$206.98
Use 20220 for percutaneous needle or trocar biopsy of a superficial bone site; 20225 is for a deep bone site.
On this page
CMS RVU26D · Effective 2026-10-01
20225 Bone biopsy Medicare reimbursement rates in Nebraska
Reports percutaneous sampling of a deep bone with a needle or trocar to investigate a lesion, suspected infection, or other bone abnormality. Compare 20225 office and facility rates across CMS payment localities in Nebraska.
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 20225 in Nebraska?
Nebraska 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
$338.07
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$105.92
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 procedures
About 20225: Deep bone needle biopsy
Reports percutaneous sampling of a deep bone with a needle or trocar to investigate a lesion, suspected infection, or other bone abnormality.
The clinician advances a biopsy needle or trocar through the skin to obtain tissue from a deep bone site. Orthopedic surgeons, radiologists, and interventional radiologists may perform the procedure when evaluation of a bone lesion, suspected osteomyelitis, or another bone abnormality requires tissue. The procedure is distinct from an open biopsy, which uses a surgical exposure, and from needle sampling of a superficial bone site.
Report 20225 when the documented approach is percutaneous and the sampled bone is deep; the operative or procedure note should identify the bone and target, the needle or trocar technique, and the reason for sampling. CMS assigns 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 for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 20225
- 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 RVU2.39 · 22%
- Practice expense (office) RVU8.27 · 76%
- Malpractice RVU0.26 · 2%
11.6K
Medicare services in 2024 · #1394 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.
20225 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
20240 is an open biopsy of a superficial bone. 20225 uses a percutaneous needle or trocar to sample deep bone.
No office rate
Both concern deep bone, but 20245 uses an open approach; 20225 uses a percutaneous needle or trocar.
Compare 20225 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
Nebraska →
Office / nonfacility
$338.07
Facility
$105.92
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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 20225 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
1,733
- Code
- 20225
- Physician work
- 2.39
- Practice expense
- 8.27
- Malpractice
- 0.26
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.39 | × 1.000 | 2.3900 |
| Practice expense | 8.27 | × 0.923 | 7.6332 |
| Malpractice | 0.26 | × 0.378 | 0.0983 |
| Total RVUs | 10.1215 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$338.07
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.39 | 1 |
| Practice expense | 8.27 | 0.923 |
| Malpractice | 0.26 | 0.378 |
(2.39 × 1 + 8.27 × 0.923 + 0.26 × 0.378) × $33.4009 = $338.07
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.39 | 1 |
| Practice expense | 0.74 | 0.923 |
| Malpractice | 0.26 | 0.378 |
(2.39 × 1 + 0.74 × 0.923 + 0.26 × 0.378) × $33.4009 = $105.92
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.
20225 billing questions
How does 20225 differ from 20220?
Both describe percutaneous bone sampling with a needle or trocar. Choose 20225 for a deep bone site and 20220 for a superficial bone site.
When is 20245 more appropriate?
20245 describes an open biopsy of a deep bone. Use 20225 when the deep-bone sample is obtained percutaneously with a needle or trocar.
Can modifier 50 be used for bilateral bone biopsies?
No. CMS identifies modifier 50 as inappropriate for 20225; document the sampled site or sites and follow applicable coding instructions.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 20225. Co-surgeons and team surgery are not permitted.
What same-day care is included in the payment?
The 0-day global period includes same-day preoperative and postoperative care. Routine care related to the biopsy is part of the procedure.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment 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.
1,7302020F,,Dilated fundus eval done,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
1,7312021F,,Dilat macular exam done,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
1,73220220,,Bone biopsy trocar/ndl supfc,A,,1.61,4.90,,0.51,,0.17,6.68,2.29,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,73320225,,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068