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

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 Queens, NY, Medicare pays $423.96 for 20225 in the office and $126.67 when it’s performed in a hospital or facility.

$423.96Office (non-facility)
$126.67Hospital or facility
+16.2%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $423.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

20225 in Queens, NY vs other payment areas
  1. Queens, NY · this page$423.96
  2. Manhattan, NY · New York$419.68−$4.28
  3. NYC suburbs and Long Island, NY · New York$429.50+$5.54
  4. Poughkeepsie and northern NYC suburbs, NY · New York$396.40−$27.56
  5. Rest of New York · New York$348.35−$75.61
  6. Los Angeles, CA · California$415.64−$8.32
  7. Washington, DC area · District of Columbia$419.20−$4.76

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

Every other payment area

20225 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$389.34$127.52
Chicago, ILIllinois$377.92$125.16
AlaskaAlaska$418.71$150.85
AlabamaAlabama$326.44$106.37
ArkansasArkansas$321.58$105.53
ArizonaArizona$354.92$111.21
Bakersfield, CACalifornia$389.38$113.72
Chico, CACalifornia$388.58$112.93

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 20225 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work2.39× 1.0642.5430
Practice expense8.27× 1.1829.7751
Malpractice0.26× 1.4420.3749
Total RVUs12.6930
Conversion factor× 33.4009

Office rate, Queens, NY$423.96

Office: (2.39 × 1.064 + 8.27 × 1.182 + 0.26 × 1.442) × $33.4009 = $423.96

Facility: (2.39 × 1.064 + 0.74 × 1.182 + 0.26 × 1.442) × $33.4009 = $126.67

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, Queens, NY
Same family
20220Bone biopsy, trocar or needle, superficialPercutaneous needle or trocar bone biopsy for a superficial rather than deep site.$258.86
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 Queens, NY

20225 · Office / nonfacility

$423.96

Effective 2026-10-01

The base rate is $3.82 higher than on 2025-10-01, moving from $420.14 to $423.96 (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

    $420.14changed to$423.96

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $441.91changed to$420.14

    • 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

    $434.70changed to$441.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $471.49changed to$434.70

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.91 changed to 8.62
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $500.41changed to$471.49

    • 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 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $517.34changed to$500.41

    • 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

    $517.87changed to$517.34

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $632.16changed to$517.87

    • 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 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $634.06changed to$632.16

    • 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

    $634.37changed to$634.06

    • 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
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $639.49changed to$634.37

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.91 changed to 12.75
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $641.21changed to$639.49

    • 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

    $638.02changed to$641.21

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $631.14changed to$638.02

    • 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 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $647.22changed to$631.14

    • 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 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $647.22

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$423.96$126.67RVU26D
2026-07-01$423.96$126.67RVU26C
2026-04-01$423.96$126.67RVU26B
2026-01-01$423.96$126.67RVU26A
2025-10-01$420.14$140.67RVU25D
2025-07-01$420.14$140.67RVU25C
2025-04-01$420.14$140.67RVU25B
2025-01-01$420.14$140.67RVU25A
2024-10-01$441.91$143.18RVU24D
2024-07-01$441.91$143.18RVU24C
2024-04-01$441.91$143.18RVU24B
2024-03-09$441.91$143.18RVU24AR
2024-01-01$434.70$140.84RVU24A
2023-10-01$471.49$151.14RVU23D
2023-07-01$471.49$151.14RVU23C
2023-04-01$471.49$151.14RVU23B
2023-01-01$471.49$151.14RVU23A
2022-10-01$500.41$157.88RVU22D
2022-07-01$500.41$157.88RVU22C
2022-04-01$500.41$157.88RVU22B
2022-01-01$500.41$157.88RVU22A
2021-10-01$517.34$158.26RVU21D
2021-07-01$517.34$158.26RVU21C
2021-04-01$517.34$158.26RVU21B
2021-01-01$517.34$158.26RVU21A
2020-10-01$517.87$162.11RVU20D
2020-07-01$517.87$162.11RVU20C
2020-04-01$517.87$162.11RVU20B
2020-01-01$517.87$162.11RVU20A
2019-10-01$632.16$128.77RVU19D
2019-07-01$632.16$128.77RVU19C
2019-04-01$632.16$128.77RVU19B
2019-01-01$632.16$128.77RVU19A
2018-10-01$634.06$129.49RVU18D
2018-07-01$634.06$129.49RVU18C
2018-04-01$634.06$129.49RVU18B
2018-01-01$634.06$129.49RVU18AR1
2017-10-01$634.37$131.35RVU17D
2017-07-01$634.37$131.35RVU17C
2017-04-01$634.37$131.35RVU17B
2017-01-01$634.37$131.35RVU17A
2016-10-01$639.49$131.64RVU16D
2016-07-01$639.49$131.64RVU16C
2016-04-01$639.49$131.64RVU16B
2016-01-01$639.49$131.64RVU16A
2015-10-01$641.21$133.68RVU15D
2015-07-01$641.21$133.68RVU15C
2015-04-01$638.02$133.01RVU15B
2015-01-01$638.02$133.01RVU15A
2014-10-01$631.14$132.02RVU14D
2014-07-01$631.14$132.02RVU14C
2014-04-01$631.14$132.02RVU14B
2014-01-01$631.14$132.02RVU14A
2013-10-01$647.22$125.58RVU13D
2013-07-01$647.22$125.58RVU13C
2013-04-01$647.22$125.58RVU13B
2013-01-01$647.22$125.58RVU13AR

Price 20225 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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