CPT code 20610: Joint injection, major joint or bursa, no ultrasound2026 Medicare rate & RVUs in King County, WA
Needle aspiration of fluid from, or injection of medication into, a large joint or bursa such as the knee, shoulder, or hip, performed without ultrasound guidance.
In King County, WA, Medicare pays $78.09 for 20610 in the office and $42.44 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 20610 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 20610 covers
Code 20610 covers needle aspiration, injection, or both in a major joint or bursa, including the knee, glenohumeral joint, hip, subacromial bursa, and trochanteric bursa. A clinician may drain a knee effusion for cell count or crystal testing or inject medication into a painful joint or bursa. Orthopedists, rheumatologists, sports medicine and primary care clinicians, and advanced practice providers commonly perform it in offices. They may use palpable landmarks or separately reportable non-ultrasound imaging guidance.
Report one unit for each distinct major joint or bursa treated in a session; aspiration followed by injection of the same site remains one unit. Document the target and side, procedure performed, aspirated fluid when applicable, and injected drug and dose. Report separately payable, provider-supplied drugs with the appropriate HCPCS code and administered units. CMS assigns a 0-day global period that includes same-day preoperative and postoperative care; a significant, separately identifiable E/M requires modifier 25 on the E/M code. For multiple procedures in one session, CMS pays the highest-valued in full and others at 50%; bilateral procedures reported with modifier 50 pay at 150%. CMS does not pay an assistant at surgery or permit co-surgeons or team surgery for this code.
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 20610
Across 109 of 109 payment localities, the office rate for 20610 runs from $61.24 in Arkansas to $86.75 in San Benito County, CA. King County, WA pays $78.09. The RVUs are the same everywhere; the geographic indexes change the dollars.
- King County, WA · this page$78.09
- Rest of Washington · Washington$70.16−$7.93
- Los Angeles, CA · California$75.49−$2.60
- Washington, DC area · District of Columbia$77.58−$0.51
- Miami, FL · Florida$77.03−$1.06
- Chicago, IL · Illinois$74.80−$3.29
- Manhattan, NY · New York$79.27+$1.18
Other areas in Washington first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $82.23 | $51.29 |
| AlabamaAlabama | $62.08 | $36.65 |
| ArkansasArkansas | $61.24 | $36.28 |
| ArizonaArizona | $66.98 | $38.82 |
| Bakersfield, CACalifornia | $71.32 | $39.47 |
| Chico, CACalifornia | $70.95 | $39.10 |
| El Centro, CACalifornia | $70.97 | $39.12 |
| Fresno, CACalifornia | $70.95 | $39.10 |
| Hanford, CACalifornia | $70.95 | $39.10 |
| Madera, CACalifornia | $70.95 | $39.10 |
| Merced, CACalifornia | $70.95 | $39.10 |
| Modesto, CACalifornia | $70.95 | $39.10 |
| Napa, CACalifornia | $80.61 | $42.31 |
| Oxnard, CACalifornia | $74.94 | $40.59 |
| Redding, CACalifornia | $70.95 | $39.10 |
| Rest of CaliforniaCalifornia | $70.95 | $39.10 |
| Riverside, CACalifornia | $72.35 | $40.50 |
| Sacramento, CACalifornia | $74.03 | $40.24 |
| Salinas, CACalifornia | $73.75 | $40.07 |
| San Diego, CACalifornia | $75.18 | $40.43 |
| Marin County, CACalifornia | $84.79 | $43.81 |
| San Francisco, CACalifornia | $84.64 | $43.66 |
| San Benito County, CACalifornia | $86.75 | $44.84 |
| Santa Clara County, CACalifornia | $86.14 | $44.24 |
| San Luis Obispo, CACalifornia | $72.61 | $39.52 |
| Santa Cruz, CACalifornia | $75.66 | $40.35 |
| Santa Maria, CACalifornia | $73.94 | $40.06 |
| Santa Rosa, CACalifornia | $76.40 | $40.71 |
| Stockton, CACalifornia | $70.95 | $39.10 |
| Vallejo, CACalifornia | $80.40 | $42.10 |
| Visalia, CACalifornia | $70.95 | $39.10 |
| Yuba City, CACalifornia | $70.95 | $39.10 |
| ColoradoColorado | $70.64 | $39.72 |
| ConnecticutConnecticut | $73.22 | $41.92 |
| DelawareDelaware | $68.03 | $39.32 |
| Fort Lauderdale, FLFlorida | $72.82 | $43.38 |
| Rest of FloridaFlorida | $69.29 | $41.50 |
| Atlanta, GAGeorgia | $70.38 | $40.85 |
| Rest of GeorgiaGeorgia | $65.46 | $39.53 |
| Hawaii, Guam, HIHawaii | $72.29 | $39.25 |
| IowaIowa | $62.89 | $36.31 |
| IdahoIdaho | $63.42 | $36.68 |
| East St. Louis, ILIllinois | $70.11 | $43.38 |
| Rest of IllinoisIllinois | $67.88 | $41.35 |
| Suburban Chicago, ILIllinois | $73.38 | $43.54 |
| IndianaIndiana | $63.75 | $36.81 |
| KansasKansas | $62.93 | $36.66 |
| KentuckyKentucky | $64.14 | $38.30 |
| New Orleans, LALouisiana | $67.11 | $39.77 |
| Rest of LouisianaLouisiana | $64.17 | $38.45 |
| Metropolitan Boston, MAMassachusetts | $76.90 | $42.20 |
| Rest of MassachusettsMassachusetts | $70.39 | $39.79 |
| Baltimore area, MDMaryland | $73.07 | $41.89 |
| Rest of MarylandMaryland | $69.17 | $39.76 |
| Rest of MaineMaine | $64.06 | $37.33 |
| Southern Maine, MEMaine | $66.85 | $38.06 |
| Detroit, MIMichigan | $70.43 | $42.39 |
| Rest of MichiganMichigan | $66.00 | $39.46 |
| MinnesotaMinnesota | $66.87 | $36.97 |
| Metropolitan Kansas City, MOMissouri | $66.34 | $39.06 |
| Metropolitan St. Louis, MOMissouri | $66.95 | $39.29 |
| Rest of MissouriMissouri | $63.35 | $38.30 |
| MississippiMississippi | $62.29 | $37.27 |
| MontanaMontana | $68.80 | $39.74 |
| North CarolinaNorth Carolina | $64.64 | $37.53 |
| North DakotaNorth Dakota | $66.23 | $37.17 |
| NebraskaNebraska | $63.12 | $36.30 |
| New HampshireNew Hampshire | $69.85 | $39.60 |
| Northern New JerseyNew Jersey | $76.92 | $43.21 |
| Rest of New JerseyNew Jersey | $73.82 | $42.09 |
| New MexicoNew Mexico | $66.46 | $39.82 |
| NevadaNevada | $68.12 | $39.03 |
| NYC suburbs and Long Island, NYNew York | $81.50 | $46.94 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $74.56 | $42.74 |
| Queens, NYNew York | $79.42 | $45.08 |
| Rest of New YorkNew York | $65.58 | $37.97 |
| OhioOhio | $65.47 | $38.94 |
| OklahomaOklahoma | $63.69 | $37.74 |
| Portland, OROregon | $72.41 | $40.12 |
| Rest of OregonOregon | $67.36 | $38.42 |
| Metropolitan Philadelphia, PAPennsylvania | $71.70 | $41.45 |
| Rest of PennsylvaniaPennsylvania | $65.39 | $38.71 |
| Puerto RicoPuerto Rico | $69.17 | $39.79 |
| Rhode IslandRhode Island | $70.10 | $40.09 |
| South CarolinaSouth Carolina | $65.21 | $38.36 |
| South DakotaSouth Dakota | $65.92 | $36.86 |
| TennesseeTennessee | $63.27 | $36.86 |
| Austin, TXTexas | $70.61 | $39.87 |
| Beaumont, TXTexas | $65.01 | $38.57 |
| Brazoria, TXTexas | $67.71 | $38.91 |
| Dallas, TXTexas | $68.27 | $39.32 |
| Fort Worth, TXTexas | $67.93 | $39.28 |
| Galveston, TXTexas | $67.99 | $39.14 |
| Houston, TXTexas | $70.37 | $41.52 |
| Rest of TexasTexas | $66.41 | $38.83 |
| UtahUtah | $66.04 | $38.72 |
| VirginiaVirginia | $66.87 | $38.31 |
| Virgin Islands, VIUnited States Virgin Islands | $69.17 | $39.79 |
| VermontVermont | $66.27 | $37.51 |
| WisconsinWisconsin | $64.17 | $36.34 |
| West VirginiaWest Virginia | $65.60 | $40.35 |
| WyomingWyoming | $67.68 | $38.62 |
20610 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$61.24
$82.23
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $82.23 | 1 |
| AL | $62.08 | 1 |
| AR | $61.24 | 1 |
| AZ | $66.98 | 1 |
| CA | $70.95–$86.75 | 29 |
| CO | $70.64 | 1 |
| CT | $73.22 | 1 |
| DC | $77.58 | 1 |
| DE | $68.03 | 1 |
| FL | $69.29–$77.03 | 3 |
| GA | $65.46–$70.38 | 2 |
| GU | $72.29 | 1 |
| HI | $72.29 | 1 |
| IA | $62.89 | 1 |
| ID | $63.42 | 1 |
| IL | $67.88–$74.80 | 4 |
| IN | $63.75 | 1 |
| KS | $62.93 | 1 |
| KY | $64.14 | 1 |
| LA | $64.17–$67.11 | 2 |
| MA | $70.39–$76.90 | 2 |
| MD | $69.17–$77.58 | 3 |
| ME | $64.06–$66.85 | 2 |
| MI | $66.00–$70.43 | 2 |
| MN | $66.87 | 1 |
| MO | $63.35–$66.95 | 3 |
| MS | $62.29 | 1 |
| MT | $68.80 | 1 |
| NC | $64.64 | 1 |
| ND | $66.23 | 1 |
| NE | $63.12 | 1 |
| NH | $69.85 | 1 |
| NJ | $73.82–$76.92 | 2 |
| NM | $66.46 | 1 |
| NV | $68.12 | 1 |
| NY | $65.58–$81.50 | 5 |
| OH | $65.47 | 1 |
| OK | $63.69 | 1 |
| OR | $67.36–$72.41 | 2 |
| PA | $65.39–$71.70 | 2 |
| PR | $69.17 | 1 |
| RI | $70.10 | 1 |
| SC | $65.21 | 1 |
| SD | $65.92 | 1 |
| TN | $63.27 | 1 |
| TX | $65.01–$70.61 | 8 |
| UT | $66.04 | 1 |
| VA | $66.87–$77.58 | 2 |
| VI | $69.17 | 1 |
| VT | $66.27 | 1 |
| WA | $70.16–$78.09 | 2 |
| WI | $64.17 | 1 |
| WV | $65.60 | 1 |
| WY | $67.68 | 1 |
How the 20610 rate is calculated
Each of 20610’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 · 20610
RVUs × geographic indexes × conversion factor
Work0.77
0.77 RVUs× 1.000 GPCI
Practice expense1.16
1.16 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
2.0600
Conversion factor
$33.4009
Medicare rate
$68.81
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
1,771
- Code
- 20610
- Physician work
- 0.77
- Practice expense
- 1.16
- Malpractice
- 0.13
GPCI2026.csv
108
- Locality
- King County, WA
- Physician work
- 1.050
- Practice expense
- 1.227
- Malpractice
- 0.817
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.77 | × 1.050 | 0.8085 |
| Practice expense | 1.16 | × 1.227 | 1.4233 |
| Malpractice | 0.13 | × 0.817 | 0.1062 |
| Total RVUs | 2.3380 | ||
| Conversion factor | × 33.4009 | ||
Office rate, King County, WA$78.09
Office: (0.77 × 1.05 + 1.16 × 1.227 + 0.13 × 0.817) × $33.4009 = $78.09
Facility: (0.77 × 1.05 + 0.29 × 1.227 + 0.13 × 0.817) × $33.4009 = $42.44
Payment rules and modifiers for 20610
The CMS indicators that decide how 20610 is paid alongside other services.
CMS payment indicators · 20610
Joint injection, major joint or bursa, no ultrasound
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
20610 without 50 · national office
$68.81
Joint injection, major joint or bursa, no ultrasound
20610-50 · Bilateral: 150%
$103.22
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).
How 20610 has changed in King County, WA
20610 · Office / nonfacility
$78.09
Effective 2026-10-01
The base rate is $6.81 higher than on 2025-10-01, moving from $71.28 to $78.09 (9.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$71.28changed to$78.09
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.79 changed to 0.77
- Practice expense RVU 1.04 changed to 1.16
- 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.
January 1, 2025
RVU25A
$73.35changed to$71.28
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$72.16changed to$73.35
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$72.85changed to$72.16
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.02 changed to 1.04
- Malpractice RVU 0.12 changed to 0.13
- 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
January 1, 2023
RVU23A
$73.28changed to$72.85
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.01 changed to 1.02
- 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.
January 1, 2022
RVU22A
$72.07changed to$73.28
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.96 changed to 1.01
- Malpractice RVU 0.13 changed to 0.12
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$69.41changed to$72.07
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.86 changed to 0.96
- Malpractice RVU 0.12 changed to 0.13
- 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.
January 1, 2020
RVU20A
$66.31changed to$69.41
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.80 changed to 0.86
- 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.
January 1, 2019
RVU19A
$66.65changed to$66.31
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.81 changed to 0.80
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$65.62changed to$66.65
- Conversion factor 35.8887 changed to 35.9996
- 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.
January 1, 2017
RVU17A
$64.20changed to$65.62
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.80 changed to 0.81
- 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.
January 1, 2016
RVU16A
$64.67changed to$64.20
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.81 changed to 0.80
- Malpractice RVU 0.11 changed to 0.12
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$64.35changed to$64.67
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$64.68changed to$64.35
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.80 changed to 0.81
- Practice expense GPCI 1.150 changed to 1.155
- Malpractice GPCI 0.688 changed to 0.495
Held through RVU15B.
January 1, 2014
RVU14A
$65.01changed to$64.68
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.87 changed to 0.80
- Malpractice RVU 0.12 changed to 0.11
- Practice expense GPCI 1.144 changed to 1.150
- Malpractice GPCI 0.881 changed to 0.688
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $65.01
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $78.09 | $42.44 | RVU26D |
| 2026-07-01 | $78.09 | $42.44 | RVU26C |
| 2026-04-01 | $78.09 | $42.44 | RVU26B |
| 2026-01-01 | $78.09 | $42.44 | RVU26A |
| 2025-10-01 | $71.28 | $47.60 | RVU25D |
| 2025-07-01 | $71.28 | $47.60 | RVU25C |
| 2025-04-01 | $71.28 | $47.60 | RVU25B |
| 2025-01-01 | $71.28 | $47.60 | RVU25A |
| 2024-10-01 | $73.35 | $48.99 | RVU24D |
| 2024-07-01 | $73.35 | $48.99 | RVU24C |
| 2024-04-01 | $73.35 | $48.99 | RVU24B |
| 2024-03-09 | $73.35 | $48.99 | RVU24AR |
| 2024-01-01 | $72.16 | $48.19 | RVU24A |
| 2023-10-01 | $72.85 | $48.72 | RVU23D |
| 2023-07-01 | $72.85 | $48.72 | RVU23C |
| 2023-04-01 | $72.85 | $48.72 | RVU23B |
| 2023-01-01 | $72.85 | $48.72 | RVU23A |
| 2022-10-01 | $73.28 | $48.90 | RVU22D |
| 2022-07-01 | $73.28 | $48.90 | RVU22C |
| 2022-04-01 | $73.28 | $48.90 | RVU22B |
| 2022-01-01 | $73.28 | $48.90 | RVU22A |
| 2021-10-01 | $72.07 | $49.58 | RVU21D |
| 2021-07-01 | $72.07 | $49.58 | RVU21C |
| 2021-04-01 | $72.07 | $49.58 | RVU21B |
| 2021-01-01 | $72.07 | $49.58 | RVU21A |
| 2020-10-01 | $69.41 | $50.41 | RVU20D |
| 2020-07-01 | $69.41 | $50.41 | RVU20C |
| 2020-04-01 | $69.41 | $50.41 | RVU20B |
| 2020-01-01 | $69.41 | $50.41 | RVU20A |
| 2019-10-01 | $66.31 | $50.20 | RVU19D |
| 2019-07-01 | $66.31 | $50.20 | RVU19C |
| 2019-04-01 | $66.31 | $50.20 | RVU19B |
| 2019-01-01 | $66.31 | $50.20 | RVU19A |
| 2018-10-01 | $66.65 | $50.56 | RVU18D |
| 2018-07-01 | $66.65 | $50.56 | RVU18C |
| 2018-04-01 | $66.65 | $50.56 | RVU18B |
| 2018-01-01 | $66.65 | $50.56 | RVU18AR1 |
| 2017-10-01 | $65.62 | $49.51 | RVU17D |
| 2017-07-01 | $65.62 | $49.51 | RVU17C |
| 2017-04-01 | $65.62 | $49.51 | RVU17B |
| 2017-01-01 | $65.62 | $49.51 | RVU17A |
| 2016-10-01 | $64.20 | $48.07 | RVU16D |
| 2016-07-01 | $64.20 | $48.07 | RVU16C |
| 2016-04-01 | $64.20 | $48.07 | RVU16B |
| 2016-01-01 | $64.20 | $48.07 | RVU16A |
| 2015-10-01 | $64.67 | $48.49 | RVU15D |
| 2015-07-01 | $64.67 | $48.49 | RVU15C |
| 2015-04-01 | $64.35 | $48.24 | RVU15B |
| 2015-01-01 | $64.35 | $48.24 | RVU15A |
| 2014-10-01 | $64.68 | $49.02 | RVU14D |
| 2014-07-01 | $64.68 | $49.02 | RVU14C |
| 2014-04-01 | $64.68 | $49.02 | RVU14B |
| 2014-01-01 | $64.68 | $49.02 | RVU14A |
| 2013-10-01 | $65.01 | $48.27 | RVU13D |
| 2013-07-01 | $65.01 | $48.27 | RVU13C |
| 2013-04-01 | $65.01 | $48.27 | RVU13B |
| 2013-01-01 | $65.01 | $48.27 | RVU13AR |
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
- 20610 in Auburn · multiple payment areas
- Baring
- Beaux Arts Village
- Bellevue
- Black Diamond
20610 billing questions
Which joints qualify for 20610 rather than 20605 or 20600?
20610 is for major joints and bursae such as the knee, shoulder, hip, and subacromial bursa. Intermediate sites like the wrist, elbow, ankle, and olecranon bursa go to 20605, and small joints of the fingers and toes go to 20600.
If the knee is aspirated and then injected in the same session, is that two units?
No. Aspiration and injection of the same joint in one session are one unit of 20610, even if separate needle passes are needed.
How are bilateral knee injections reported to Medicare?
Report 20610 with modifier 50 on one line with one unit; CMS pays bilateral procedures at 150%. For a knee and a shoulder treated in the same session, report both sites; the multiple-procedure reduction applies, and a distinct-site modifier is used only when needed to identify separately reportable services.
Can an office visit be billed on the same day?
Yes, when the provider performs a significant, separately identifiable evaluation beyond the usual pre-injection assessment; append modifier 25 to the E/M code. The decision to inject and the brief assessment of the treated joint are included in the 0-day global.
What if imaging guidance is used?
If ultrasound guidance includes permanently recorded images and a written report, report 20611 instead of 20610; do not add 76942. For fluoroscopic needle guidance, report 20610 with the appropriate guidance code, such as 77002.
Is the injected drug included?
An eligible, provider-supplied corticosteroid or hyaluronan product may be reported separately with its HCPCS drug code and units based on the administered dose. Local anesthetic used for the procedure is not separately billed.
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
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