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CPT code 20220: Bone biopsy, trocar or needle, superficial2026 Medicare rate & RVUs in Washington, DC area

A clinician obtains a sample from an anatomically superficial bone with a trocar or needle to evaluate suspected infection, neoplasm, or other bone disease.

CMS RVU26DEffective Oct 1, 2026One payment locality11.6K Medicare services in 2024

In Washington, DC area, Medicare pays $255.80 for 20220 in the office and $83.07 when it’s performed in a hospital or facility.

$255.80Office (non-facility)
$83.07Hospital or facility
+14.6%vs the national office rate ($223.12)

Check a contract rate as a % of Medicare · 20220 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 20220 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 20220 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 20220 covers

Code 20220 describes sampling bone through a trocar or biopsy needle at a site classified as superficial, rather than exposing bone through an open incision. Typical targets include the ilium, sternum, ribs, and spinous processes. The service may be performed by an interventional radiologist, orthopedic surgeon, or another clinician experienced in percutaneous bone sampling, often in an imaging or procedure suite; it may also be performed in an office setting when appropriate. The purpose may be to investigate a focal lesion, suspected bone infection, or unexplained abnormality and provide tissue for pathology or microbiology.

Choose 20220 based on the bone-site category and needle or trocar approach; use 20225 for a deep site and an open bone-biopsy code when bone is exposed surgically. Documentation should identify the target bone, approach, specimen obtained, and clinical indication. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery reporting 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 Washington, DC area compares for 20220

Across 109 of 109 payment localities, the office rate for 20220 runs from $197.29 in Arkansas to $298.74 in San Benito County, CA. Washington, DC area pays $255.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

20220 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$255.80
  2. Los Angeles, CA · California$253.37−$2.43
  3. Miami, FL · Florida$238.51−$17.29
  4. Chicago, IL · Illinois$231.67−$24.13
  5. Manhattan, NY · New York$256.40+$0.60
  6. Alaska · Alaska$258.09+$2.29
  7. Alabama · Alabama$200.20−$55.60

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

20220 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$197.29$71.33
ArizonaArizona$217.23$75.14
Bakersfield, CACalifornia$237.63$76.92
Chico, CACalifornia$237.11$76.40
El Centro, CACalifornia$237.14$76.43
Fresno, CACalifornia$237.11$76.40
Hanford, CACalifornia$237.11$76.40
Madera, CACalifornia$237.11$76.40

20220 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.

$197.29

$267.93

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

View every state and territory as a table
20220 office rate range by state
State / territoryOffice rate rangeLocalities
AK$258.091
AL$200.201
AR$197.291
AZ$217.231
CA$237.11–$298.7429
CO$232.991
CT$237.991
DC$255.801
DE$220.851
FL$218.77–$238.513
GA$206.53–$227.042
GU$243.151
HI$243.151
IA$205.781
ID$207.031
IL$212.08–$232.304
IN$208.251
KS$204.591
KY$204.471
LA$204.06–$214.232
MA$231.50–$256.452
MD$225.15–$255.803
ME$207.88–$219.552
MI$209.61–$221.282
MN$223.871
MO$200.38–$215.273
MS$198.891
MT$223.111
NC$210.101
ND$219.751
NE$206.981
NH$229.121
NJ$240.88–$253.082
NM$210.681
NV$222.331
NY$213.25–$262.365
OH$208.921
OK$204.341
OR$220.78–$240.692
PA$209.39–$231.892
PR$224.831
RI$228.931
SC$209.831
SD$219.351
TN$205.601
TX$207.99–$232.078
UT$212.721
VA$218.67–$255.802
VI$224.831
VT$218.681
WA$231.13–$261.922
WI$212.311
WV$204.131
WY$221.641

See 20220 in every payment locality

How the 20220 rate is calculated

Each of 20220’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 · 20220

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.61

1.61 RVUs× 1.000 GPCI

Practice expense4.90

4.90 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

6.6800

Conversion factor

$33.4009

Medicare rate

$223.12

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,732

Code
20220
Physician work
1.61
Practice expense
4.90
Malpractice
0.17

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 20220 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.61× 1.0541.6969
Practice expense4.90× 1.1785.7722
Malpractice0.17× 1.1130.1892
Total RVUs7.6583
Conversion factor× 33.4009

Office rate, Washington, DC area$255.80

Office: (1.61 × 1.054 + 4.9 × 1.178 + 0.17 × 1.113) × $33.4009 = $255.80

Facility: (1.61 × 1.054 + 0.51 × 1.178 + 0.17 × 1.113) × $33.4009 = $83.07

Open 20220 in the RVU calculator

Payment rules and modifiers for 20220

The CMS indicators that decide how 20220 is paid alongside other services.

CMS payment indicators · 20220

Bone biopsy, trocar or needle, superficial

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

20220 without 51 · national office

$223.12

Bone biopsy, trocar or needle, superficial

20220-51 · Second procedure: 50%

$111.56

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 20220

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

Codes related to 20220
CodeHow it relatesOffice range, Washington, DC area
Same family
20225Bone biopsy, deep, needle or trocarNeedle or trocar biopsy for a deep bone site rather than a superficial site.$419.20
Used instead
20240Bone biopsy, open, superficialOpen biopsy for a superficial bone site when the bone is exposed surgically.No office rate
20245Bone biopsy, open approach, deep siteOpen biopsy for a deep bone site rather than needle or trocar sampling.No office rate

How 20220 has changed in Washington, DC area

20220 · Office / nonfacility

$255.80

Effective 2026-10-01

The base rate is $0.94 higher than on 2025-10-01, moving from $254.86 to $255.80 (0.4%).

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

    $254.86changed to$255.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.65 changed to 1.61
    • Practice expense RVU 4.99 changed to 4.90
    • Malpractice RVU 0.16 changed to 0.17
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $267.43changed to$254.86

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.12 changed to 4.99

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $263.07changed to$267.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $282.94changed to$263.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.27 changed to 5.12
    • Malpractice RVU 0.17 changed to 0.16
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $297.00changed to$282.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.39 changed to 5.27
    • Malpractice RVU 0.14 changed to 0.17
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $308.11changed to$297.00

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.58 changed to 5.39
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $300.24changed to$308.11

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.26 changed to 5.58
    • Malpractice RVU 0.13 changed to 0.15
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $200.91changed to$300.24

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.27 changed to 1.65
    • Practice expense RVU 3.41 changed to 5.26
    • Malpractice RVU 0.11 changed to 0.13
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $199.83changed to$200.91

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.39 changed to 3.41

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $199.39changed to$199.83

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $200.41changed to$199.39

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.41 changed to 3.39
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $200.70changed to$200.41

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.40 changed to 3.41

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $199.70changed to$200.70

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $197.20changed to$199.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.36 changed to 3.40
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $197.11changed to$197.20

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.62 changed to 3.36
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $197.11

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$255.80$83.07RVU26D
2026-07-01$255.80$83.07RVU26C
2026-04-01$255.80$83.07RVU26B
2026-01-01$255.80$83.07RVU26A
2025-10-01$254.86$92.53RVU25D
2025-07-01$254.86$92.53RVU25C
2025-04-01$254.86$92.53RVU25B
2025-01-01$254.86$92.53RVU25A
2024-10-01$267.43$94.43RVU24D
2024-07-01$267.43$94.43RVU24C
2024-04-01$267.43$94.43RVU24B
2024-03-09$267.43$94.43RVU24AR
2024-01-01$263.07$92.89RVU24A
2023-10-01$282.94$97.81RVU23D
2023-07-01$282.94$97.81RVU23C
2023-04-01$282.94$97.81RVU23B
2023-01-01$282.94$97.81RVU23A
2022-10-01$297.00$98.53RVU22D
2022-07-01$297.00$98.53RVU22C
2022-04-01$297.00$98.53RVU22B
2022-01-01$297.00$98.53RVU22A
2021-10-01$308.11$99.80RVU21D
2021-07-01$308.11$99.80RVU21C
2021-04-01$308.11$99.80RVU21B
2021-01-01$308.11$99.80RVU21A
2020-10-01$300.24$102.39RVU20D
2020-07-01$300.24$102.39RVU20C
2020-04-01$300.24$102.39RVU20B
2020-01-01$300.24$102.39RVU20A
2019-10-01$200.91$82.36RVU19D
2019-07-01$200.91$82.36RVU19C
2019-04-01$200.91$82.36RVU19B
2019-01-01$200.91$82.36RVU19A
2018-10-01$199.83$82.70RVU18D
2018-07-01$199.83$82.70RVU18C
2018-04-01$199.83$82.70RVU18B
2018-01-01$199.83$82.70RVU18AR1
2017-10-01$199.39$83.06RVU17D
2017-07-01$199.39$83.06RVU17C
2017-04-01$199.39$83.06RVU17B
2017-01-01$199.39$83.06RVU17A
2016-10-01$200.41$83.92RVU16D
2016-07-01$200.41$83.92RVU16C
2016-04-01$200.41$83.92RVU16B
2016-01-01$200.41$83.92RVU16A
2015-10-01$200.70$84.23RVU15D
2015-07-01$200.70$84.23RVU15C
2015-04-01$199.70$83.81RVU15B
2015-01-01$199.70$83.81RVU15A
2014-10-01$197.20$83.09RVU14D
2014-07-01$197.20$83.09RVU14C
2014-04-01$197.20$83.09RVU14B
2014-01-01$197.20$83.09RVU14A
2013-10-01$197.11$79.72RVU13D
2013-07-01$197.11$79.72RVU13C
2013-04-01$197.11$79.72RVU13B
2013-01-01$197.11$79.72RVU13AR

Price 20220 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

20220 billing questions

How do I choose between 20220 and 20225?

Use 20220 for a bone site classified as superficial, such as the ilium, sternum, ribs, or spinous process. Use 20225 for a deep bone site; the distinction is not determined only by how far the needle travels.

Does 20220 include an open surgical exposure?

No. This code is for needle or trocar sampling. When the bone is exposed through an incision, consider the applicable open bone-biopsy code, such as 20240 for a superficial site.

Can imaging guidance be billed separately?

The code describes bone sampling, not image guidance itself. Separately report guidance only when a distinct guidance service is performed, documented, and meets the requirements of the applicable guidance code.

How are other procedures in the same session paid?

Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are reduced by 50% when performed in the same session.

Can I append modifier 50 or report an assistant?

Modifier 50 is inappropriate for this code. CMS also restricts assistant-at-surgery payment and does not permit co-surgeon or team-surgery reporting.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care. Document the biopsy target, needle or trocar approach, specimen, and indication.

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 20220PPRRVU2026_Oct_nonQPP.csv, line 1,732 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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