$206.28$93.33RVU25C
2025-04-01$206.28$93.33RVU25B
2025-01-01$206.28$93.33RVU25A
2024-10-01$214.93$94.74RVU24D
2024-07-01$214.93$94.74RVU24C
2024-04-01$214.93$94.74RVU24B
2024-03-09$214.93$94.74RVU24AR
2024-01-01$211.43$93.19RVU24A
2023-10-01$223.33$95.71RVU23D
2023-07-01$223.33$95.71RVU23C
2023-04-01$223.33$95.71RVU23B
2023-01-01$223.33$95.71RVU23A
2022-10-01$232.83$96.67RVU22D
2022-07-01$232.83$96.67RVU22C
2022-04-01$232.83$96.67RVU22B
2022-01-01$232.83$96.67RVU22A
2021-10-01$236.58$96.43RVU21D
2021-07-01$236.58$96.43RVU21C
2021-04-01$236.58$96.43RVU21B
2021-01-01$236.58$96.43RVU21A
2020-10-01$222.90$99.83RVU20D
2020-07-01$222.90$99.83RVU20C
2020-04-01$222.90$99.83RVU20B
2020-01-01$222.90$99.83RVU20A
2019-10-01$219.17$100.92RVU19D
2019-07-01$219.17$100.92RVU19C
2019-04-01$219.17$100.92RVU19B
2019-01-01$219.17$100.92RVU19A
2018-10-01$216.73$101.18RVU18D
2018-07-01$216.73$101.18RVU18C
2018-04-01$216.73$101.18RVU18B
2018-01-01$216.73$101.18RVU18AR1
2017-10-01$217.26$101.75RVU17D
2017-07-01$217.26$101.75RVU17C
2017-04-01$217.26$101.75RVU17B
2017-01-01$217.26$101.75RVU17A
2016-10-01$217.49$101.58RVU16D
2016-07-01$217.49$101.58RVU16C
2016-04-01$217.49$101.58RVU16B
2016-01-01$217.49$101.58RVU16A
2015-10-01$218.64$101.95RVU15D
2015-07-01$218.64$101.95RVU15C
2015-04-01$217.56$101.44RVU15B
2015-01-01$217.56$101.44RVU15A
2014-10-01$213.22$97.95RVU14D
2014-07-01$213.22$97.95RVU14C
2014-04-01$213.22$97.95RVU14B
2014-01-01$213.22$97.95RVU14A
2013-10-01$217.65$94.05RVU13D
2013-07-01$217.65$94.05RVU13C
2013-04-01$217.65$94.05RVU13B
2013-01-01$217.65$94.05RVU13AR

Price 20200 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

20200 billing questions

How does this differ from 20205?

Use 20200 for an open biopsy of superficial muscle. Code 20205 describes an open biopsy of deep muscle.

When is 20206 more appropriate?

Code 20206 describes a percutaneous needle muscle biopsy. Use 20200 when the documented method is an open biopsy of superficial muscle.

Can modifier 50 be used for biopsies on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

Is same-day postoperative care separately included?

The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon report this procedure?

Medicare does not pay an assistant-at-surgery claim for 20200. Co-surgeons and team surgery are not permitted.

What documentation supports reporting 20200?

The operative report should identify the muscle and site, establish that the biopsy was open and superficial, and state why tissue was obtained.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 20200PPRRVU2026_Oct_nonQPP.csv, line 1,727 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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