$209.61–$221.28
Both concern superficial bone sampling, but 20220 describes a trocar or needle approach; this code is for open sampling.
On this page
CMS RVU26D · Effective 2026-10-01
20240 Bone biopsy Medicare reimbursement rates in Michigan
Report this service when a clinician uses an open approach to obtain a specimen from a superficial bone for diagnostic evaluation. Compare 20240 office and facility rates across CMS payment localities in Michigan.
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 20240 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$125.12–$132.35
2 of 2 localities have a supported rate.
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 20240: Open superficial bone biopsy
Report this service when a clinician uses an open approach to obtain a specimen from a superficial bone for diagnostic evaluation.
The clinician makes an incision and obtains bone tissue directly from a superficial site for diagnostic evaluation, such as investigation of a suspected bone lesion or infection. An orthopedic surgeon or another qualified proceduralist may perform the biopsy in an operating room or an office-based setting, depending on the clinical circumstances. The tissue may be submitted for pathologic or microbiologic examination according to the diagnostic question.
Choose this code when the documented method is open and the sampled bone is superficial; a needle or trocar technique, or a deep bone site, points to a different code. The operative note should identify the bone and site, explain the reason for sampling, and describe the open approach and specimen obtained. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same 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 restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 20240
- 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 RVU2.54 · 67%
- Practice expense (office) RVU0.95 · 25%
- Malpractice RVU0.30 · 8%
6.6K
Medicare services in 2024 · #1691 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.
20240 compared with similar codes
Office rates for Michigan, from the same CMS release.
$341.83–$361.03
20225 is for deep bone sampling by trocar or needle. This code describes an open approach to superficial bone.
No office rate
Both use an open approach, but 20245 is selected for a deep bone site rather than a superficial one.
Compare 20240 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$132.35
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$125.12
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20240 billing questions
How is this distinguished from a needle bone biopsy?
Use this code for an open approach to superficial bone. A trocar or needle approach is reported with the corresponding percutaneous bone-biopsy code.
When should the deep open bone biopsy code be used instead?
Use the deep open code when the documented biopsy site is deep rather than superficial. The operative note should support the site and approach selected.
Is modifier 50 appropriate for bilateral biopsies?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How are same-session procedures affected by the multiple procedure rule?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard 50% reduction.
Can an assistant surgeon, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment is restricted for this code. Co-surgeon and team-surgery billing are not permitted.
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.
1,73320225,,Bone biopsy trocar/ndl deep,A,,2.39,8.27,,0.74,,0.26,10.92,3.39,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7342022F,,Dilat rta xm evc rtnopthy,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7352023F,,Dilat rta xm w/o rtnopthy,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,73620240,,Bone biopsy open superficial,A,,2.54,0.95,NA,0.95,,0.30,3.79,3.79,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,73720245,,Bone biopsy open deep,A,,5.85,2.18,NA,2.18,,1.05,9.08,9.08,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7382024F,,7 fld rta photo evc rtnopthy,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,73920250,,Biopsy vrt bdy open thoracic,A,,5.06,5.08,NA,5.08,,1.46,11.60,11.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00