CPT code 20225: Bone biopsy, deep, needle or trocar2026 Medicare rate & RVUs

Medicare pays $364.74 for 20225 nationally in the office and $113.23 in a hospital or facility. Local office rates run $321.58–$491.58.

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

What 20225 covers

The clinician advances a biopsy needle or trocar through the skin to obtain tissue from a deep bone site. Orthopedic surgeons, radiologists, and interventional radiologists may perform the procedure when evaluation of a bone lesion, suspected osteomyelitis, or another bone abnormality requires tissue. The procedure is distinct from an open biopsy, which uses a surgical exposure, and from needle sampling of a superficial bone site.

Report 20225 when the documented approach is percutaneous and the sampled bone is deep; the operative or procedure note should identify the bone and target, the needle or trocar technique, and the reason for sampling. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur 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 for this code. Medicare does not pay an assistant at surgery, 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.

Where 20225 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

20225 rates by state

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

How the 20225 rate is calculated

Each of 20225’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 20225

The CMS indicators that decide how 20225 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

20225 compared with similar codes

How to choose

20220Bone biopsyTrocar or needle, superficial

Use 20220 for percutaneous needle or trocar biopsy of a superficial bone site; 20225 is for a deep bone site.

20240Bone biopsyOpen, superficial

20240 is an open biopsy of a superficial bone. 20225 uses a percutaneous needle or trocar to sample deep bone.

20245Bone biopsyOpen approach, deep site

Both concern deep bone, but 20245 uses an open approach; 20225 uses a percutaneous needle or trocar.

Codes related to 20225

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

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