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CPT code 20225: Bone biopsy, deep, needle or trocar2026 Medicare rate & RVUs in Los Angeles, CA

Reports percutaneous sampling of a deep bone with a needle or trocar to investigate a lesion, suspected infection, or other bone abnormality.

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

In Los Angeles, CA, Medicare pays $415.64 for 20225 in the office and $118.11 when it’s performed in a hospital or facility.

$415.64Office (non-facility)
$118.11Hospital or facility
+14.0%vs the national office rate ($364.74)

Check a contract rate as a % of Medicare · 20225 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 20225 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 20225 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 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.

How Los Angeles, CA compares for 20225

Across 109 of 109 payment localities, the office rate for 20225 runs from $321.58 in Arkansas to $491.58 in San Benito County, CA. Los Angeles, CA pays $415.64. The RVUs are the same everywhere; the geographic indexes change the dollars.

20225 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$415.64
  2. Bakersfield, CA · California$389.38−$26.26
  3. Chico, CA · California$388.58−$27.06
  4. El Centro, CA · California$388.63−$27.01
  5. Fresno, CA · California$388.58−$27.06
  6. Hanford, CA · California$388.58−$27.06
  7. Madera, CA · California$388.58−$27.06

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

Every other payment area

20225 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$388.58$112.93
Modesto, CACalifornia$388.58$112.93
Napa, CACalifornia$453.33$121.85
Oxnard, CACalifornia$413.97$116.69
Redding, CACalifornia$388.58$112.93
Rest of CaliforniaCalifornia$388.58$112.93
Riverside, CACalifornia$391.42$115.76
Sacramento, CACalifornia$408.61$116.10

20225 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.

$321.58

$440.08

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

View every state and territory as a table
20225 office rate range by state
State / territoryOffice rate rangeLocalities
AK$418.711
AL$326.441
AR$321.581
AZ$354.921
CA$388.58–$491.5829
CO$381.471
CT$389.431
DC$419.201
DE$360.951
FL$356.95–$389.343
GA$336.57–$371.142
GU$398.921
HI$398.921
IA$336.021
ID$338.061
IL$345.60–$379.464
IN$340.111
KS$333.911
KY$333.341
LA$332.61–$349.622
MA$378.89–$420.642
MD$368.14–$419.203
ME$339.36–$359.052
MI$341.83–$361.032
MN$366.631
MO$326.39–$351.503
MS$324.081
MT$364.721
NC$343.101
ND$359.581
NE$338.071
NH$374.981
NJ$394.19–$414.552
NM$343.561
NV$363.561
NY$348.35–$429.505
OH$340.781
OK$333.251
OR$361.05–$394.452
PA$341.61–$379.182
PR$367.651
RI$374.431
SC$342.441
SD$358.971
TN$335.581
TX$339.26–$379.938
UT$347.281
VA$357.49–$419.202
VI$367.651
VT$357.691
WA$378.34–$429.842
WI$347.131
WV$332.301
WY$362.481

See 20225 in every payment locality

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.

How the rate is built · 20225

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.39

2.39 RVUs× 1.000 GPCI

Practice expense8.27

8.27 RVUs× 1.000 GPCI

Malpractice0.26

0.26 RVUs× 1.000 GPCI

Adjusted RVUs

10.9200

Conversion factor

$33.4009

Medicare rate

$364.74

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

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,733

Code
20225
Physician work
2.39
Practice expense
8.27
Malpractice
0.26

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 20225 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work2.39× 1.0412.4880
Practice expense8.27× 1.1839.7834
Malpractice0.26× 0.6640.1726
Total RVUs12.4440
Conversion factor× 33.4009

Office rate, Los Angeles, CA$415.64

Office: (2.39 × 1.041 + 8.27 × 1.183 + 0.26 × 0.664) × $33.4009 = $415.64

Facility: (2.39 × 1.041 + 0.74 × 1.183 + 0.26 × 0.664) × $33.4009 = $118.11

Open 20225 in the RVU calculator

Payment rules and modifiers for 20225

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

CMS payment indicators · 20225

Bone biopsy, deep, needle or trocar

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

20225 without 51 · national office

$364.74

Bone biopsy, deep, needle or trocar

20225-51 · Second procedure: 50%

$182.37

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 20225

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

Codes related to 20225
CodeHow it relatesOffice range, Los Angeles, CA
Same family
20220Bone biopsy, trocar or needle, superficialPercutaneous needle or trocar bone biopsy for a superficial rather than deep site.$253.37
20240Bone biopsy, open, superficialOpen biopsy of a superficial bone site, rather than percutaneous sampling.No office rate
20245Bone biopsy, open approach, deep siteOpen biopsy of a deep bone site, rather than needle or trocar sampling.No office rate

How 20225 has changed in Los Angeles, CA

20225 · Office / nonfacility

$415.64

Effective 2026-10-01

The base rate is $3.83 higher than on 2025-10-01, moving from $411.81 to $415.64 (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

    $411.81changed to$415.64

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.45 changed to 2.39
    • Practice expense RVU 8.38 changed to 8.27
    • Malpractice RVU 0.25 changed to 0.26
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $433.33changed to$411.81

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.62 changed to 8.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $426.25changed to$433.33

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $450.69changed to$426.25

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.91 changed to 8.62
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $467.75changed to$450.69

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.17 changed to 8.91
    • Malpractice RVU 0.23 changed to 0.25
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $484.49changed to$467.75

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.49 changed to 9.17
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $490.75changed to$484.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.24 changed to 9.49
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $612.01changed to$490.75

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.87 changed to 2.45
    • Practice expense RVU 12.66 changed to 9.24
    • Malpractice RVU 0.18 changed to 0.23
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $613.88changed to$612.01

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.72 changed to 12.66

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $610.64changed to$613.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.75 changed to 12.72
    • Malpractice RVU 0.19 changed to 0.18
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $612.93changed to$610.64

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.91 changed to 12.75
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $613.71changed to$612.93

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.86 changed to 12.91
    • Malpractice RVU 0.21 changed to 0.19

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $610.66changed to$613.71

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $603.99changed to$610.66

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.73 changed to 12.86
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $619.43changed to$603.99

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.97 changed to 12.73
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$619.43

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$415.64$118.11RVU26D
2026-07-01$415.64$118.11RVU26C
2026-04-01$415.64$118.11RVU26B
2026-01-01$415.64$118.11RVU26A
2025-10-01$411.81$132.57RVU25D
2025-07-01$411.81$132.57RVU25C
2025-04-01$411.81$132.57RVU25B
2025-01-01$411.81$132.57RVU25A
2024-10-01$433.33$134.84RVU24D
2024-07-01$433.33$134.84RVU24C
2024-04-01$433.33$134.84RVU24B
2024-03-09$433.33$134.84RVU24AR
2024-01-01$426.25$132.64RVU24A
2023-10-01$450.69$137.47RVU23D
2023-07-01$450.69$137.47RVU23C
2023-04-01$450.69$137.47RVU23B
2023-01-01$450.69$137.47RVU23A
2022-10-01$467.75$140.02RVU22D
2022-07-01$467.75$140.02RVU22C
2022-04-01$467.75$140.02RVU22B
2022-01-01$467.75$140.02RVU22A
2021-10-01$484.49$140.91RVU21D
2021-07-01$484.49$140.91RVU21C
2021-04-01$484.49$140.91RVU21B
2021-01-01$484.49$140.91RVU21A
2020-10-01$490.75$146.13RVU20D
2020-07-01$490.75$146.13RVU20C
2020-04-01$490.75$146.13RVU20B
2020-01-01$490.75$146.13RVU20A
2019-10-01$612.01$118.26RVU19D
2019-07-01$612.01$118.26RVU19C
2019-04-01$612.01$118.26RVU19B
2019-01-01$612.01$118.26RVU19A
2018-10-01$613.88$118.98RVU18D
2018-07-01$613.88$118.98RVU18C
2018-04-01$613.88$118.98RVU18B
2018-01-01$613.88$118.98RVU18AR1
2017-10-01$610.64$120.62RVU17D
2017-07-01$610.64$120.62RVU17C
2017-04-01$610.64$120.62RVU17B
2017-01-01$610.64$120.62RVU17A
2016-10-01$612.93$121.17RVU16D
2016-07-01$612.93$121.17RVU16C
2016-04-01$612.93$121.17RVU16B
2016-01-01$612.93$121.17RVU16A
2015-10-01$613.71$122.26RVU15D
2015-07-01$613.71$122.26RVU15C
2015-04-01$610.66$121.65RVU15B
2015-01-01$610.66$121.65RVU15A
2014-10-01$603.99$121.13RVU14D
2014-07-01$603.99$121.13RVU14C
2014-04-01$603.99$121.13RVU14B
2014-01-01$603.99$121.13RVU14A
2013-10-01$619.43$115.70RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 20225 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

20225 billing questions

How does 20225 differ from 20220?

Both describe percutaneous bone sampling with a needle or trocar. Choose 20225 for a deep bone site and 20220 for a superficial bone site.

When is 20245 more appropriate?

20245 describes an open biopsy of a deep bone. Use 20225 when the deep-bone sample is obtained percutaneously with a needle or trocar.

Can modifier 50 be used for bilateral bone biopsies?

No. CMS identifies modifier 50 as inappropriate for 20225; document the sampled site or sites and follow applicable coding instructions.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 20225. Co-surgeons and team surgery are not permitted.

What same-day care is included in the payment?

The 0-day global period includes same-day preoperative and postoperative care. Routine care related to the biopsy is part of the procedure.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

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 20225PPRRVU2026_Oct_nonQPP.csv, line 1,733 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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