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

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 Delaware, Medicare pays $220.85 for 20220 in the office and $75.98 when it’s performed in a hospital or facility.

$220.85Office (non-facility)
$75.98Hospital or facility
−1.0%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 Delaware
  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 Delaware 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. Delaware pays $220.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

20220 in Delaware vs other payment areas
  1. Delaware · this page$220.85
  2. Los Angeles, CA · California$253.37+$32.52
  3. Washington, DC area · District of Columbia$255.80+$34.95
  4. Miami, FL · Florida$238.51+$17.66
  5. Chicago, IL · Illinois$231.67+$10.82
  6. Manhattan, NY · New York$256.40+$35.55
  7. Alaska · Alaska$258.09+$37.24

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

Every other payment area

20220 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$200.20$71.89
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

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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 20220 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.61× 1.0051.6180
Practice expense4.90× 0.9884.8412
Malpractice0.17× 0.8990.1528
Total RVUs6.6121
Conversion factor× 33.4009

Office rate, Delaware$220.85

Office: (1.61 × 1.005 + 4.9 × 0.988 + 0.17 × 0.899) × $33.4009 = $220.85

Facility: (1.61 × 1.005 + 0.51 × 0.988 + 0.17 × 0.899) × $33.4009 = $75.98

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, Delaware
Same family
20225Bone biopsy, deep, needle or trocarNeedle or trocar biopsy for a deep bone site rather than a superficial site.$360.95
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 Delaware

20220 · Office / nonfacility

$220.85

Effective 2026-10-01

The base rate is $1.97 higher than on 2025-10-01, moving from $218.88 to $220.85 (0.9%).

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

    $218.88changed to$220.85

    • 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 1.009 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

    $229.54changed to$218.88

    • 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

    $225.80changed to$229.54

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $241.54changed to$225.80

    • 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 1.007 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

    $252.51changed to$241.54

    • 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 1.005 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

    $261.70changed to$252.51

    • 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

    $258.52changed to$261.70

    • 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 1.006 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

    $175.75changed to$258.52

    • 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 1.007 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

    $174.83changed to$175.75

    • 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

    $175.09changed to$174.83

    • Conversion factor 35.8887 changed to 35.9996
    • 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

    $176.55changed to$175.09

    • 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 1.012 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

    $176.81changed to$176.55

    • 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

    $175.93changed to$176.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $174.44changed to$175.93

    • 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
    • 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

    $174.83changed to$174.44

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.62 changed to 3.36
    • 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: $174.83

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$220.85$75.98RVU26D
2026-07-01$220.85$75.98RVU26C
2026-04-01$220.85$75.98RVU26B
2026-01-01$220.85$75.98RVU26A
2025-10-01$218.88$83.79RVU25D
2025-07-01$218.88$83.79RVU25C
2025-04-01$218.88$83.79RVU25B
2025-01-01$218.88$83.79RVU25A
2024-10-01$229.54$85.57RVU24D
2024-07-01$229.54$85.57RVU24C
2024-04-01$229.54$85.57RVU24B
2024-03-09$229.54$85.57RVU24AR
2024-01-01$225.80$84.17RVU24A
2023-10-01$241.54$87.98RVU23D
2023-07-01$241.54$87.98RVU23C
2023-04-01$241.54$87.98RVU23B
2023-01-01$241.54$87.98RVU23A
2022-10-01$252.51$88.40RVU22D
2022-07-01$252.51$88.40RVU22C
2022-04-01$252.51$88.40RVU22B
2022-01-01$252.51$88.40RVU22A
2021-10-01$261.70$89.46RVU21D
2021-07-01$261.70$89.46RVU21C
2021-04-01$261.70$89.46RVU21B
2021-01-01$261.70$89.46RVU21A
2020-10-01$258.52$93.08RVU20D
2020-07-01$258.52$93.08RVU20C
2020-04-01$258.52$93.08RVU20B
2020-01-01$258.52$93.08RVU20A
2019-10-01$175.75$75.50RVU19D
2019-07-01$175.75$75.50RVU19C
2019-04-01$175.75$75.50RVU19B
2019-01-01$175.75$75.50RVU19A
2018-10-01$174.83$75.78RVU18D
2018-07-01$174.83$75.78RVU18C
2018-04-01$174.83$75.78RVU18B
2018-01-01$174.83$75.78RVU18AR1
2017-10-01$175.09$76.13RVU17D
2017-07-01$175.09$76.13RVU17C
2017-04-01$175.09$76.13RVU17B
2017-01-01$175.09$76.13RVU17A
2016-10-01$176.55$76.88RVU16D
2016-07-01$176.55$76.88RVU16C
2016-04-01$176.55$76.88RVU16B
2016-01-01$176.55$76.88RVU16A
2015-10-01$176.81$77.16RVU15D
2015-07-01$176.81$77.16RVU15C
2015-04-01$175.93$76.77RVU15B
2015-01-01$175.93$76.77RVU15A
2014-10-01$174.44$75.90RVU14D
2014-07-01$174.44$75.90RVU14C
2014-04-01$174.44$75.90RVU14B
2014-01-01$174.44$75.90RVU14A
2013-10-01$174.83$72.53RVU13D
2013-07-01$174.83$72.53RVU13C
2013-04-01$174.83$72.53RVU13B
2013-01-01$174.83$72.53RVU13AR

Price 20220 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

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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