Purpose: Small renal masses (SRMs) are becoming increasingly prevalent with increased usage of radiological imaging. Suspicious SRMs may be monitored, surgically resected, or ablated. Invasive therapy can be associated with significant morbidity. Percutaneous renal biopsy (PRB) is usually reserved for diagnosis of benign renal disease, renal secondary metastatic disease, or renal origin of metastatic disease. Not infrequently SRMs are benign or of low malignant potential, suggesting overtreatment. Current literature supports the use of PRB in primary diagnostic assessment of SRMs. We aim to assess the rates of PRB in Australia since 2000. Methods: Between January 2000 and November 2024, 12-monthly data regarding PRB were extracted from Medicare Benefit Scheme item reports with item number 36561. Paediatric patients aged <15 years were excluded. Population-adjusted incidences were calculated using publicly available demographic data. Results: During the study period, 31, 870 PRBs were performed for SRMs in Australia. During the study period, rates of PRBs approximately increased by two and a half fold from 3.0 to 8.0 per 100,000 population. Further statistical analysis is being conducted and will be provided as part of the final presentation. Conclusion: Current literature supports the use of renal biopsy for the investigation of SRMs. This shift in practice is concordant with increased Medicare billings of PRB in Australia over the past two decades. Despite this locoregional differences remain necessitating consensus in practice.