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CPT code 20600: Joint aspiration/injection, small joint, without ultrasound2026 Medicare rate & RVUs in King County, WA

Reports aspiration and/or injection of a small joint or bursa, such as a finger or toe joint, when the service is performed without ultrasound guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality436.6K Medicare services in 2024

In King County, WA, Medicare pays $63.97 for 20600 in the office and $33.64 when it’s performed in a hospital or facility.

$63.97Office (non-facility)
$33.64Hospital or facility
+14.0%vs the national office rate ($56.11)

Check a contract rate as a % of Medicare · 20600 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 20600 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 20600 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 20600 covers

This service covers needle aspiration, injection, or both in a small joint or bursa without ultrasound guidance. Common sites include the metacarpophalangeal or interphalangeal joints of the hand and the joints of the toes. Orthopedists, rheumatologists, primary care clinicians, and other clinicians who treat joint symptoms may perform it in an office or facility setting. Aspiration may be performed to evaluate or relieve a small-joint effusion; injection may be used to treat a joint condition or local inflammation.

Select the code by the treated structure’s size and whether ultrasound guidance is used: use 20600 for a small joint or bursa without ultrasound, 20604 for the ultrasound-guided small-joint service, and different codes for intermediate or major structures. Document the site, laterality, indication, and aspiration or injection performed. The 0-day global period includes same-day preoperative and postoperative care. For bilateral treatment, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How King County, WA compares for 20600

Across 109 of 109 payment localities, the office rate for 20600 runs from $50.30 in Arkansas to $71.40 in San Benito County, CA. King County, WA pays $63.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

20600 in King County, WA vs other payment areas
  1. King County, WA · this page$63.97
  2. Rest of Washington · Washington$57.45−$6.52
  3. Los Angeles, CA · California$61.96−$2.01
  4. Washington, DC area · District of Columbia$63.28−$0.69
  5. Miami, FL · Florida$61.51−$2.46
  6. Chicago, IL · Illinois$59.88−$4.09
  7. Manhattan, NY · New York$64.24+$0.27

Other areas in Washington first, then benchmark localities. Bars start at $0.

Every other payment area

20600 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$67.69$41.36
AlabamaAlabama$50.95$29.32
ArkansasArkansas$50.30$29.06
ArizonaArizona$54.73$30.78
Bakersfield, CACalifornia$58.55$31.46
Chico, CACalifornia$58.32$31.23
El Centro, CACalifornia$58.33$31.24
Fresno, CACalifornia$58.32$31.23

20600 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$50.30

$67.69

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
20600 office rate range by state
State / territoryOffice rate rangeLocalities
AK$67.691
AL$50.951
AR$50.301
AZ$54.731
CA$58.32–$71.4029
CO$57.841
CT$59.571
DC$63.281
DE$55.571
FL$56.05–$61.513
GA$53.16–$57.232
GU$59.381
HI$59.381
IA$51.781
ID$52.141
IL$54.83–$59.884
IN$52.401
KS$51.711
KY$52.331
LA$52.31–$54.592
MA$57.61–$62.922
MD$56.49–$63.283
ME$52.54–$54.842
MI$53.67–$56.822
MN$55.161
MO$51.62–$54.583
MS$50.961
MT$56.111
NC$53.001
ND$54.531
NE$51.981
NH$57.091
NJ$60.18–$62.772
NM$53.991
NV$55.701
NY$53.72–$65.835
OH$53.351
OK$52.091
OR$55.19–$59.332
PA$53.34–$58.332
PR$56.431
RI$57.291
SC$53.281
SD$54.341
TN$51.961
TX$53.04–$57.718
UT$53.921
VA$54.78–$63.282
VI$56.431
VT$54.471
WA$57.45–$63.972
WI$52.921
WV$53.061
WY$55.421

See 20600 in every payment locality

How the 20600 rate is calculated

Each of 20600’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 20600

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.64

0.64 RVUs× 1.000 GPCI

Practice expense0.96

0.96 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

1.6800

Conversion factor

$33.4009

Medicare rate

$56.11

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,766

Code
20600
Physician work
0.64
Practice expense
0.96
Malpractice
0.08

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 20600 in King County, WA
ComponentRVULocality factorAdjusted
Physician work0.64× 1.0500.6720
Practice expense0.96× 1.2271.1779
Malpractice0.08× 0.8170.0654
Total RVUs1.9153
Conversion factor× 33.4009

Office rate, King County, WA$63.97

Office: (0.64 × 1.05 + 0.96 × 1.227 + 0.08 × 0.817) × $33.4009 = $63.97

Facility: (0.64 × 1.05 + 0.22 × 1.227 + 0.08 × 0.817) × $33.4009 = $33.64

Open 20600 in the RVU calculator

Payment rules and modifiers for 20600

The CMS indicators that decide how 20600 is paid alongside other services.

CMS payment indicators · 20600

Joint aspiration/injection, small joint, without ultrasound

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

20600 without 50 · national office

$56.11

Joint aspiration/injection, small joint, without ultrasound

20600-50 · Bilateral: 150%

$84.17

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 20600

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 20600
CodeHow it relatesOffice range, King County, WA
Same family
20604Joint aspiration or injection, small joint or bursaSmall-joint or bursa aspiration or injection when ultrasound guidance is used.$100.32
20605Joint procedure, intermediate joint, no ultrasoundAspiration or injection of an intermediate joint or bursa without ultrasound guidance.$65.08
20606Joint aspiration, intermediate joint, ultrasound-guidedAspiration or injection of an intermediate joint or bursa with ultrasound guidance.$108.13
20610Joint injection, major joint or bursa, no ultrasoundAspiration or injection of a major joint or bursa without ultrasound guidance.$78.09
20611Joint aspiration/injection, ultrasound-guided major joint or bursaAspiration or injection of a major joint or bursa with ultrasound guidance.$119.62

How 20600 has changed in King County, WA

20600 · Office / nonfacility

$63.97

Effective 2026-10-01

The base rate is $4.77 higher than on 2025-10-01, moving from $59.20 to $63.97 (8.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $59.20changed to$63.97

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.66 changed to 0.64
    • Practice expense RVU 0.88 changed to 0.96
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $60.80changed to$59.20

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.87 changed to 0.88
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $59.81changed to$60.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $59.80changed to$59.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.84 changed to 0.87
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $59.96changed to$59.80

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.82 changed to 0.84
    • Malpractice RVU 0.09 changed to 0.08
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $58.38changed to$59.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.77 changed to 0.82

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $56.47changed to$58.38

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.69 changed to 0.77
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $53.54changed to$56.47

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.64 changed to 0.69
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $53.15changed to$53.54

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $52.12changed to$53.15

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.63 changed to 0.64
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $51.10changed to$52.12

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.62 changed to 0.63
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $51.29changed to$51.10

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $51.03changed to$51.29

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $51.50changed to$51.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $50.80changed to$51.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.66 changed to 0.62
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $50.80

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$63.97$33.64RVU26D
2026-07-01$63.97$33.64RVU26C
2026-04-01$63.97$33.64RVU26B
2026-01-01$63.97$33.64RVU26A
2025-10-01$59.20$37.50RVU25D
2025-07-01$59.20$37.50RVU25C
2025-04-01$59.20$37.50RVU25B
2025-01-01$59.20$37.50RVU25A
2024-10-01$60.80$38.47RVU24D
2024-07-01$60.80$38.47RVU24C
2024-04-01$60.80$38.47RVU24B
2024-03-09$60.80$38.47RVU24AR
2024-01-01$59.81$37.84RVU24A
2023-10-01$59.80$38.13RVU23D
2023-07-01$59.80$38.13RVU23C
2023-04-01$59.80$38.13RVU23B
2023-01-01$59.80$38.13RVU23A
2022-10-01$59.96$38.48RVU22D
2022-07-01$59.96$38.48RVU22C
2022-04-01$59.96$38.48RVU22B
2022-01-01$59.96$38.48RVU22A
2021-10-01$58.38$38.79RVU21D
2021-07-01$58.38$38.79RVU21C
2021-04-01$58.38$38.79RVU21B
2021-01-01$58.38$38.79RVU21A
2020-10-01$56.47$39.58RVU20D
2020-07-01$56.47$39.58RVU20C
2020-04-01$56.47$39.58RVU20B
2020-01-01$56.47$39.58RVU20A
2019-10-01$53.54$39.09RVU19D
2019-07-01$53.54$39.09RVU19C
2019-04-01$53.54$39.09RVU19B
2019-01-01$53.54$39.09RVU19A
2018-10-01$53.15$38.71RVU18D
2018-07-01$53.15$38.71RVU18C
2018-04-01$53.15$38.71RVU18B
2018-01-01$53.15$38.71RVU18AR1
2017-10-01$52.12$38.07RVU17D
2017-07-01$52.12$38.07RVU17C
2017-04-01$52.12$38.07RVU17B
2017-01-01$52.12$38.07RVU17A
2016-10-01$51.10$37.45RVU16D
2016-07-01$51.10$37.45RVU16C
2016-04-01$51.10$37.45RVU16B
2016-01-01$51.10$37.45RVU16A
2015-10-01$51.29$37.59RVU15D
2015-07-01$51.29$37.59RVU15C
2015-04-01$51.03$37.40RVU15B
2015-01-01$51.03$37.40RVU15A
2014-10-01$51.50$37.91RVU14D
2014-07-01$51.50$37.91RVU14C
2014-04-01$51.50$37.91RVU14B
2014-01-01$51.50$37.91RVU14A
2013-10-01$50.80$36.79RVU13D
2013-07-01$50.80$36.79RVU13C
2013-04-01$50.80$36.79RVU13B
2013-01-01$50.80$36.79RVU13AR

Price 20600 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 20600 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

20600 billing questions

When should 20600 be chosen instead of 20604?

Use 20600 for a small joint or bursa treated without ultrasound guidance. When ultrasound guidance is used for the small-joint service, use 20604.

How is a small joint distinguished from an intermediate joint?

20600 is for small joints, such as finger or toe joints; 20605 is for an intermediate joint or bursa. Select based on the treated structure, not the medication injected.

Can aspiration and injection at the same small joint be reported separately?

The service includes aspiration, injection, or both at the treated small joint or bursa. Do not report separate units merely because both actions were performed at that site.

How should bilateral small-joint treatment be reported?

When the procedure is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.

What documentation supports reporting 20600?

Identify the small joint or bursa, side, clinical reason, whether fluid was aspirated or medication injected, and that ultrasound guidance was not used.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 20600PPRRVU2026_Oct_nonQPP.csv, line 1,766 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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