$630.59
Choose 24065 for superficial soft tissue and 24066 for deep soft tissue; the relevant distinction is the tissue plane sampled.
On this page
CMS RVU26D · Effective 2026-10-01
24065 Soft-tissue biopsy Medicare reimbursement rates in Kentucky
Reports diagnostic sampling of superficial soft tissue in the upper arm or elbow when tissue is obtained rather than the lesion being completely excised. Compare 24065 office and facility rates across CMS payment localities in Kentucky.
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.
What does Medicare pay for 24065 in Kentucky?
Kentucky has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$241.05
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$140.09
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Musculoskeletal procedure
About 24065: Superficial upper-arm soft-tissue biopsy
Reports diagnostic sampling of superficial soft tissue in the upper arm or elbow when tissue is obtained rather than the lesion being completely excised.
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.
CMS billing rules for 24065
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are 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 procedure with modifier 50 is paid at 150%.
- 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 RVU2.08 · 26%
- Practice expense (office) RVU5.49 · 70%
- Malpractice RVU0.28 · 4%
262
Medicare services in 2024 · #4097 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.
24065 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$522.37
24075 describes excision of a small superficial arm or elbow lesion, rather than diagnostic biopsy sampling.
No office rate
24071 describes excision of a larger superficial arm or elbow lesion; 24065 is for biopsy sampling, not complete lesion removal.
Compare 24065 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Kentucky →
Office / nonfacility
$241.05
Facility
$140.09
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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 24065 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,258
- Code
- 24065
- Physician work
- 2.08
- Practice expense
- 5.49
- Malpractice
- 0.28
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.08 | × 1.000 | 2.0800 |
| Practice expense | 5.49 | × 0.889 | 4.8806 |
| Malpractice | 0.28 | × 0.915 | 0.2562 |
| Total RVUs | 7.2168 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$241.05
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.08 | 1 |
| Practice expense | 5.49 | 0.889 |
| Malpractice | 0.28 | 0.915 |
(2.08 × 1 + 5.49 × 0.889 + 0.28 × 0.915) × $33.4009 = $241.05
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.08 | 1 |
| Practice expense | 2.09 | 0.889 |
| Malpractice | 0.28 | 0.915 |
(2.08 × 1 + 2.09 × 0.889 + 0.28 × 0.915) × $33.4009 = $140.09
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.
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 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.
2,25523935,,Inc dp opn b1 crtx hum/elbw,A,,6.22,7.31,NA,7.31,,1.30,14.83,14.83,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25624000,,Arthrt elbw expl drg/rmvl fb,A,,5.93,6.66,NA,6.66,,1.22,13.81,13.81,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25724006,,Arthrt elbw capsl exc rls,A,,9.50,8.46,NA,8.46,,1.93,19.89,19.89,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25824065,,Biopsy arm/elbow soft tissue,A,,2.08,5.49,,2.09,,0.28,7.85,4.45,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25924066,,Biopsy arm/elbow soft tissue,A,,5.22,14.13,,6.03,,1.20,20.55,12.45,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26024071,,Exc arm/elbow les sc 3 cm/>,A,,5.56,4.86,NA,4.86,,1.31,11.73,11.73,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26124073,,Ex arm/elbow tum deep 5 cm/>,A,,9.88,7.43,NA,7.43,,2.25,19.56,19.56,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631