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See a sample rate comparisonCPT 20206 Fee Schedule
Medicare rates as of October 2026
CPT 20206 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Biopsy Muscle Percutaneous Needle
| 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 |
| Add-on Codes | 77002 |
| Common Revenue Codes | 03610360Sign up to view all 9 |
| Medicare Fee Schedule | $209.76 national non-facility rate (2026)View Medicare rates for 20206 |
| Medicaid Fee Schedule | $168.80 median of the 8 states in the free previewView Medicaid rates for 20206 |
National average reimbursement for CPT 20206 by major payers:
$268.20
BCBS / Anthem
$317.98
UnitedHealthcare
$338.94
Aetna
$115.90
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20206.
CPT 20206
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
Mercy Medical Center
$572.24Published ratePatricia Copley
Deaconess Hospital Inc
$413.23Published rateNatalie Drummond
Town Center Orthopaedic Associates, P.C.
$342.86Published rateAndrea Infantino
Deaconess Hospital Inc
$189.86Published rateRyan Miyamoto
Town Center Orthopaedic Associates, P.C.
$79.43Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 20206 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20206. 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 20206. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20206 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 20206 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20206 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 20206 in an ambulatory surgery center?
CMS lists CPT 20206 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 20206?
CMS add-on code edits list CPT 20206 as a primary code for these add-on codes: 77002.
Which revenue codes are billed with CPT 20206?
Hospital price transparency files list CPT 20206 under these revenue codes: including 0361, 0360, 0761, 0510 and 0490. A revenue code names the hospital department or charge category for the line; it does not change what the service is.