FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

20205 in Merced

Office / nonfacility

$353.00

Base rate per service

Facility setting

$142.87

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Surgical biopsy

About 20205: Open deep muscle tissue biopsy

Reports open sampling of deep muscle tissue for diagnostic evaluation when a superficial sample or percutaneous needle approach is not the method performed.

The clinician obtains a muscle specimen through an incision that reaches deep muscle tissue. This approach may be selected when evaluation of suspected neuromuscular disease requires tissue for laboratory examination and a needle sample is not performed. A surgeon commonly performs the procedure in a hospital or ambulatory surgery setting; the specimen is sent for pathologic evaluation.

Select this code for an open biopsy of deep muscle, not a superficial muscle sample or percutaneous needle biopsy. The operative note should identify the muscle sampled and document the open approach and depth. Same-day preoperative and postoperative care is included in the 0-day global period. When other procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

CMS billing rules for 20205

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.29 · 23%
  • Practice expense (office) RVU7.20 · 71%
  • Malpractice RVU0.65 · 6%

2K

Medicare services in 2024 · #2473 by national volume

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.

20205 compared with similar codes

Office rates for Merced, from the same CMS release.

20200

Muscle biopsy

Superficial, open approach

$254.37

Choose 20200 for an open sample of superficial muscle; 20205 is for an open approach that reaches deep muscle tissue.

20206

Muscle biopsy

Percutaneous needle approach

$225.28

Choose 20206 when muscle is sampled percutaneously with a needle. The open deep-muscle approach is reported with 20205.

20245

Bone biopsy

Open approach, deep site

No office rate

20245 is an open biopsy of deep bone, not muscle. Select the code based on the tissue sampled.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 20205 is $354.74—$1.74 higher than the $353.00 rate in Merced. Both use the same code, release and participation basis.

20205 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $353.00

  2. Bakersfield

    $354.74

    $1.74 higher than Merced

  3. Chico

    $353.00

    The same base rate than Merced

  4. El Centro

    $353.11

    $0.11 higher than Merced

  5. Fresno

    $353.00

    The same base rate than Merced

  6. Hanford-Corcoran

    $353.00

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $378.54

    $25.54 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 20205 ranges from $294.25 in Arkansas to $443.32 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 20205

    Office

    $353.00

    Facility

    $142.87

    The same base rate than Merced for the office setting.

  • Modesto

    California · 20205

    Office

    $353.00

    Facility

    $142.87

    The same base rate than Merced for the office setting.

  • Napa

    California · 20205

    Office

    $409.30

    Facility

    $156.61

    $56.30 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 20205

    Office

    $376.41

    Facility

    $149.80

    $23.41 higher than Merced for the office setting.

  • Redding

    California · 20205

    Office

    $353.00

    Facility

    $142.87

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 20205

    Office

    $353.00

    Facility

    $142.87

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 20205

    Office

    $359.96

    Facility

    $149.83

    $6.96 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 20205

    Office

    $370.56

    Facility

    $147.59

    $17.56 higher than Merced for the office setting.

  • Salinas

    California · 20205

    Office

    $369.22

    Facility

    $147.02

    $16.22 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 20205

    Office

    $378.17

    Facility

    $148.87

    $25.17 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 20205

    Office

    $432.81

    Facility

    $162.48

    $79.81 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 20205

    Office

    $432.07

    Facility

    $161.74

    $79.07 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 20205

    Office

    $443.32

    Facility

    $166.86

    $90.32 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 20205

    Office

    $440.30

    Facility

    $163.84

    $87.30 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 20205

    Office

    $363.34

    Facility

    $144.97

    $10.34 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 20205

    Office

    $381.92

    Facility

    $148.98

    $28.92 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 20205

    Office

    $370.67

    Facility

    $147.13

    $17.67 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 20205

    Office

    $385.74

    Facility

    $150.30

    $32.74 higher than Merced for the office setting.

  • Stockton

    California · 20205

    Office

    $353.00

    Facility

    $142.87

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 20205

    Office

    $408.23

    Facility

    $155.54

    $55.23 higher than Merced for the office setting.

  • Visalia

    California · 20205

    Office

    $353.00

    Facility

    $142.87

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 20205

    Office

    $353.00

    Facility

    $142.87

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 20205

    Office

    $388.08

    Facility

    $162.23

    $35.08 higher than Merced for the office setting.

  • Miami

    Florida · 20205

    Office

    $381.74

    Facility

    $182.16

    $28.74 higher than Merced for the office setting.

  • Chicago

    Illinois · 20205

    Office

    $368.54

    Facility

    $175.86

    $15.54 higher than Merced for the office setting.

  • Manhattan

    New York · 20205

    Office

    $395.26

    Facility

    $172.48

    $42.26 higher than Merced for the office setting.

  • Alaska*

    Alaska · 20205

    Office

    $382.81

    Facility

    $178.63

    $29.81 higher than Merced for the office setting.

  • Alabama

    Alabama · 20205

    Office

    $299.20

    Facility

    $131.45

    $53.80 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 20205

    Office

    $294.25

    Facility

    $129.56

    $58.75 lower than Merced for the office setting.

  • Arizona

    Arizona · 20205

    Office

    $328.10

    Facility

    $142.33

    $24.90 lower than Merced for the office setting.

  • Colorado

    Colorado · 20205

    Office

    $350.24

    Facility

    $146.25

    $2.76 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 20205

    Office

    $363.29

    Facility

    $156.81

    $10.29 higher than Merced for the office setting.

  • Delaware

    Delaware · 20205

    Office

    $333.99

    Facility

    $144.57

    $19.01 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 20205

    Office

    $359.35

    Facility

    $165.14

    $6.35 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · 20205

    Office

    $339.02

    Facility

    $155.74

    $13.98 lower than Merced for the office setting.

  • Atlanta

    Georgia · 20205

    Office

    $347.13

    Facility

    $152.34

    $5.87 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 20205

    Office

    $316.88

    Facility

    $145.87

    $36.12 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 20205

    Office

    $362.49

    Facility

    $144.50

    $9.49 higher than Merced for the office setting.

  • Iowa

    Iowa · 20205

    Office

    $305.15

    Facility

    $129.73

    $47.85 lower than Merced for the office setting.

  • Idaho

    Idaho · 20205

    Office

    $308.00

    Facility

    $131.62

    $45.00 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 20205

    Office

    $341.46

    Facility

    $165.08

    $11.54 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 20205

    Office

    $329.99

    Facility

    $154.94

    $23.01 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 20205

    Office

    $362.47

    Facility

    $165.58

    $9.47 higher than Merced for the office setting.

  • Indiana

    Indiana · 20205

    Office

    $309.97

    Facility

    $132.24

    $43.03 lower than Merced for the office setting.

  • Kansas

    Kansas · 20205

    Office

    $304.83

    Facility

    $131.51

    $48.17 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 20205

    Office

    $310.15

    Facility

    $139.71

    $42.85 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 20205

    Office

    $327.45

    Facility

    $147.04

    $25.55 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 20205

    Office

    $310.12

    Facility

    $140.44

    $42.88 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 20205

    Office

    $386.09

    Facility

    $157.17

    $33.09 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 20205

    Office

    $348.25

    Facility

    $146.37

    $4.75 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 20205

    Office

    $362.61

    Facility

    $156.89

    $9.61 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 20205

    Office

    $340.56

    Facility

    $146.53

    $12.44 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 20205

    Office

    $311.24

    Facility

    $134.86

    $41.76 lower than Merced for the office setting.

  • Southern Maine

    Maine · 20205

    Office

    $328.51

    Facility

    $138.51

    $24.49 lower than Merced for the office setting.

  • Detroit

    Michigan · 20205

    Office

    $345.16

    Facility

    $160.15

    $7.84 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 20205

    Office

    $320.56

    Facility

    $145.52

    $32.44 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 20205

    Office

    $330.37

    Facility

    $133.09

    $22.63 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 20205

    Office

    $323.52

    Facility

    $143.49

    $29.48 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 20205

    Office

    $327.19

    Facility

    $144.67

    $25.81 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 20205

    Office

    $304.93

    Facility

    $139.67

    $48.07 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 20205

    Office

    $299.59

    Facility

    $134.52

    $53.41 lower than Merced for the office setting.

  • Montana**

    Montana · 20205

    Office

    $338.64

    Facility

    $146.92

    $14.36 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 20205

    Office

    $314.74

    Facility

    $135.86

    $38.26 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 20205

    Office

    $325.79

    Facility

    $134.07

    $27.21 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 20205

    Office

    $306.66

    Facility

    $129.71

    $46.34 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 20205

    Office

    $345.83

    Facility

    $146.25

    $7.17 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 20205

    Office

    $383.46

    Facility

    $161.06

    $30.46 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 20205

    Office

    $365.98

    Facility

    $156.62

    $12.98 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 20205

    Office

    $323.09

    Facility

    $147.28

    $29.91 lower than Merced for the office setting.

  • Nevada**

    Nevada · 20205

    Office

    $335.30

    Facility

    $143.39

    $17.70 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 20205

    Office

    $407.64

    Facility

    $179.68

    $54.64 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 20205

    Office

    $369.53

    Facility

    $159.60

    $16.53 higher than Merced for the office setting.

  • Queens

    New York · 20205

    Office

    $396.94

    Facility

    $170.33

    $43.94 higher than Merced for the office setting.

  • Rest Of New York

    New York · 20205

    Office

    $320.21

    Facility

    $138.08

    $32.79 lower than Merced for the office setting.

  • Ohio

    Ohio · 20205

    Office

    $317.94

    Facility

    $142.90

    $35.06 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 20205

    Office

    $308.11

    Facility

    $136.90

    $44.89 lower than Merced for the office setting.

  • Portland

    Oregon · 20205

    Office

    $361.05

    Facility

    $148.04

    $8.05 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 20205

    Office

    $331.28

    Facility

    $140.32

    $21.72 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 20205

    Office

    $354.11

    Facility

    $154.53

    $1.11 higher than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 20205

    Office

    $317.77

    Facility

    $141.77

    $35.23 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 20205

    Office

    $341.00

    Facility

    $147.17

    $12.00 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 20205

    Office

    $345.73

    Facility

    $147.68

    $7.27 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 20205

    Office

    $317.15

    Facility

    $140.00

    $35.85 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 20205

    Office

    $324.27

    Facility

    $132.55

    $28.73 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 20205

    Office

    $306.75

    Facility

    $132.47

    $46.25 lower than Merced for the office setting.

  • Austin

    Texas · 20205

    Office

    $350.31

    Facility

    $147.47

    $2.69 lower than Merced for the office setting.

  • Beaumont

    Texas · 20205

    Office

    $315.50

    Facility

    $141.03

    $37.50 lower than Merced for the office setting.

  • Brazoria

    Texas · 20205

    Office

    $332.36

    Facility

    $142.36

    $20.64 lower than Merced for the office setting.

  • Dallas

    Texas · 20205

    Office

    $335.33

    Facility

    $144.37

    $17.67 lower than Merced for the office setting.

  • Fort Worth

    Texas · 20205

    Office

    $333.21

    Facility

    $144.17

    $19.79 lower than Merced for the office setting.

  • Galveston

    Texas · 20205

    Office

    $333.88

    Facility

    $143.50

    $19.12 lower than Merced for the office setting.

  • Houston

    Texas · 20205

    Office

    $345.78

    Facility

    $155.40

    $7.22 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 20205

    Office

    $324.31

    Facility

    $142.37

    $28.69 lower than Merced for the office setting.

  • Utah

    Utah · 20205

    Office

    $322.04

    Facility

    $141.82

    $30.96 lower than Merced for the office setting.

  • Virginia

    Virginia · 20205

    Office

    $328.21

    Facility

    $139.75

    $24.79 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 20205

    Office

    $341.00

    Facility

    $147.17

    $12.00 lower than Merced for the office setting.

  • Vermont

    Vermont · 20205

    Office

    $325.56

    Facility

    $135.75

    $27.44 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 20205

    Office

    $347.24

    Facility

    $145.35

    $5.76 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 20205

    Office

    $393.13

    Facility

    $157.89

    $40.13 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 20205

    Office

    $313.56

    Facility

    $129.89

    $39.44 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 20205

    Office

    $316.54

    Facility

    $149.93

    $36.46 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 20205

    Office

    $333.04

    Facility

    $141.32

    $19.96 lower than Merced for the office setting.

See how rates vary across the country

20205 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$294.25

$398.16

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$382.811
AL$299.201
AR$294.251
AZ$328.101
CA$353.00–$443.3229
CO$350.241
CT$363.291
DC$388.081
DE$333.991
FL$339.02–$381.743
GA$316.88–$347.132
GU$362.491
HI$362.491
IA$305.151
ID$308.001
IL$329.99–$368.544
IN$309.971
KS$304.831
KY$310.151
LA$310.12–$327.452
MA$348.25–$386.092
MD$340.56–$388.083
ME$311.24–$328.512
MI$320.56–$345.162
MN$330.371
MO$304.93–$327.193
MS$299.591
MT$338.641
NC$314.741
ND$325.791
NE$306.661
NH$345.831
NJ$365.98–$383.462
NM$323.091
NV$335.301
NY$320.21–$407.645
OH$317.941
OK$308.111
OR$331.28–$361.052
PA$317.77–$354.112
PR$341.001
RI$345.731
SC$317.151
SD$324.271
TN$306.751
TX$315.50–$350.318
UT$322.041
VA$328.21–$388.082
VI$341.001
VT$325.561
WA$347.24–$393.132
WI$313.561
WV$316.541
WY$333.041

Explore 20205 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 20205 in Merced, the physician’s office rate is $353.00 and the facility-setting rate is $142.87: a difference of $210.13.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 20205 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$388.30

$353.00 × 110% = $388.30

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 20205 in Merced.

PPRRVU2026_Oct_nonQPP.csv

1,728

Code
20205
Physician work
2.29
Practice expense
7.20
Malpractice
0.65

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 20205 in Merced
ComponentRVULocality factorAdjusted
Physician work2.29× 1.0172.3289
Practice expense7.20× 1.0967.8912
Malpractice0.65× 0.5360.3484
Total RVUs10.5685
Conversion factor× 33.4009

Office / nonfacility rate, Merced$353.00

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 20205 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.291.017
Practice expense7.21.096
Malpractice0.650.536

(2.29 × 1.017 + 7.2 × 1.096 + 0.65 × 0.536) × $33.4009 = $353.00

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.291.017
Practice expense1.461.096
Malpractice0.650.536

(2.29 × 1.017 + 1.46 × 1.096 + 0.65 × 0.536) × $33.4009 = $142.87

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

20205 · Office / nonfacility

$353.00

Effective 2026-10-01

The base rate is $50.43 higher than on 2025-10-01, moving from $302.57 to $353.00 (16.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $302.57changed to$353.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.35 changed to 2.29
    • Practice expense RVU 6.05 changed to 7.20
    • Malpractice RVU 0.64 changed to 0.65
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $302.57

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$353.00$142.87RVU26D
2026-07-01$353.00$142.87RVU26C
2026-04-01$353.00$142.87RVU26B
2026-01-01$353.00$142.87RVU26A
2025-10-01$302.57$148.42RVU25D
2025-07-01$302.57$148.42RVU25C
2025-04-01$302.57$148.42RVU25B
2025-01-01$302.57$148.42RVU25A

20205 billing questions

How is this distinguished from a superficial muscle biopsy?

Use 20205 when the open approach reaches deep muscle tissue. A superficial muscle sample is reported with 20200.

How does this differ from a percutaneous muscle biopsy?

This code describes an open approach to deep muscle. Use 20206 when the muscle is sampled percutaneously with a needle.

Is the pathology examination included?

The code reports obtaining the muscle specimen. A pathologist may separately report the tissue examination, such as 88305, when that service is performed and documented.

Can modifier 50 be used for biopsies on both sides?

Modifier 50 is inappropriate for this descriptor and anatomy, so do not report a bilateral adjustment.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 20205. Co-surgeon and team-surgery reporting are not permitted.

What same-session payment reduction should the billing team expect?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure payment.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 20205PPRRVU2026_Oct_nonQPP.csv, line 1,728 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet