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CPT code 20206: Muscle biopsy, percutaneous needle approach2026 Medicare rate & RVUs in Delaware

Reports needle sampling of muscle through the skin to investigate suspected myopathy, including inflammatory, metabolic, or inherited muscle disease.

CMS RVU26DEffective Oct 1, 2026One payment locality16.8K Medicare services in 2024

In Delaware, Medicare pays $207.46 for 20206 in the office and $50.71 when it’s performed in a hospital or facility.

$207.46Office (non-facility)
$50.71Hospital or facility
−1.1%vs the national office rate ($209.76)

Check a contract rate as a % of Medicare · 20206 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 20206 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 20206 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 20206 covers

A clinician advances a biopsy needle through the skin into a selected muscle and obtains tissue for diagnostic evaluation. Neurologists, rheumatologists, surgeons, and other qualified clinicians may perform this procedure in an office or facility when a muscle specimen is needed to evaluate suspected inflammatory, metabolic, or inherited myopathy. The report should identify the sampled muscle and document the percutaneous needle approach and clinical reason for obtaining tissue.

Choose this code for needle sampling, rather than an open muscle biopsy code, based on the method actually performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 20206

Across 109 of 109 payment localities, the office rate for 20206 runs from $183.49 in Arkansas to $288.39 in San Benito County, CA. Delaware pays $207.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

20206 in Delaware vs other payment areas
  1. Delaware · this page$207.46
  2. Los Angeles, CA · California$241.64+$34.18
  3. Washington, DC area · District of Columbia$242.84+$35.38
  4. Miami, FL · Florida$222.50+$15.04
  5. Chicago, IL · Illinois$215.61+$8.15
  6. Manhattan, NY · New York$242.12+$34.66
  7. Alaska · Alaska$235.60+$28.14

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

Every other payment area

20206 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$186.45$47.63
ArkansasArkansas$183.49$47.20
ArizonaArizona$203.84$50.11
Bakersfield, CACalifornia$225.61$51.73
Chico, CACalifornia$225.28$51.39
El Centro, CACalifornia$225.30$51.41
Fresno, CACalifornia$225.28$51.39
Hanford, CACalifornia$225.28$51.39

20206 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.

$183.49

$256.84

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

View every state and territory as a table
20206 office rate range by state
State / territoryOffice rate rangeLocalities
AK$235.601
AL$186.451
AR$183.491
AZ$203.841
CA$225.28–$288.3929
CO$220.461
CT$224.551
DC$242.841
DE$207.461
FL$203.96–$222.503
GA$191.71–$213.372
GU$232.011
HI$232.011
IA$192.781
ID$193.931
IL$196.72–$217.514
IN$195.191
KS$191.261
KY$190.171
LA$189.63–$200.012
MA$218.74–$244.382
MD$211.86–$242.843
ME$194.47–$206.842
MI$195.12–$206.202
MN$212.211
MO$185.69–$201.433
MS$184.661
MT$209.751
NC$196.791
ND$207.581
NE$194.101
NH$216.421
NJ$227.39–$239.842
NM$196.081
NV$209.321
NY$199.98–$247.815
OH$194.681
OK$190.351
OR$207.97–$228.612
PA$195.31–$218.172
PR$211.611
RI$215.711
SC$196.011
SD$207.321
TN$192.251
TX$193.87–$219.488
UT$198.961
VA$205.72–$242.842
VI$211.611
VT$206.211
WA$218.51–$250.132
WI$199.921
WV$188.591
WY$208.801

See 20206 in every payment locality

How the 20206 rate is calculated

Each of 20206’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 · 20206

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.97

0.97 RVUs× 1.000 GPCI

Practice expense5.20

5.20 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

6.2800

Conversion factor

$33.4009

Medicare rate

$209.76

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

1,729

Code
20206
Physician work
0.97
Practice expense
5.20
Malpractice
0.11

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 20206 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.97× 1.0050.9748
Practice expense5.20× 0.9885.1376
Malpractice0.11× 0.8990.0989
Total RVUs6.2113
Conversion factor× 33.4009

Office rate, Delaware$207.46

Office: (0.97 × 1.005 + 5.2 × 0.988 + 0.11 × 0.899) × $33.4009 = $207.46

Facility: (0.97 × 1.005 + 0.45 × 0.988 + 0.11 × 0.899) × $33.4009 = $50.71

Open 20206 in the RVU calculator

Payment rules and modifiers for 20206

The CMS indicators that decide how 20206 is paid alongside other services.

CMS payment indicators · 20206

Muscle biopsy, percutaneous needle 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

20206 without 51 · national office

$209.76

Muscle biopsy, percutaneous needle approach

20206-51 · Second procedure: 50%

$104.88

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 20206

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

Codes related to 20206
CodeHow it relatesOffice range, Delaware
Used instead
20200Muscle biopsy, superficial, open approachOpen superficial muscle biopsy, rather than percutaneous needle sampling.$238.63
20205Muscle biopsy, open deep-muscle approachDeep muscle biopsy by a different approach; select based on the procedure performed.$333.99
Often billed with
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationUltrasound guidance may be reported when performed and separately documented for needle placement.$63.61

How 20206 has changed in Delaware

20206 · Office / nonfacility

$207.46

Effective 2026-10-01

The base rate is $2.33 higher than on 2025-10-01, moving from $205.13 to $207.46 (1.1%).

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

    $205.13changed to$207.46

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.99 changed to 0.97
    • Practice expense RVU 5.29 changed to 5.20
    • Malpractice RVU 0.10 changed to 0.11
    • 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

    $216.71changed to$205.13

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.46 changed to 5.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $213.17changed to$216.71

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $229.76changed to$213.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.65 changed to 5.46
    • 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

    $243.16changed to$229.76

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.82 changed to 5.65
    • Malpractice RVU 0.09 changed to 0.10
    • 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

    $253.02changed to$243.16

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.04 changed to 5.82

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $248.56changed to$253.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.68 changed to 6.04
    • 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

    $246.31changed to$248.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.63 changed to 5.68
    • 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

    $245.71changed to$246.31

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.61 changed to 5.63
    • Malpractice RVU 0.10 changed to 0.09

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $245.47changed to$245.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.59 changed to 5.61
    • 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

    $247.58changed to$245.47

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.63 changed to 5.59
    • 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

    $248.10changed to$247.58

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.62 changed to 5.63

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $246.86changed to$248.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $244.29changed to$246.86

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.52 changed to 5.62
    • 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

    $248.78changed to$244.29

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.98 changed to 5.52
    • 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: $248.78

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$207.46$50.71RVU26D
2026-07-01$207.46$50.71RVU26C
2026-04-01$207.46$50.71RVU26B
2026-01-01$207.46$50.71RVU26A
2025-10-01$205.13$55.28RVU25D
2025-07-01$205.13$55.28RVU25C
2025-04-01$205.13$55.28RVU25B
2025-01-01$205.13$55.28RVU25A
2024-10-01$216.71$56.22RVU24D
2024-07-01$216.71$56.22RVU24C
2024-04-01$216.71$56.22RVU24B
2024-03-09$216.71$56.22RVU24AR
2024-01-01$213.17$55.31RVU24A
2023-10-01$229.76$57.44RVU23D
2023-07-01$229.76$57.44RVU23C
2023-04-01$229.76$57.44RVU23B
2023-01-01$229.76$57.44RVU23A
2022-10-01$243.16$58.19RVU22D
2022-07-01$243.16$58.19RVU22C
2022-04-01$243.16$58.19RVU22B
2022-01-01$243.16$58.19RVU22A
2021-10-01$253.02$58.31RVU21D
2021-07-01$253.02$58.31RVU21C
2021-04-01$253.02$58.31RVU21B
2021-01-01$253.02$58.31RVU21A
2020-10-01$248.56$61.01RVU20D
2020-07-01$248.56$61.01RVU20C
2020-04-01$248.56$61.01RVU20B
2020-01-01$248.56$61.01RVU20A
2019-10-01$246.31$61.59RVU19D
2019-07-01$246.31$61.59RVU19C
2019-04-01$246.31$61.59RVU19B
2019-01-01$246.31$61.59RVU19A
2018-10-01$245.71$62.29RVU18D
2018-07-01$245.71$62.29RVU18C
2018-04-01$245.71$62.29RVU18B
2018-01-01$245.71$62.29RVU18AR1
2017-10-01$245.47$62.64RVU17D
2017-07-01$245.47$62.64RVU17C
2017-04-01$245.47$62.64RVU17B
2017-01-01$245.47$62.64RVU17A
2016-10-01$247.58$62.64RVU16D
2016-07-01$247.58$62.64RVU16C
2016-04-01$247.58$62.64RVU16B
2016-01-01$247.58$62.64RVU16A
2015-10-01$248.10$62.86RVU15D
2015-07-01$248.10$62.86RVU15C
2015-04-01$246.86$62.55RVU15B
2015-01-01$246.86$62.55RVU15A
2014-10-01$244.29$62.09RVU14D
2014-07-01$244.29$62.09RVU14C
2014-04-01$244.29$62.09RVU14B
2014-01-01$244.29$62.09RVU14A
2013-10-01$248.78$59.11RVU13D
2013-07-01$248.78$59.11RVU13C
2013-04-01$248.78$59.11RVU13B
2013-01-01$248.78$59.11RVU13AR

Price 20206 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

20206 billing questions

How does 20206 differ from 20200?

20206 is for muscle tissue obtained with a percutaneous needle. 20200 is used when the muscle biopsy is performed by an open approach.

When would 20205 be selected instead?

Use 20205 for a deep muscle biopsy performed by an approach described by that code, rather than a percutaneous needle biopsy. Document the approach and target muscle.

Can modifier 50 be used for biopsies on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.

Is same-day evaluation and aftercare included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

How does Medicare treat other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction. An assistant at surgery is not paid; co-surgeons and team surgery are not permitted.

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 20206PPRRVU2026_Oct_nonQPP.csv, line 1,729 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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