No office rate
Use 20250 for an open thoracic vertebral body biopsy; use 20251 for the corresponding cervical or lumbar region.
On this page
CMS RVU26D · Effective 2026-10-01
20250 Vertebral biopsy Medicare reimbursement rates in Oklahoma
Reports open sampling of a thoracic vertebral body, typically to investigate a suspected bone lesion, infection, or other abnormality. Compare 20250 office and facility rates across CMS payment localities in Oklahoma.
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 20250 in Oklahoma?
Oklahoma 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
No supported rate
Facility setting
$358.42
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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.
Orthopedic surgery
About 20250: Open thoracic vertebral body biopsy
Reports open sampling of a thoracic vertebral body, typically to investigate a suspected bone lesion, infection, or other abnormality.
This service involves surgically exposing a thoracic vertebral body and removing tissue for diagnostic evaluation. It is generally performed by a spine surgeon, orthopedic surgeon, or neurosurgeon in a facility setting when a vertebral abnormality requires tissue sampling. The open approach distinguishes it from a biopsy obtained with a trocar or needle; the vertebral level distinguishes it from the corresponding cervical or lumbar procedure.
Select the code when the operative documentation identifies an open biopsy of a thoracic vertebral body. Documentation should establish the vertebral site, open approach, reason for sampling, and tissue obtained. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures 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. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 20250
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU5.06 · 44%
- Practice expense (office) RVU5.08 · 44%
- Malpractice RVU1.46 · 13%
105
Medicare services in 2024 · #4840 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.
20250 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
$204.34
20220 describes a superficial-site bone biopsy using a trocar or needle, not open sampling of a thoracic vertebral body.
$333.25
20225 describes a deep-site bone biopsy using a trocar or needle. The open approach and thoracic vertebral site support 20250 instead.
Compare 20250 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$358.42
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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 20250 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
1,739
- Code
- 20250
- Physician work
- 5.06
- Practice expense
- 5.08
- Malpractice
- 1.46
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.06 | × 1.000 | 5.0600 |
| Practice expense | 5.08 | × 0.893 | 4.5364 |
| Malpractice | 1.46 | × 0.777 | 1.1344 |
| Total RVUs | 10.7309 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$358.42
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.06 | 1 |
| Practice expense | 5.08 | 0.893 |
| Malpractice | 1.46 | 0.777 |
(5.06 × 1 + 5.08 × 0.893 + 1.46 × 0.777) × $33.4009 = $358.42
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.
20250 billing questions
How does this differ from 20251?
This code is for an open biopsy of a thoracic vertebral body. Code 20251 is the corresponding open vertebral body biopsy for the lumbar or cervical region.
Can this code be used for a needle biopsy?
No. This code describes an open approach. A trocar or needle approach may instead point to 20220 or 20225, depending on the documented biopsy level and method.
Are related postoperative visits included?
Yes. The 10-day global period includes related postoperative visits during that period.
Should modifier 50 be reported for bilateral sampling?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How does Medicare reduce payment 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 multiple-procedure reduction.
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.
1,73620240,,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
1,74020251,,Biopsy vrt bdy open lmbr/crv,A,,5.58,5.37,NA,5.37,,1.66,12.61,12.61,0,010,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7412025F,,7 fld rta photo w/o 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
1,7422026F,,Eye img valid 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
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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193