$262.18
Choose 21920 for superficial soft-tissue sampling. Choose 21925 when the documented biopsy reaches deep soft tissue in the back or flank.
On this page
CMS RVU26D · Effective 2026-10-01
21925 Soft-tissue biopsy Medicare reimbursement rates in Minnesota
Reports open sampling of deep soft tissue in the back or flank when a surgeon obtains tissue for diagnosis rather than removing the lesion. Compare 21925 office and facility rates across CMS payment localities in Minnesota.
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 21925 in Minnesota?
Minnesota 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
$529.26
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$353.98
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
Surgical procedure
About 21925: Deep soft-tissue biopsy of the back
Reports open sampling of deep soft tissue in the back or flank when a surgeon obtains tissue for diagnosis rather than removing the lesion.
This service involves surgically obtaining a tissue sample from a deep soft-tissue abnormality in the back or flank. A surgeon may perform the biopsy when imaging or examination identifies a mass that needs tissue diagnosis, particularly when sampling is needed from tissue beneath the superficial layers. The procedure is performed in a setting equipped for surgical access and specimen handling; the removed sample is sent for pathologic evaluation.
Choose this code when the operative report supports deep-tissue sampling, not complete removal of the lesion. Document the back or flank site, the depth and tissue sampled, and that the procedure was a biopsy. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Do not append modifier 50; CMS provides no bilateral adjustment for this service. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 21925
- 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 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 RVU4.51 · 28%
- Practice expense (office) RVU10.72 · 66%
- Malpractice RVU1.03 · 6%
190
Medicare services in 2024 · #4363 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.
21925 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$525.58
21930 describes removal of a small superficial back lesion. 21925 describes a deep-tissue biopsy, not complete excision.
No office rate
21932 is for removing a small deep back tumor. Use 21925 when the surgeon samples deep tissue for diagnosis instead of removing the tumor.
Compare 21925 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
Minnesota →
Office / nonfacility
$529.26
Facility
$353.98
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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 21925 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
2,034
- Code
- 21925
- Physician work
- 4.51
- Practice expense
- 10.72
- Malpractice
- 1.03
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.51 | × 1.000 | 4.5100 |
| Practice expense | 10.72 | × 1.029 | 11.0309 |
| Malpractice | 1.03 | × 0.296 | 0.3049 |
| Total RVUs | 15.8458 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$529.26
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.51 | 1 |
| Practice expense | 10.72 | 1.029 |
| Malpractice | 1.03 | 0.296 |
(4.51 × 1 + 10.72 × 1.029 + 1.03 × 0.296) × $33.4009 = $529.26
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.51 | 1 |
| Practice expense | 5.62 | 1.029 |
| Malpractice | 1.03 | 0.296 |
(4.51 × 1 + 5.62 × 1.029 + 1.03 × 0.296) × $33.4009 = $353.98
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.
21925 billing questions
How does 21925 differ from 21920?
21925 is for sampling deep soft tissue in the back or flank. Use 21920 when the documented biopsy is superficial.
Can 21925 be used when the entire mass is removed?
No. This code describes obtaining tissue for diagnosis; select an excision or resection code when the operative work removes the lesion.
What documentation supports 21925?
The operative report should identify the back or flank site, the deep tissue sampled, and the biopsy purpose. It should distinguish sampling from complete lesion removal.
Should modifier 50 be reported for biopsies on both sides?
No. CMS provides no bilateral adjustment for this service, so modifier 50 is inappropriate.
How does the 90-day global period affect postoperative care?
The day-before preoperative visit and related postoperative care for 90 days are included in the global period.
Can an assistant or co-surgeon be paid for 21925?
Assistant-at-surgery payment is restricted by statute. CMS does not permit co-surgeons or team surgery for this code.
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.
2,03121825,,Treat sternum fracture,A,,7.57,7.44,NA,7.44,,1.87,16.88,16.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03221899,,Unlisted px neck/thorax,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03321920,,Biopsy soft tissue of back,A,,2.06,5.54,,1.90,,0.30,7.90,4.26,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03421925,,Biopsy soft tissue of back,A,,4.51,10.72,,5.62,,1.03,16.26,11.16,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03521930,,Exc back les sc < 3 cm,A,,4.82,10.30,,4.63,,1.07,16.19,10.52,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03621931,,Exc back les sc 3 cm/>,A,,6.71,5.21,NA,5.21,,1.66,13.58,13.58,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,03721932,,Exc back tum deep < 5 cm,A,,9.57,6.96,NA,6.96,,2.25,18.78,18.78,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002