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CPT 20250 Fee Schedule

Last Verified: February 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 Vertebral Body Open Thoracic
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

51 - Multiple procedures

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 20250

National average reimbursement for CPT 20250 by major payers:

bcbs

$523.37

uhc

$525.06

aetna

$536.01

cigna

$648.50

Preview provider-level rates for...
For billing codeCPT 20250
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 20250

United
20250$2200.001528219474 - CLARKSTON ASC PARTNERS LLC, CLARKSTON SURGERY CENTER203360827 - (MI) CLARKSTON ASC PARTNERS, LLC DBA CLARKSTON SURGERY CENTERMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$3060.001972874907 - CAPITAL CITY SURGERY CENTER, LLC260804803 - (NC) CAPITAL CITY SURGERY CENTER LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$6623.001528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$6410.001740236454 - PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT LLC, PRINCESS ANNE AMBULATORY SURGERY CENTER204920880 - (VA) PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT, LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$3318.001033351119 - SSM ST CLARE SURGICAL CENTER LLC, SSM ST CLARE SURGICAL CENTER261439695 - (MO) SSM ST CLARE SURGICAL CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$2009.001134665193 - NHPE, LLC, NEW HYDE PARK ENDOSCOPY471158058NYAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$4227.001619333010 - ORANGE ASC, LTD, ORTHOPEDIC ONE SURGERY CENTER AT EASTON464700223 - (OH) ORANGE ASC LTD DBA ORTHOPEDIC ONE SURGERY CENTER AT EASTONOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$3188.001114302353 - POINT OF ROCKS SURGERY CENTER, LLC464992977 - (MD) POINT OF ROCKS SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$425.001164488219 - ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC621508557TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$1290.001528047040 - ENDOSCOPY CENTER OF KNOXVILLE LP, THE ENDOSCOPY CENTER621512837 - (TN) ENDOSCOPY CENTER OF KNOXVILLE LPTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$1571.001447254172 - SURGICENTER OF BALTIMORE LLC, SURGICENTER OF BALTIMORE521658841 - (MD) SURGICENTER OF BALTIMORE LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$2795.001962568543 - ENDOSCOPY CENTER OF OCEAN COUNTY, LLC223461117 - (NJ) ENDOSCOPY CENTER OF OCEAN COUNTY, PCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$1906.001154422541 - BRUNSWICK PAIN TREATMENT CENTER, LLC562441571 - (GA) BRUNSWICK PAIN TREATMENT CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$2211.001689635757 - ATLANTICARE SURGERY CENTER LLC223491867NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
20250$3347.001295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC881811228FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 20250 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 20250 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 20250 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.

CodeComplexityDescription
20225-CPTModerateBiopsy Bone Trocar/Needle Deep
20245-CPTModerateBiopsy Bone Open; Deep (Eg Humeral Shaft Ischium Femoral Shaft). (Desc Revised 1/1/2017)
20250-CPTModerateBiopsy Vertebral Body Open Thoracic
20251-CPTModerateBiopsy Verteb Body Open Lumbar/Cerv

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 20250 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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