$241.05
Both codes describe arm or elbow soft-tissue biopsy; 24066 is for deep tissue, while 24065 is for superficial tissue.
On this page
CMS RVU26D · Effective 2026-10-01
24066 Soft-tissue biopsy Medicare reimbursement rates in Kentucky
Report this service when a surgeon obtains a biopsy from deep soft tissue in the upper arm or elbow area to diagnose a lesion or mass. Compare 24066 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 24066 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
$630.59
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$390.08
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 surgery
About 24066: Deep arm or elbow soft-tissue biopsy
Report this service when a surgeon obtains a biopsy from deep soft tissue in the upper arm or elbow area to diagnose a lesion or mass.
A surgeon obtains tissue from a deep soft-tissue lesion in the upper arm or around the elbow for diagnostic evaluation. This is appropriate when the target lies beneath superficial tissues and sampling, rather than complete tumor removal, is the operative objective. Orthopedic surgeons, including orthopedic oncologists, commonly perform the procedure in a hospital or ambulatory surgery setting when the lesion requires operative access.
Report 24066 for a deep biopsy; distinguish it from the superficial biopsy in 24065. The operative report should identify the arm or elbow site, describe the target’s depth and the tissue sampled, and make clear that the service was a biopsy rather than excision. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral procedures reported with modifier 50, payment is 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 24066
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 RVU5.22 · 25%
- Practice expense (office) RVU14.13 · 69%
- Malpractice RVU1.20 · 6%
122
Medicare services in 2024 · #4722 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.
24066 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
24066 reports diagnostic sampling of deep soft tissue. 24076 describes excision of a deep arm or elbow tumor smaller than 5 cm.
No office rate
Use 24073 for excision of a deep arm or elbow tumor 5 cm or larger; use 24066 when the operative service is a biopsy.
$522.37
24075 is for excision of a small superficial lesion in the arm or elbow area, not biopsy of deep soft tissue.
Compare 24066 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
$630.59
Facility
$390.08
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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 24066 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,259
- Code
- 24066
- Physician work
- 5.22
- Practice expense
- 14.13
- Malpractice
- 1.20
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.22 | × 1.000 | 5.2200 |
| Practice expense | 14.13 | × 0.889 | 12.5616 |
| Malpractice | 1.20 | × 0.915 | 1.0980 |
| Total RVUs | 18.8796 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$630.59
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.22 | 1 |
| Practice expense | 14.13 | 0.889 |
| Malpractice | 1.2 | 0.915 |
(5.22 × 1 + 14.13 × 0.889 + 1.2 × 0.915) × $33.4009 = $630.59
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.22 | 1 |
| Practice expense | 6.03 | 0.889 |
| Malpractice | 1.2 | 0.915 |
(5.22 × 1 + 6.03 × 0.889 + 1.2 × 0.915) × $33.4009 = $390.08
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.
24066 billing questions
How do I choose between 24066 and 24065?
Use 24066 for a biopsy of deep soft tissue in the upper arm or elbow area. Use 24065 when the biopsied tissue is superficial.
When should the surgeon report an excision code instead?
Choose an excision code when the operative objective is removal of a lesion or tumor, rather than obtaining tissue for diagnosis. The relevant code depends on the tissue depth, size, and extent of removal.
Is the pathology examination included in 24066?
24066 describes the surgeon’s tissue acquisition. A pathology examination is a distinct service when separately performed and reported.
What documentation supports reporting 24066?
Document the upper-arm or elbow site, the target’s deep location, the tissue obtained, and the diagnostic biopsy intent. The operative note should distinguish sampling from removal of the lesion.
How does Medicare handle bilateral reporting and multiple procedures?
For a bilateral procedure reported with modifier 50, Medicare pays 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment is restricted for this code. Medicare does not permit co-surgeons or team surgery.
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.
2,25624000,,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
2,26224075,,Exc arm/elbow les sc < 3 cm,A,,4.13,12.02,,4.57,,0.90,17.05,9.60,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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