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See a sample rate comparisonCPT 20245 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.
Biops Bone Open; Deep (Eg Humerus Ischium Femur), Biopsy Bone Open; Deep (Eg Humerus Ischium Femur)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20245 |
| Medicaid Fee Schedule | View Medicaid rates for 20245 |
National average reimbursement for CPT 20245 by major payers:
$578.37
$604.96
$612.82
$672.32
Compare published rates across providers.
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CPT 20245
5 of 25 sample ratesHigher to lower in this preview
Aurora Gi Asc LLC, Wisconsin Digestive Health Center
Aurora Gi Asc LLC
$7,169.00Published rateOrthopedic Ambulatory Surgery Center Of Chesterfield, LLC
Orthopedic Ambulatory Surgery Center Of Chesterfield LLC
$1,804.00Published rateMedical Heights Surgery Center, Inc., Kentucky Surgery Center
Baptist Health Surgery Center, L
$1,354.00Published ratePremier Physicians Centers, Inc
Premier Physicians Centers, Inc.
$880.00Published rateAmbulatory Foot And Ankle Center, Inc.
Ambulatory Foot And Ankle Center Inc
$552.00Published rate
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See a sample payer proposalCPT 20245 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20245 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 20245 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 |
|---|---|---|
| 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 |
| 20245-CPT | Moderate | Biops Bone Open; Deep (Eg Humerus Ischium Femur), Biopsy Bone Open; Deep (Eg Humerus Ischium Femur) |
| 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 20245. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20245 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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