CPT code 20245: Bone biopsy, open approach, deep site2026 Medicare rate & RVUs

Medicare pays $303.28 for 20245 nationally in a facility.

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

What 20245 covers

A surgeon obtains bone tissue from a deep site through an open approach, rather than through a percutaneous trocar or needle technique. The specimen may be taken to investigate suspected osteomyelitis, a primary bone tumor, metastatic disease, or another unexplained bone lesion. Orthopedic and orthopedic oncology surgeons commonly perform the procedure in an operating room; it may also be performed in an appropriately equipped office setting.

Select this code when the documented procedure is an open biopsy of a deep bone site. The operative note should identify the bone and site, describe the open approach and sampling, and state the clinical reason for obtaining tissue. Same-day preoperative and postoperative care is included in the 0-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, 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 20245 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

20245 rates by state

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

How the 20245 rate is calculated

Each of 20245’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 20245

The CMS indicators that decide how 20245 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

20245 compared with similar codes

How to choose

20240Bone biopsyOpen, superficial

Both describe open bone biopsy. Choose 20240 for a superficial site and 20245 for a deep site.

20225Bone biopsyDeep, needle or trocar

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

20250Vertebral biopsyOpen, thoracic level

20250 is specific to open biopsy of a thoracic vertebral body; 20245 is for deep bone sites outside that specific code description.

20251Vertebral biopsyOpen, cervical or lumbar

20251 is specific to open biopsy of a lumbar or cervical vertebral body; 20245 describes open biopsy of a deep bone site more generally.

Codes related to 20245

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