Ablate bone tumor(s) perq

CPT code 20982 covers the minimally invasive destruction of bone tumors using a needle or probe inserted through the skin, typically using heat, cold, or radiofrequency energy to kill cancer cells without major surgery.

Showing rates for

National Average

Base Medicare rate

$3,226.89

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

7.02

PE RVU (NF)

91.66

MP RVU

1.08

Total RVU

99.76

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify site-of-service designation carefully—the $2873.67 difference between facility ($353.22) and non-facility ($3226.89) rates is one of the largest gaps in CPT
Impact: Incorrect place-of-service code can result in $2873.67 underpayment or compliance violations
Bill imaging guidance separately using appropriate radiology codes (77013 for CT guidance, 77022 for MRI guidance) as these are not bundled with 20982
Impact: Adds $150-300 in additional reimbursement per case; commonly overlooked revenue
Document whether ablating single or multiple tumors—20982 is reported per tumor, and modifier 59 may be appropriate for separate lesions in different anatomic sites
Impact: Proper coding of multiple tumors can double or triple procedure revenue with appropriate documentation
Obtain pre-authorization for ablation of metastatic lesions, as many payers require medical necessity review for non-osteoid osteoma indications
Impact: Pre-authorization prevents denials averaging $3226.89 per case and delays in payment
Ensure pathology or imaging confirmation of tumor is documented in medical record prior to ablation to support medical necessity
Impact: Lack of diagnostic confirmation is a common reason for denial; prevents 100% of reimbursement
Code separately for bone biopsy (20220-20225) if performed at a different session; do not report biopsy codes when biopsy is integral to tumor targeting during ablation
Impact: Unbundling biopsy from same-session ablation risks audit and recoupment; separate session biopsy adds $150-400

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 20982 in 2025?

Medicare pays $3226.89 for CPT 20982 in non-facility settings and $353.22 in facility settings for 2025, based on a total RVU of 99.76 and conversion factor of 32.3465. The dramatic difference reflects facility overhead costs covered separately in hospital settings.

Can CPT 20982 be billed for multiple bone tumors in the same session?

Yes, CPT 20982 can be reported for multiple bone tumors when ablating distinct, separate lesions. Use modifier 59 or XS to indicate separate tumors in different anatomic locations, and thoroughly document each tumor's location, size, and separate ablation in the operative note.

Is imaging guidance included in CPT 20982 or billed separately?

Imaging guidance is not included in CPT 20982 and should be billed separately using CT guidance (77013) or MRI guidance (77022) codes. These are recognized as separately reportable services according to NCCI edits and typically add $150-300 to the procedure reimbursement.

What types of bone tumors are covered under CPT 20982?

CPT 20982 covers percutaneous ablation of both benign tumors (most commonly osteoid osteoma) and malignant tumors (primary bone cancers and metastatic lesions). Medical necessity requirements vary by tumor type, with osteoid osteoma having the most established coverage and metastatic lesions often requiring prior authorization.

What documentation is required to bill CPT 20982 without denials?

Required documentation includes pre-procedure imaging confirming the tumor, operative note detailing percutaneous approach and ablation technique, specific tumor location and size, imaging modality used for guidance, confirmation of adequate ablation zone, and medical necessity justification including symptoms and prior treatments attempted.

How does facility vs. non-facility designation affect CPT 20982 reimbursement?

The facility vs. non-facility designation creates a $2873.67 payment difference for CPT 20982—the non-facility rate is $3226.89 while the facility rate is only $353.22. Non-facility rates apply only when performed in physician-owned offices or ASCs with all equipment and overhead costs borne by the practice.

What modifiers are most commonly used with CPT 20982?

Common modifiers for CPT 20982 include modifier 59 (distinct tumors in separate locations), modifier 50 (bilateral procedures), modifier 22 (increased complexity), modifier 52 (reduced services), and modifier 76/78 (repeat procedures). Modifier 59 is particularly important when ablating multiple tumors to ensure separate payment for each lesion.