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Billing code 25066: Soft-tissue biopsyMedicare rate & RVUs

Report this service when a surgeon obtains a tissue sample from a deep soft-tissue mass in the forearm or wrist for diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.1K Medicare services in 2024

Medicare pays $358.39 for 25066 nationally in a facility.

Medicare rate · 25066

Soft-tissue biopsy

Swap in your local Medicare rate.

Work RVUs
4.16
Total RVUs
10.73
Global days
090

National rate · 2026

$358.39

Facility setting, before claim adjustments.

See every locality for 25066 → · 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 25066 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 25066 covers

This service covers obtaining a diagnostic tissue sample from a deep soft-tissue mass in the forearm or wrist, rather than removing the entire lesion. An orthopedic or hand surgeon commonly performs the biopsy in an operating room when the target lies beneath superficial tissues and requires operative exposure. The sample may be submitted for pathologic examination; the biopsy code describes the surgeon’s tissue-sampling procedure, not the pathologist’s interpretation.

Choose this code when the operative report supports a deep biopsy and describes the target, its location, the approach, and the tissue obtained. A superficial biopsy belongs to the related lower-level code; complete lesion removal is coded by the applicable excision code instead. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures reported with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery; 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 25066 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

25066 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$322.50
Alaska*Unavailable$428.05
ArizonaUnavailable$348.49
ArkansasUnavailable$318.03
AtlantaUnavailable$367.39
AustinUnavailable$366.69
BakersfieldUnavailable$368.76
Baltimore/Surr. CntysUnavailable$381.13
BeaumontUnavailable$339.16
BrazoriaUnavailable$351.75

25066 rates by state

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

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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
25066 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 25066 rate is calculated

Each of 25066’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 · 25066

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.16Practice expense 5.75Malpractice 0.82

10.7300 adjusted RVUs×$33.4009 conversion factor=$358.39

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 25066

25066 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25066

Soft-tissue biopsy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 25066

Soft-tissue biopsy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

25066 without 50 · national facility

$358.39

Soft-tissue biopsy

25066-50 · Bilateral: 150%

$537.59

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

25066 compared with similar codes

Compare codes

25066 vs 25065 vs 25076 vs 25073: national Medicare rates

Swap in your local Medicare rate.

  • 25066
    Soft-tissue biopsy · 4.16 wRVU
    —
  • 25065
    Soft-tissue biopsy · 1.99 wRVU
    $261.86
  • 25076
    Forearm tumor excision · 6.57 wRVU
    —
  • 25073
    Tumor excision · 6.95 wRVU
    —

How to choose

25065Soft-tissue biopsy
Use 25066 for a deep soft-tissue biopsy in the forearm or wrist; use 25065 when the biopsy target is superficial.
25076Forearm tumor excision
Use 25066 when the surgeon obtains a diagnostic tissue sample. Use 25076 when a deep lesion under 3 cm is excised.
25073Tumor excision
Use 25066 for sampling a deep lesion. Use 25073 when the deep lesion is excised and measures 3 cm or larger.

Codes related to 25066

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

Codes related to 25066
CodeHow it relatesNational office range
Same family
25065Soft-tissue biopsyRelated forearm or wrist soft-tissue biopsy code for a superficial target.$231.10–$347.07
Used instead
25076Forearm tumor excisionDeep lesion excision under 3 cm when the lesion is removed rather than sampled.No office rate
25073Tumor excisionDeep lesion excision 3 cm or larger when the lesion is removed.No office rate
25075Forearm tumor excisionSuperficial lesion excision under 3 cm when complete removal replaces diagnostic sampling.$483.43–$729.32
25071Forearm mass excisionSuperficial lesion excision 3 cm or larger when complete removal replaces biopsy.No office rate

25066 billing questions

How does this differ from 25065?

This code is for biopsy of deep forearm or wrist soft tissue. Code 25065 is for a superficial biopsy.

Can the surgeon report this when the whole mass is removed?

No. This code represents obtaining a diagnostic sample, not complete lesion removal. Select the applicable excision code when the operative service removes the lesion.

What documentation supports the deep-tissue selection?

Document the mass location and depth, the operative exposure or approach, and the tissue sampled. The record should make clear that the target was deep rather than superficial.

How is bilateral biopsy handled?

CMS identifies this as a bilateral procedure. When both sides are treated and modifier 50 is reported, payment is 150%.

Does the biopsy code include pathology interpretation?

The code describes the surgeon’s tissue-sampling procedure. A pathologist’s examination and interpretation of the submitted specimen are a separate professional service when performed and appropriately reported.

What global-period services are included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days.

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 25066PPRRVU2026_Oct_nonQPP.csv, line 2,379 (RVU26D)

Open CMS sourceHow we calculate rates

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