Billing code 20220: Bone biopsyMedicare rate & RVUs

Medicare pays $223.12 for 20220 nationally in the office and $76.49 in a hospital or facility. Local office rates run $197.29–$298.74.

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

What 20220 covers

Code 20220 describes sampling bone through a trocar or biopsy needle at a site classified as superficial, rather than exposing bone through an open incision. Typical targets include the ilium, sternum, ribs, and spinous processes. The service may be performed by an interventional radiologist, orthopedic surgeon, or another clinician experienced in percutaneous bone sampling, often in an imaging or procedure suite; it may also be performed in an office setting when appropriate. The purpose may be to investigate a focal lesion, suspected bone infection, or unexplained abnormality and provide tissue for pathology or microbiology.

Choose 20220 based on the bone-site category and needle or trocar approach; use 20225 for a deep site and an open bone-biopsy code when bone is exposed surgically. Documentation should identify the target bone, approach, specimen obtained, and clinical indication. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one 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 statutorily restricted, and co-surgeon and team-surgery reporting 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 20220 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

20220 rates by state

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

How the 20220 rate is calculated

Each of 20220’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 20220

The CMS indicators that decide how 20220 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

20220 compared with similar codes

How to choose

20225Bone biopsy

Both describe bone sampling with a trocar or needle. Choose 20220 for a superficial site and 20225 for a deep site.

20240Bone biopsy

Both apply to superficial bone sites, but 20240 is for an open biopsy involving surgical exposure rather than needle or trocar sampling.

20245Bone biopsy

20245 describes open sampling at a deep bone site; 20220 is for needle or trocar sampling at a superficial site.

Codes related to 20220

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