CPT code 20205: Muscle biopsy, open deep-muscle approach2026 Medicare rate & RVUs in Vermont

In Vermont, Medicare pays $325.56 for 20205 in the office and $135.75 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 20205 nationwide

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

What 20205 covers

The clinician obtains a muscle specimen through an incision that reaches deep muscle tissue. This approach may be selected when evaluation of suspected neuromuscular disease requires tissue for laboratory examination and a needle sample is not performed. A surgeon commonly performs the procedure in a hospital or ambulatory surgery setting; the specimen is sent for pathologic evaluation.

Select this code for an open biopsy of deep muscle, not a superficial muscle sample or percutaneous needle biopsy. The operative note should identify the muscle sampled and document the open approach and depth. Same-day preoperative and postoperative care is included in the 0-day global period. When other procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Medicare does not pay an assistant at surgery for this code; 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 Vermont compares for 20205

Across 109 of 109 payment localities, the office rate for 20205 runs from $294.25 in Arkansas to $443.32 in San Benito County, CA. Vermont pays $325.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

20205 rates by state

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

See 20205 in every payment locality

How the 20205 rate is calculated

Each of 20205’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.

Payment rules and modifiers for 20205

The CMS indicators that decide how 20205 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 20205

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

How 20205 has changed in Vermont

Price 20205 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates