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CPT code 20605: Joint procedure, intermediate joint, no ultrasound2026 Medicare rate & RVUs in Houston, TX

Report this service for aspiration and/or injection of an intermediate joint or bursa, such as the wrist, elbow, ankle, or acromioclavicular joint, without ultrasound guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality352.7K Medicare services in 2024

In Houston, TX, Medicare pays $58.07 for 20605 in the office and $33.19 when it’s performed in a hospital or facility.

$58.07Office (non-facility)
$33.19Hospital or facility
+1.7%vs the national office rate ($57.12)

Check a contract rate as a % of Medicare · 20605 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 20605 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 20605 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 20605 covers

Orthopedists, rheumatologists, sports medicine clinicians, and other qualified practitioners use this service to withdraw fluid from or inject medication into an intermediate joint or bursa. Common targets include the wrist, elbow, ankle, acromioclavicular joint, and temporomandibular joint. It is performed in settings such as an office, clinic, or hospital outpatient department when the clinical need calls for treatment or fluid sampling at one of these sites without ultrasound guidance.

Select the code based on the treated site and whether aspiration, injection, or both are performed; document the specific joint or bursa, laterality, procedure, and clinical reason. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard reduction to the others. For bilateral treatment reported with modifier 50, CMS pays 150%. Assistant-at-surgery services are not paid; 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 Houston, TX compares for 20605

Across 109 of 109 payment localities, the office rate for 20605 runs from $51.25 in Arkansas to $72.62 in San Benito County, CA. Houston, TX pays $58.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

20605 in Houston, TX vs other payment areas
  1. Houston, TX · this page$58.07
  2. Austin, TX · Texas$58.73+$0.66
  3. Beaumont, TX · Texas$54.01−$4.06
  4. Brazoria, TX · Texas$56.41−$1.66
  5. Dallas, TX · Texas$56.80−$1.27
  6. Fort Worth, TX · Texas$56.52−$1.55
  7. Galveston, TX · Texas$56.61−$1.46

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

Every other payment area

20605 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$55.20$31.43
Los Angeles, CACalifornia$63.05$33.42
Washington, DC areaDistrict of Columbia$64.37$34.87
Miami, FLFlorida$62.53$36.45
Chicago, ILIllinois$60.89$35.72
Manhattan, NYNew York$65.34$36.23
AlaskaAlaska$69.04$42.37
AlabamaAlabama$51.91$29.99

20605 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.

$51.25

$69.04

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

View every state and territory as a table
20605 office rate range by state
State / territoryOffice rate rangeLocalities
AK$69.041
AL$51.911
AR$51.251
AZ$55.731
CA$59.36–$72.6229
CO$58.871
CT$60.611
DC$64.371
DE$56.571
FL$57.03–$62.533
GA$54.13–$58.242
GU$60.431
HI$60.431
IA$52.751
ID$53.121
IL$55.80–$60.894
IN$53.381
KS$52.681
KY$53.291
LA$53.28–$55.572
MA$58.64–$64.012
MD$57.51–$64.373
ME$53.51–$55.842
MI$54.64–$57.812
MN$56.171
MO$52.58–$55.573
MS$51.911
MT$57.111
NC$53.981
ND$55.531
NE$52.961
NH$58.111
NJ$61.24–$63.872
NM$54.961
NV$56.701
NY$54.70–$66.945
OH$54.321
OK$53.051
OR$56.19–$60.382
PA$54.31–$59.362
PR$57.431
RI$58.311
SC$54.251
SD$55.341
TN$52.931
TX$54.01–$58.738
UT$54.901
VA$55.78–$64.372
VI$57.431
VT$55.471
WA$58.48–$65.082
WI$53.911
WV$54.021
WY$56.421

See 20605 in every payment locality

How the 20605 rate is calculated

Each of 20605’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 · 20605

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.66

0.66 RVUs× 1.000 GPCI

Practice expense0.97

0.97 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

1.7100

Conversion factor

$33.4009

Medicare rate

$57.12

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

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,768

Code
20605
Physician work
0.66
Practice expense
0.97
Malpractice
0.08

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 20605 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work0.66× 1.0080.6653
Practice expense0.97× 0.9930.9632
Malpractice0.08× 1.3760.1101
Total RVUs1.7386
Conversion factor× 33.4009

Office rate, Houston, TX$58.07

Office: (0.66 × 1.008 + 0.97 × 0.993 + 0.08 × 1.376) × $33.4009 = $58.07

Facility: (0.66 × 1.008 + 0.22 × 0.993 + 0.08 × 1.376) × $33.4009 = $33.19

Open 20605 in the RVU calculator

Payment rules and modifiers for 20605

The CMS indicators that decide how 20605 is paid alongside other services.

CMS payment indicators · 20605

Joint procedure, intermediate joint, no 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

20605 without 50 · national office

$57.12

Joint procedure, intermediate joint, no ultrasound

20605-50 · Bilateral: 150%

$85.68

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 20605

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

Codes related to 20605
CodeHow it relatesOffice range, Houston, TX
Same family
20600Joint aspiration/injection, small joint, without ultrasoundCovers aspiration or injection at the small-joint or bursa level without ultrasound guidance.$57.06
20610Joint injection, major joint or bursa, no ultrasoundCovers aspiration or injection at the major-joint or bursa level without ultrasound guidance.$70.37
20604Joint aspiration or injection, small joint or bursaUltrasound-guided counterpart for the small-joint or bursa level.$88.41
20611Joint aspiration/injection, ultrasound-guided major joint or bursaUltrasound-guided counterpart for the major-joint or bursa level.$105.81
Used instead
20606Joint aspiration, intermediate joint, ultrasound-guidedUse for an intermediate joint or bursa procedure performed with ultrasound guidance.$95.56

How 20605 has changed in Houston, TX

20605 · Office / nonfacility

$58.07

Effective 2026-10-01

The base rate is $3.25 higher than on 2025-10-01, moving from $54.82 to $58.07 (5.9%).

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

    $54.82changed to$58.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.68 changed to 0.66
    • Practice expense RVU 0.89 changed to 0.97
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $56.89changed to$54.82

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $55.96changed to$56.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $57.44changed to$55.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.87 changed to 0.89
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $57.36changed to$57.44

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.85 changed to 0.87
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $56.40changed to$57.36

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.81 changed to 0.85

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $54.66changed to$56.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.72 changed to 0.81
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $52.50changed to$54.66

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.68 changed to 0.72
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $52.44changed to$52.50

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $51.87changed to$52.44

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.67 changed to 0.68
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $51.32changed to$51.87

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.66 changed to 0.67
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $51.16changed to$51.32

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $50.91changed to$51.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $50.77changed to$50.91

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.65 changed to 0.66
    • Malpractice RVU 0.08 changed to 0.07
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $65.71changed to$50.77

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 0.98 changed to 0.68
    • Practice expense RVU 0.83 changed to 0.65
    • Malpractice RVU 0.12 changed to 0.08
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $65.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$58.07$33.19RVU26D
2026-07-01$58.07$33.19RVU26C
2026-04-01$58.07$33.19RVU26B
2026-01-01$58.07$33.19RVU26A
2025-10-01$54.82$36.98RVU25D
2025-07-01$54.82$36.98RVU25C
2025-04-01$54.82$36.98RVU25B
2025-01-01$54.82$36.98RVU25A
2024-10-01$56.89$38.19RVU24D
2024-07-01$56.89$38.19RVU24C
2024-04-01$56.89$38.19RVU24B
2024-03-09$56.89$38.19RVU24AR
2024-01-01$55.96$37.57RVU24A
2023-10-01$57.44$38.50RVU23D
2023-07-01$57.44$38.50RVU23C
2023-04-01$57.44$38.50RVU23B
2023-01-01$57.44$38.50RVU23A
2022-10-01$57.36$38.48RVU22D
2022-07-01$57.36$38.48RVU22C
2022-04-01$57.36$38.48RVU22B
2022-01-01$57.36$38.48RVU22A
2021-10-01$56.40$38.80RVU21D
2021-07-01$56.40$38.80RVU21C
2021-04-01$56.40$38.80RVU21B
2021-01-01$56.40$38.80RVU21A
2020-10-01$54.66$39.57RVU20D
2020-07-01$54.66$39.57RVU20C
2020-04-01$54.66$39.57RVU20B
2020-01-01$54.66$39.57RVU20A
2019-10-01$52.50$39.00RVU19D
2019-07-01$52.50$39.00RVU19C
2019-04-01$52.50$39.00RVU19B
2019-01-01$52.50$39.00RVU19A
2018-10-01$52.44$39.32RVU18D
2018-07-01$52.44$39.32RVU18C
2018-04-01$52.44$39.32RVU18B
2018-01-01$52.44$39.32RVU18AR1
2017-10-01$51.87$38.83RVU17D
2017-07-01$51.87$38.83RVU17C
2017-04-01$51.87$38.83RVU17B
2017-01-01$51.87$38.83RVU17A
2016-10-01$51.32$38.71RVU16D
2016-07-01$51.32$38.71RVU16C
2016-04-01$51.32$38.71RVU16B
2016-01-01$51.32$38.71RVU16A
2015-10-01$51.16$38.51RVU15D
2015-07-01$51.16$38.51RVU15C
2015-04-01$50.91$38.32RVU15B
2015-01-01$50.91$38.32RVU15A
2014-10-01$50.77$38.54RVU14D
2014-07-01$50.77$38.54RVU14C
2014-04-01$50.77$38.54RVU14B
2014-01-01$50.77$38.54RVU14A
2013-10-01$65.71$52.75RVU13D
2013-07-01$65.71$52.75RVU13C
2013-04-01$65.71$52.75RVU13B
2013-01-01$65.71$52.75RVU13AR

Price 20605 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

20605 billing questions

How does this differ from codes for small or major joints?

Choose the code level based on the joint or bursa treated. This code is for intermediate sites such as the wrist, elbow, ankle, acromioclavicular joint, or temporomandibular joint.

Can this code be reported when ultrasound guides the procedure?

No. For ultrasound-guided aspiration or injection of an intermediate joint or bursa, use 20606 instead.

What should the procedure note identify?

Document the specific joint or bursa, side, whether fluid was aspirated or medication injected, and the clinical reason for the procedure.

How is bilateral treatment reported under the CMS rule?

Report bilateral treatment with modifier 50; CMS pays 150% for the bilateral procedure.

Does the code include the injected medication?

The code describes the aspiration or injection procedure, not a particular drug. It does not by itself identify or report the medication administered.

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 20605PPRRVU2026_Oct_nonQPP.csv, line 1,768 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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