Billing code 20220: Bone biopsyMedicare rate & RVUs in Florida
A clinician obtains a sample from an anatomically superficial bone with a trocar or needle to evaluate suspected infection, neoplasm, or other bone disease.
Medicare pays $218.77–$238.51 for 20220 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$218.77 to $238.51
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $229.83 | $81.30 |
| Miami | $238.51 | $85.87 |
| Rest Of Florida | $218.77 | $78.59 |
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.
How the rate is built · 20220
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.61Practice expense 4.90Malpractice 0.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 20220
The CMS indicators that decide how 20220 is paid alongside other services.
CMS payment indicators · 20220
Bone biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20220 without 51 · national office
$223.12
Bone biopsy
20220-51 · Second procedure: 50%
$111.56
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%).
20220 compared with similar codes
Compare codes
20220 vs 20225 vs 20240 vs 20245: national Medicare rates
Swap in your local Medicare rate.
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.
20220 billing questions
How do I choose between 20220 and 20225?
Use 20220 for a bone site classified as superficial, such as the ilium, sternum, ribs, or spinous process. Use 20225 for a deep bone site; the distinction is not determined only by how far the needle travels.
Does 20220 include an open surgical exposure?
No. This code is for needle or trocar sampling. When the bone is exposed through an incision, consider the applicable open bone-biopsy code, such as 20240 for a superficial site.
Can imaging guidance be billed separately?
The code describes bone sampling, not image guidance itself. Separately report guidance only when a distinct guidance service is performed, documented, and meets the requirements of the applicable guidance code.
How are other procedures in the same session paid?
Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are reduced by 50% when performed in the same session.
Can I append modifier 50 or report an assistant?
Modifier 50 is inappropriate for this code. CMS also restricts assistant-at-surgery payment and does not permit co-surgeon or team-surgery reporting.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Document the biopsy target, needle or trocar approach, specimen, and indication.
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
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