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See a sample rate comparisonCPT 20200 Fee Schedule
Medicare rates as of October 2026
CPT 20200 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Biopsy Muscle Superficial
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5072 - Level 2 Excision/ Biopsy/ Incision and Drainage |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 03600361Sign up to view all 3 |
| Medicare Fee Schedule | $241.82 national non-facility rate (2026)View Medicare rates for 20200 |
| Medicaid Fee Schedule | $186.615 median of the 8 states in the free previewView Medicaid rates for 20200 |
National average reimbursement for CPT 20200 by major payers:
$250.38
BCBS / Anthem
$270.08
UnitedHealthcare
$297.05
Aetna
$164.75
Cigna
Compare published rates across providers.
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CPT 20200
5 of 25 sample ratesHigher to lower in this preview
Los Gatos Surgical Center, A California Limited Partnership, Endoscopy Center Of Silicon Valley
$3,933.00Published rateCentral Maine Eye Surgery Center LLC
$1,276.00Published rateUpnt Surgery LLC
$774.00Published rateTglp, Lp, The Endoscopy Center Of Texarkana
Tglp Lp
$460.00Published rateKara Doucet
Deaconess Hospital Inc
$165.16Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 20200 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20200. Select one to see its fee schedule.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20200 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is CPT 20200 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20200 to APC 5072 (Level 2 Excision/ Biopsy/ Incision and Drainage). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20200 in an ambulatory surgery center?
CMS lists CPT 20200 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 20200?
Hospital price transparency files list CPT 20200 under these revenue codes: 0360, 0361 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.