Billing code 24065: Soft-tissue biopsyMedicare rate & RVUs

Reports diagnostic sampling of superficial soft tissue in the upper arm or elbow when tissue is obtained rather than the lesion being completely excised.

CMS RVU26DEffective Oct 1, 2026109 payment localities262 Medicare services in 2024

Medicare pays $262.20 for 24065 nationally in the office and $148.63 in a hospital or facility. Local office rates run $231.81–$346.55.

Medicare rate · 24065

Soft-tissue biopsy

Swap in your local Medicare rate.

Work RVUs
2.08
Total RVUs
7.85
Global days
010

National rate · 2026

$262.20

Office setting, before claim adjustments.

See every locality for 24065 → · 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 24065 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 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

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

109 payment localities

$231.81 to $346.55

$231.81$289.18$346.55
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

24065 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$235.22$135.85
Alaska*$304.65$183.71
Arizona$255.17$145.12
Arkansas$231.81$134.26
Atlanta$267.22$151.84
Austin$271.91$151.76
Bakersfield$277.46$153.00
Baltimore/Surr. Cntys$278.91$157.06
Beaumont$245.03$141.69
Brazoria$259.05$146.50

24065 rates by state

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

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.

$231.81

$311.60

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
24065 office rate range by state
State / territoryOffice rate rangeLocalities
AK$304.651
AL$235.221
AR$231.811
AZ$255.171
CA$276.64–$346.5529
CO$272.721
CT$279.671
DC$299.651
DE$259.401
FL$258.83–$284.013
GA$244.19–$267.222
GU$283.381
HI$283.381
IA$240.971
ID$242.601
IL$251.51–$275.714
IN$244.001
KS$239.951
KY$241.051
LA$240.72–$252.652
MA$271.13–$299.592
MD$264.33–$299.653
ME$243.99–$257.102
MI$247.45–$262.192
MN$260.931
MO$236.65–$253.413
MS$234.271
MT$262.181
NC$246.541
ND$256.641
NE$242.261
NH$268.551
NJ$282.75–$296.552
NM$248.861
NV$260.821
NY$250.25–$309.325
OH$246.321
OK$240.491
OR$258.69–$281.272
PA$246.65–$272.772
PR$264.071
RI$268.561
SC$246.861
SD$255.991
TN$241.181
TX$245.03–$271.918
UT$250.241
VA$256.33–$299.652
VI$264.071
VT$255.741
WA$270.58–$305.582
WI$248.021
WV$242.211
WY$259.771

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

Swap in your local Medicare rate.

Work 2.08Practice expense 5.49Malpractice 0.28

7.8500 adjusted RVUs×$33.4009 conversion factor=$262.20

All indexes start 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

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 24065

Soft-tissue biopsy

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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

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).

When to use modifier 50

24065 compared with similar codes

Compare codes

24065 vs 24066 vs 24075 vs 24071: national Medicare rates

Swap in your local Medicare rate.

  • 24065
    Soft-tissue biopsy · 2.08 wRVU
    $262.20
  • 24066
    Soft-tissue biopsy · 5.22 wRVU
    $686.39+$424.19
  • 24075
    Soft-tissue excision · 4.13 wRVU
    $569.49+$307.29
  • 24071
    Soft-tissue excision · 5.56 wRVU
    —

How to choose

24066Soft-tissue biopsy
Choose 24065 for superficial soft tissue and 24066 for deep soft tissue; the relevant distinction is the tissue plane sampled.
24075Soft-tissue excision
24075 describes excision of a small superficial arm or elbow lesion, rather than diagnostic biopsy sampling.
24071Soft-tissue excision
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 under the CMS facts for this code?

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
RVUs for 24065PPRRVU2026_Oct_nonQPP.csv, line 2,258 (RVU26D)

Open CMS sourceHow we calculate rates

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