$340.78
Both describe bone sampling with a trocar or needle. Choose 20220 for a superficial site and 20225 for a deep site.
On this page
CMS RVU26D · Effective 2026-10-01
20220 Bone biopsy Medicare reimbursement rates in Ohio
A clinician obtains a sample from an anatomically superficial bone with a trocar or needle to evaluate suspected infection, neoplasm, or other bone disease. Compare 20220 office and facility rates across CMS payment localities in Ohio.
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 20220 in Ohio?
Ohio 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
$208.92
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$75.05
1 of 1 localities have a supported rate.
Payment area: Ohio
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 procedure
About 20220: Superficial percutaneous bone biopsy
A clinician obtains a sample from an anatomically superficial bone with a trocar or needle to evaluate suspected infection, neoplasm, or other bone disease.
Code 20220 describes sampling bone through a trocar or biopsy needle at a site classified as superficial, rather than exposing bone through an open incision. Typical targets include the ilium, sternum, ribs, and spinous processes. The service may be performed by an interventional radiologist, orthopedic surgeon, or another clinician experienced in percutaneous bone sampling, often in an imaging or procedure suite; it may also be performed in an office setting when appropriate. The purpose may be to investigate a focal lesion, suspected bone infection, or unexplained abnormality and provide tissue for pathology or microbiology.
Choose 20220 based on the bone-site category and needle or trocar approach; use 20225 for a deep site and an open bone-biopsy code when bone is exposed surgically. Documentation should identify the target bone, approach, specimen obtained, and clinical indication. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one 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 statutorily restricted, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 20220
- 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 RVU1.61 · 24%
- Practice expense (office) RVU4.90 · 73%
- Malpractice RVU0.17 · 3%
11.6K
Medicare services in 2024 · #1396 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.
20220 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Both apply to superficial bone sites, but 20240 is for an open biopsy involving surgical exposure rather than needle or trocar sampling.
No office rate
20245 describes open sampling at a deep bone site; 20220 is for needle or trocar sampling at a superficial site.
Compare 20220 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
Ohio →
Office / nonfacility
$208.92
Facility
$75.05
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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 20220 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
1,732
- Code
- 20220
- Physician work
- 1.61
- Practice expense
- 4.90
- Malpractice
- 0.17
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.61 | × 1.000 | 1.6100 |
| Practice expense | 4.90 | × 0.913 | 4.4737 |
| Malpractice | 0.17 | × 1.008 | 0.1714 |
| Total RVUs | 6.2551 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$208.92
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.61 | 1 |
| Practice expense | 4.9 | 0.913 |
| Malpractice | 0.17 | 1.008 |
(1.61 × 1 + 4.9 × 0.913 + 0.17 × 1.008) × $33.4009 = $208.92
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.61 | 1 |
| Practice expense | 0.51 | 0.913 |
| Malpractice | 0.17 | 1.008 |
(1.61 × 1 + 0.51 × 0.913 + 0.17 × 1.008) × $33.4009 = $75.05
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.
20220 billing questions
How do I choose between 20220 and 20225?
Use 20220 for a bone site classified as superficial, such as the ilium, sternum, ribs, or spinous process. Use 20225 for a deep bone site; the distinction is not determined only by how far the needle travels.
Does 20220 include an open surgical exposure?
No. This code is for needle or trocar sampling. When the bone is exposed through an incision, consider the applicable open bone-biopsy code, such as 20240 for a superficial site.
Can imaging guidance be billed separately?
The code describes bone sampling, not image guidance itself. Separately report guidance only when a distinct guidance service is performed, documented, and meets the requirements of the applicable guidance code.
How are other procedures in the same session paid?
Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are reduced by 50% when performed in the same session.
Can I append modifier 50 or report an assistant?
Modifier 50 is inappropriate for this code. CMS also restricts assistant-at-surgery payment and does not permit co-surgeon or team-surgery reporting.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Document the biopsy target, needle or trocar approach, specimen, and indication.
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.
1,72920206,,Biopsy muscle perq needle,A,,0.97,5.20,,0.45,,0.11,6.28,1.53,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7302020F,,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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703