CPT code 20240: Bone biopsy, open, superficial2026 Medicare rate & RVUs in Missouri
Report this service when a clinician uses an open approach to obtain a specimen from a superficial bone for diagnostic evaluation.
CMS doesn’t publish an office rate for 20240 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 20240 covers
The clinician makes an incision and obtains bone tissue directly from a superficial site for diagnostic evaluation, such as investigation of a suspected bone lesion or infection. An orthopedic surgeon or another qualified proceduralist may perform the biopsy in an operating room or an office-based setting, depending on the clinical circumstances. The tissue may be submitted for pathologic or microbiologic examination according to the diagnostic question.
Choose this code when the documented method is open and the sampled bone is superficial; a needle or trocar technique, or a deep bone site, points to a different code. The operative note should identify the bone and site, explain the reason for sampling, and describe the open approach and specimen obtained. This minor procedure has 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; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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 20240 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $124.42 |
| Metropolitan St. Louis, MO | Unavailable | $125.09 |
| Rest of Missouri | Unavailable | $121.95 |
How the 20240 rate is calculated
Each of 20240’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 · 20240
RVUs × geographic indexes × conversion factor
Work2.54
2.54 RVUs× 1.000 GPCI
Practice expense0.95
0.95 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
3.7900
Conversion factor
$33.4009
Medicare rate
$126.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20240
The CMS indicators that decide how 20240 is paid alongside other services.
CMS payment indicators · 20240
Bone biopsy, open, superficial
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20240 without 51 · national facility
$126.59
Bone biopsy, open, superficial
20240-51 · Second procedure: 50%
$63.30
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%).
20240 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20220Bone biopsyTrocar or needle, superficial
- Both concern superficial bone sampling, but 20220 describes a trocar or needle approach; this code is for open sampling.
- 20225Bone biopsyDeep, needle or trocar
- 20225 is for deep bone sampling by trocar or needle. This code describes an open approach to superficial bone.
- 20245Bone biopsyOpen approach, deep site
- Both use an open approach, but 20245 is selected for a deep bone site rather than a superficial one.
20240 billing questions
How is this distinguished from a needle bone biopsy?
Use this code for an open approach to superficial bone. A trocar or needle approach is reported with the corresponding percutaneous bone-biopsy code.
When should the deep open bone biopsy code be used instead?
Use the deep open code when the documented biopsy site is deep rather than superficial. The operative note should support the site and approach selected.
Is modifier 50 appropriate for bilateral biopsies?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How are same-session procedures affected by the multiple procedure rule?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard 50% reduction.
Can an assistant surgeon, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment is restricted for this code. Co-surgeon and team-surgery billing are not permitted.
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
Fee sheets · Coming soon
Put 20240 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist