Billing code 20225: Bone biopsyMedicare rate & RVUs in Nevada
Reports percutaneous sampling of a deep bone with a needle or trocar to investigate a lesion, suspected infection, or other bone abnormality.
Medicare pays $363.56 for 20225 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 20225 covers
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.
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 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $363.56 | $111.80 |
How the 20225 rate is calculated
Each of 20225’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 20225
RVUs × geographic indexes × conversion factor
Work2.39
2.39 RVUs× 1.000 GPCI
Practice expense8.27
8.27 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
10.9200
Conversion factor
$33.4009
Medicare rate
$364.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20225
The CMS indicators that decide how 20225 is paid alongside other services.
CMS payment indicators · 20225
Bone biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20225 without 51 · national office
$364.74
Bone biopsy
20225-51 · Second procedure: 50%
$182.37
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
20225 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20220Bone biopsy
- Use 20220 for percutaneous needle or trocar biopsy of a superficial bone site; 20225 is for a deep bone site.
- 20240Bone biopsy
- 20240 is an open biopsy of a superficial bone. 20225 uses a percutaneous needle or trocar to sample deep bone.
- 20245Bone biopsy
- Both concern deep bone, but 20245 uses an open approach; 20225 uses a percutaneous needle or trocar.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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