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Billing code 20240: Bone biopsyMedicare rate & RVUs

Report this service when a clinician uses an open approach to obtain a specimen from a superficial bone for diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.6K Medicare services in 2024

Medicare pays $126.59 for 20240 nationally in a facility.

Medicare rate · 20240

Bone biopsy

Swap in your local Medicare rate.

Work RVUs
2.54
Total RVUs
3.79
Global days
000

National rate · 2026

$126.59

Facility setting, before claim adjustments.

See every locality for 20240 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 20240 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

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

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

20240 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$118.27
Alaska*Unavailable$166.57
ArizonaUnavailable$124.16
ArkansasUnavailable$117.26
AtlantaUnavailable$129.37
AustinUnavailable$127.46
BakersfieldUnavailable$127.33
Baltimore/Surr. CntysUnavailable$132.64
BeaumontUnavailable$123.02
BrazoriaUnavailable$124.78

20240 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
20240 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

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

Swap in your local Medicare rate.

Work 2.54Practice expense 0.95Malpractice 0.30

3.7900 adjusted RVUs×$33.4009 conversion factor=$126.59

All indexes start 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

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

20240 without 51 · national facility

$126.59

Bone biopsy

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%).

When to use modifier 51

20240 compared with similar codes

Compare codes

20240 vs 20220 vs 20225 vs 20245: national Medicare rates

Swap in your local Medicare rate.

  • 20240
    Bone biopsy · 2.54 wRVU
    —
  • 20220
    Bone biopsy · 1.61 wRVU
    $223.12
  • 20225
    Bone biopsy · 2.39 wRVU
    $364.74
  • 20245
    Bone biopsy · 5.85 wRVU
    —

How to choose

20220Bone biopsy
Both concern superficial bone sampling, but 20220 describes a trocar or needle approach; this code is for open sampling.
20225Bone biopsy
20225 is for deep bone sampling by trocar or needle. This code describes an open approach to superficial bone.
20245Bone biopsy
Both use an open approach, but 20245 is selected for a deep bone site rather than a superficial one.

Codes related to 20240

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 20240
CodeHow it relatesNational office range
Same family
20245Bone biopsyOpen bone biopsy for a deep site rather than a superficial site.No office rate
Used instead
20220Bone biopsySuperficial bone biopsy by trocar or needle rather than an open approach.$197.29–$298.74
20225Bone biopsyDeep bone biopsy by trocar or needle rather than an open superficial approach.$321.58–$491.58

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
RVUs for 20240PPRRVU2026_Oct_nonQPP.csv, line 1,736 (RVU26D)

Open CMS sourceHow we calculate rates

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