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See a sample rate comparisonCPT 20225 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Biopsy Bone Trocar Or Needl, Biopsy Bone Trocar Or Needle Deep (Vertebral Bodyfemur) Biopsy Bone Trocar Or Needle Deep (Vertebral Body
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20225 |
| Medicaid Fee Schedule | View Medicaid rates for 20225 |
National average reimbursement for CPT 20225 by major payers:
$545.80
$689.08
$685.96
$245.29
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CPT 20225
5 of 25 sample ratesHigher to lower in this preview
Jane Park
Barnabas Health Medical Group P C
$1,532.44Published rateMaria Garcia
Barnabas Health Medical Group P C
$1,532.44Published rateSteven Soler
University Of Rochester Neurosurgery Group
$945.19Published rateGeorge Vates
University Of Rochester Neurosurgery Group
$681.59Published rateJeffrey Berg
Town Center Orthopaedic Associates, P.C.
$179.36Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 20225 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20225 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 20225 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 20220-CPT | Moderate | Biopsy Bone Trocar Or Needle, Biopsy Bone Trocar Or Needle Superficial (Eg Iliumsternum Spinous Process Ribs) Biopsy Bone Trocar Or Needle Superficial (Eg Ilium |
| 20225-CPT | Moderate | Biopsy Bone Trocar Or Needl, Biopsy Bone Trocar Or Needle Deep (Vertebral Bodyfemur) Biopsy Bone Trocar Or Needle Deep (Vertebral Body |
| 20240-CPT | Moderate | Bone Biopsy Open Superficial, Biopsy Bone Open Superficial Eg Sternum Spinous Process Rib Patella Olecranon Process Calcaneus Tarsal Metatarsal Carpal Metacarpal Phalanx |
| 20250-CPT | Moderate | Biopsy Vertebral Body Open Thoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20225 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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