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

Reports open sampling of a deep bone site to investigate conditions such as suspected infection, a bone lesion, or possible malignancy.

CMS RVU26DEffective Oct 1, 2026One payment locality4.7K Medicare services in 2024

In Utah, Medicare pays $295.33 for 20245 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$295.33Hospital or facility

Check a contract rate as a % of Medicare · 20245 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 20245 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 20245 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 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.

How Utah compares for 20245

Across 109 of 109 payment localities, the facility rate for 20245 runs from $275.86 in Nebraska to $389.96 in Alaska. Utah pays $295.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

20245 in Utah vs other payment areas
  1. Utah · this page$295.33
  2. Los Angeles, CA · California$312.83+$17.50
  3. Washington, DC area · District of Columbia$330.76+$35.43
  4. Miami, FL · Florida$359.89+$64.56
  5. Chicago, IL · Illinois$350.43+$55.10
  6. Manhattan, NY · New York$348.13+$52.80
  7. Alaska · Alaska$389.96+$94.63

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

Every other payment area

20245 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$278.96
ArkansasArkansas—$276.00
ArizonaArizona—$295.97
Bakersfield, CACalifornia—$300.27
Chico, CACalifornia—$297.32
El Centro, CACalifornia—$297.49
Fresno, CACalifornia—$297.32
Hanford, CACalifornia—$297.32

20245 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
20245 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 20245 in every payment locality

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.

How the rate is built · 20245

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.85

5.85 RVUs× 1.000 GPCI

Practice expense2.18

2.18 RVUs× 1.000 GPCI

Malpractice1.05

1.05 RVUs× 1.000 GPCI

Adjusted RVUs

9.0800

Conversion factor

$33.4009

Medicare rate

$303.28

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,737

Code
20245
Physician work
5.85
Practice expense
2.18
Malpractice
1.05

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Facility calculation for 20245 in Utah
ComponentRVULocality factorAdjusted
Physician work5.85× 1.0005.8500
Practice expense2.18× 0.9402.0492
Malpractice1.05× 0.8980.9429
Total RVUs8.8421
Conversion factor× 33.4009

Facility rate, Utah$295.33

Facility: (5.85 × 1 + 2.18 × 0.94 + 1.05 × 0.898) × $33.4009 = $295.33

Open 20245 in the RVU calculator

Payment rules and modifiers for 20245

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

CMS payment indicators · 20245

Bone biopsy, open approach, deep site

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

20245 without 51 · national facility

$303.28

Bone biopsy, open approach, deep site

20245-51 · Second procedure: 50%

$151.64

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

How 20245 has changed in Utah

20245 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$295.33RVU26D
2026-07-01Not available in this setting$295.33RVU26C
2026-04-01Not available in this setting$295.33RVU26B
2026-01-01Not available in this setting$295.33RVU26A
2025-10-01Not available in this setting$323.15RVU25D
2025-07-01Not available in this setting$323.15RVU25C
2025-04-01Not available in this setting$323.15RVU25B
2025-01-01Not available in this setting$323.15RVU25A
2024-10-01Not available in this setting$331.61RVU24D
2024-07-01Not available in this setting$331.61RVU24C
2024-04-01Not available in this setting$331.61RVU24B
2024-03-09Not available in this setting$331.61RVU24AR
2024-01-01Not available in this setting$326.20RVU24A
2023-10-01Not available in this setting$333.93RVU23D
2023-07-01Not available in this setting$333.93RVU23C
2023-04-01Not available in this setting$333.93RVU23B
2023-01-01Not available in this setting$333.93RVU23A
2022-10-01Not available in this setting$337.49RVU22D
2022-07-01Not available in this setting$337.49RVU22C
2022-04-01Not available in this setting$337.49RVU22B
2022-01-01Not available in this setting$337.49RVU22A
2021-10-01Not available in this setting$339.45RVU21D
2021-07-01Not available in this setting$339.45RVU21C
2021-04-01Not available in this setting$339.45RVU21B
2021-01-01Not available in this setting$339.45RVU21A
2020-10-01Not available in this setting$354.18RVU20D
2020-07-01Not available in this setting$354.18RVU20C
2020-04-01Not available in this setting$354.18RVU20B
2020-01-01Not available in this setting$354.18RVU20A
2019-10-01Not available in this setting$362.79RVU19D
2019-07-01Not available in this setting$362.79RVU19C
2019-04-01Not available in this setting$362.79RVU19B
2019-01-01Not available in this setting$362.79RVU19A
2018-10-01Not available in this setting$363.64RVU18D
2018-07-01Not available in this setting$363.64RVU18C
2018-04-01Not available in this setting$363.64RVU18B
2018-01-01Not available in this setting$363.64RVU18AR1
2017-10-01Not available in this setting$363.78RVU17D
2017-07-01Not available in this setting$363.78RVU17C
2017-04-01Not available in this setting$363.78RVU17B
2017-01-01Not available in this setting$363.78RVU17A
2016-10-01Not available in this setting$531.30RVU16D
2016-07-01Not available in this setting$531.30RVU16C
2016-04-01Not available in this setting$531.30RVU16B
2016-01-01Not available in this setting$531.30RVU16A
2015-10-01Not available in this setting$625.17RVU15D
2015-07-01Not available in this setting$625.17RVU15C
2015-04-01Not available in this setting$622.06RVU15B
2015-01-01Not available in this setting$622.06RVU15A
2014-10-01Not available in this setting$622.60RVU14D
2014-07-01Not available in this setting$622.60RVU14C
2014-04-01Not available in this setting$622.60RVU14B
2014-01-01Not available in this setting$622.60RVU14A
2013-10-01Not available in this setting$614.76RVU13D
2013-07-01Not available in this setting$614.76RVU13C
2013-04-01Not available in this setting$614.76RVU13B
2013-01-01Not available in this setting$614.76RVU13AR

Price 20245 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

20245 billing questions

How does this differ from code 20225?

Code 20245 is for an open approach to a deep bone site. Code 20225 describes deep bone sampling by trocar or needle.

When should 20240 be reported instead?

Use 20240 for an open biopsy of a superficial bone site. The distinction from 20245 is the depth of the site, not simply the bone's name.

Is modifier 50 appropriate for bilateral bone biopsies?

No. CMS identifies bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.

Does the code include same-day postoperative care?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery 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
RVUs for 20245PPRRVU2026_Oct_nonQPP.csv, line 1,737 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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