CPT code 24065: Soft-tissue biopsy, superficial upper arm or elbow2026 Medicare rate & RVUs in California
Reports diagnostic sampling of superficial soft tissue in the upper arm or elbow when tissue is obtained rather than the lesion being completely excised.
Medicare pays $276.64–$346.55 for 24065 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 24065 covers
Code 24065 represents sampling of superficial soft tissue in the upper arm or elbow region to establish a diagnosis, rather than removing the entire lesion as definitive treatment. The surgeon obtains tissue from a mass or other abnormality in the superficial soft-tissue layer; orthopedic and other surgeons may perform the biopsy in an office procedure room or operating room. The specimen is submitted for pathologic examination. The superficial-versus-deep distinction is based on the tissue plane involved, not simply the lesion’s diameter.
Report this code when the operative note identifies the upper-arm or elbow site, superficial depth, sampling method, and reason tissue was obtained. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral biopsies, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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.
Where 24065 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$276.64 to $346.55
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $277.46 | $153.00 |
| Chico, CA | $276.64 | $152.18 |
| El Centro, CA | $276.69 | $152.22 |
| Fresno, CA | $276.64 | $152.18 |
| Hanford, CA | $276.64 | $152.18 |
| Los Angeles, CA | $295.46 | $161.11 |
| Madera, CA | $276.64 | $152.18 |
| Marin County, CA | $338.92 | $178.80 |
| Merced, CA | $276.64 | $152.18 |
| Modesto, CA | $276.64 | $152.18 |
| Napa, CA | $320.28 | $170.61 |
| Oxnard, CA | $293.99 | $159.76 |
| Redding, CA | $276.64 | $152.18 |
| Rest of California | $276.64 | $152.18 |
| Riverside, CA | $279.68 | $155.21 |
| Sacramento, CA | $290.25 | $158.17 |
| Salinas, CA | $289.17 | $157.55 |
| San Benito County, CA | $346.55 | $182.79 |
| San Diego, CA | $295.94 | $160.12 |
| San Francisco, CA | $338.60 | $178.48 |
| San Luis Obispo, CA | $284.53 | $155.18 |
| Santa Clara County, CA | $345.25 | $181.49 |
| Santa Cruz, CA | $298.74 | $160.76 |
| Santa Maria, CA | $290.24 | $157.83 |
| Santa Rosa, CA | $301.75 | $162.29 |
| Stockton, CA | $276.64 | $152.18 |
| Vallejo, CA | $319.83 | $170.15 |
| Visalia, CA | $276.64 | $152.18 |
| Yuba City, CA | $276.64 | $152.18 |
How the 24065 rate is calculated
Each of 24065’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 · 24065
RVUs × geographic indexes × conversion factor
Work2.08
2.08 RVUs× 1.000 GPCI
Practice expense5.49
5.49 RVUs× 1.000 GPCI
Malpractice0.28
0.28 RVUs× 1.000 GPCI
Adjusted RVUs
7.8500
Conversion factor
$33.4009
Medicare rate
$262.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 24065
24065 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24065
Soft-tissue biopsy, superficial upper arm or elbow
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 24065
Soft-tissue biopsy, superficial upper arm or elbow
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
24065 without 50 · national office
$262.20
Soft-tissue biopsy, superficial upper arm or elbow
24065-50 · Bilateral: 150%
$393.30
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
24065 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 24066Soft-tissue biopsyDeep arm or elbow
- Choose 24065 for superficial soft tissue and 24066 for deep soft tissue; the relevant distinction is the tissue plane sampled.
- 24075Soft-tissue excisionSubcutaneous, under 3 cm
- 24075 describes excision of a small superficial arm or elbow lesion, rather than diagnostic biopsy sampling.
- 24071Soft-tissue excisionSubcutaneous, 3 cm or larger
- 24071 describes excision of a larger superficial arm or elbow lesion; 24065 is for biopsy sampling, not complete lesion removal.
24065 billing questions
How does 24065 differ from 24066?
Use 24065 for biopsy of superficial soft tissue in the upper arm or elbow region. Code 24066 is for biopsy of deep soft tissue.
Can 24065 be reported when the entire lesion is removed?
This code describes biopsy sampling. When the surgeon removes a lesion, evaluate the applicable excision code based on the site, tissue depth, and lesion size.
What documentation supports the superficial biopsy code?
Document the upper-arm or elbow location, the tissue plane or depth, the sampling performed, and the clinical reason for obtaining tissue.
How are bilateral biopsies reported?
Modifier 50 identifies a bilateral procedure; CMS pays the bilateral procedure at 150%.
Are postoperative visits separately paid during the global period?
Related postoperative visits for 10 days are included in the minor-procedure global period.
How does Medicare handle an assistant or additional procedures in the same session?
An assistant at surgery is not paid for this code. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others 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
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