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CPT code 27096: SI joint injection, image-guided intra-articular2026 Medicare rate & RVUs in Delaware

Reports an image-guided injection into the sacroiliac joint for diagnostic or therapeutic care when medication is delivered within the joint.

CMS RVU26DEffective Oct 1, 2026One payment locality306.9K Medicare services in 2024

In Delaware, Medicare pays $173.98 for 27096 in the office and $73.33 when it’s performed in a hospital or facility.

$173.98Office (non-facility)
$73.33Hospital or facility
−1.0%vs the national office rate ($175.69)

Check a contract rate as a % of Medicare · 27096 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 27096 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 27096 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 27096 covers

This service places a needle into the sacroiliac joint under fluoroscopic or CT guidance, typically to deliver local anesthetic, corticosteroid, or contrast. Pain medicine physicians, anesthesiologists, physiatrists, and radiologists commonly perform it in office or facility settings for suspected or established sacroiliac joint pain. The injection is intra-articular; medication placed only in nearby muscles or soft tissue is a different service.

Report the code for the guided joint injection, including the imaging guidance and arthrography when performed; do not separately report guidance for this injection. The record should identify the treated side, target joint, imaging method, needle placement, and medication or contrast delivered. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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 Delaware compares for 27096

Across 109 of 109 payment localities, the office rate for 27096 runs from $156.09 in Arkansas to $233.14 in San Benito County, CA. Delaware pays $173.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

27096 in Delaware vs other payment areas
  1. Delaware · this page$173.98
  2. Los Angeles, CA · California$198.58+$24.60
  3. Washington, DC area · District of Columbia$200.69+$26.71
  4. Miami, FL · Florida$187.88+$13.90
  5. Chicago, IL · Illinois$182.70+$8.72
  6. Manhattan, NY · New York$201.42+$27.44
  7. Alaska · Alaska$205.63+$31.65

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

Every other payment area

27096 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$158.29$69.16
ArkansasArkansas$156.09$68.58
ArizonaArizona$171.20$72.49
Bakersfield, CACalifornia$186.57$74.92
Chico, CACalifornia$186.14$74.48
El Centro, CACalifornia$186.16$74.51
Fresno, CACalifornia$186.14$74.48
Hanford, CACalifornia$186.14$74.48

27096 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.

$156.09

$209.64

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

View every state and territory as a table
27096 office rate range by state
State / territoryOffice rate rangeLocalities
AK$205.631
AL$158.291
AR$156.091
AZ$171.201
CA$186.14–$233.1429
CO$183.111
CT$187.101
DC$200.691
DE$173.981
FL$172.63–$187.883
GA$163.31–$178.742
GU$190.561
HI$190.561
IA$162.421
ID$163.391
IL$167.63–$182.954
IN$164.311
KS$161.571
KY$161.651
LA$161.36–$169.072
MA$182.02–$200.992
MD$177.26–$200.693
ME$164.09–$172.862
MI$165.60–$174.592
MN$175.961
MO$158.60–$169.803
MS$157.381
MT$175.681
NC$165.771
ND$172.911
NE$163.321
NH$180.141
NJ$189.37–$198.702
NM$166.431
NV$175.031
NY$168.15–$206.015
OH$165.031
OK$161.491
OR$173.81–$188.902
PA$165.35–$182.502
PR$176.971
RI$180.151
SC$165.651
SD$172.581
TN$162.341
TX$164.29–$182.388
UT$167.841
VA$172.22–$200.692
VI$176.971
VT$172.151
WA$181.71–$205.142
WI$167.291
WV$161.601
WY$174.471

See 27096 in every payment locality

How the 27096 rate is calculated

Each of 27096’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 · 27096

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.44

1.44 RVUs× 1.000 GPCI

Practice expense3.68

3.68 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

5.2600

Conversion factor

$33.4009

Medicare rate

$175.69

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,750

Code
27096
Physician work
1.44
Practice expense
3.68
Malpractice
0.14

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 27096 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.44× 1.0051.4472
Practice expense3.68× 0.9883.6358
Malpractice0.14× 0.8990.1259
Total RVUs5.2089
Conversion factor× 33.4009

Office rate, Delaware$173.98

Office: (1.44 × 1.005 + 3.68 × 0.988 + 0.14 × 0.899) × $33.4009 = $173.98

Facility: (1.44 × 1.005 + 0.63 × 0.988 + 0.14 × 0.899) × $33.4009 = $73.33

Open 27096 in the RVU calculator

Payment rules and modifiers for 27096

The CMS indicators that decide how 27096 is paid alongside other services.

CMS payment indicators · 27096

SI joint injection, image-guided intra-articular

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

27096 without 50 · national office

$175.69

SI joint injection, image-guided intra-articular

27096-50 · Bilateral: 150%

$263.54

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 27096

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

Codes related to 27096
CodeHow it relatesOffice range, Delaware
Used instead
20552Trigger point injection, one or two musclesUsed for trigger-point injections into one or two muscles, including an unguided SI-region injection.$51.31
64451SI nerve block, image-guided nerve injectionTargets nerves supplying the SI joint rather than injecting medication into the joint.$239.01
20610Joint injection, major joint or bursa, no ultrasoundReports aspiration or injection of a major joint or bursa at a different site, such as the hip.$68.03

How 27096 has changed in Delaware

27096 · Office / nonfacility

$173.98

Effective 2026-10-01

The base rate is $15.50 higher than on 2025-10-01, moving from $158.48 to $173.98 (9.8%).

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

    $158.48changed to$173.98

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.48 changed to 1.44
    • Practice expense RVU 3.29 changed to 3.68
    • Malpractice RVU 0.15 changed to 0.14
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $163.43changed to$158.48

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.31 changed to 3.29
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $160.76changed to$163.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $165.86changed to$160.76

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.25 changed to 3.31
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $170.27changed to$165.86

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.12 changed to 0.14
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $172.68changed to$170.27

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.26 changed to 3.25
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $169.08changed to$172.68

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.00 changed to 3.26
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $167.25changed to$169.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.96 changed to 3.00
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $165.97changed to$167.25

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.93 changed to 2.96

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $165.80changed to$165.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.92 changed to 2.93
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $168.67changed to$165.80

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.98 changed to 2.92
    • Malpractice RVU 0.13 changed to 0.12
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $168.15changed to$168.67

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.96 changed to 2.98
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $167.31changed to$168.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $169.35changed to$167.31

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.01 changed to 2.96
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $175.05changed to$169.35

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.41 changed to 3.01
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $175.05

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$173.98$73.33RVU26D
2026-07-01$173.98$73.33RVU26C
2026-04-01$173.98$73.33RVU26B
2026-01-01$173.98$73.33RVU26A
2025-10-01$158.48$80.82RVU25D
2025-07-01$158.48$80.82RVU25C
2025-04-01$158.48$80.82RVU25B
2025-01-01$158.48$80.82RVU25A
2024-10-01$163.43$82.20RVU24D
2024-07-01$163.43$82.20RVU24C
2024-04-01$163.43$82.20RVU24B
2024-03-09$163.43$82.20RVU24AR
2024-01-01$160.76$80.86RVU24A
2023-10-01$165.86$83.28RVU23D
2023-07-01$165.86$83.28RVU23C
2023-04-01$165.86$83.28RVU23B
2023-01-01$165.86$83.28RVU23A
2022-10-01$170.27$83.97RVU22D
2022-07-01$170.27$83.97RVU22C
2022-04-01$170.27$83.97RVU22B
2022-01-01$170.27$83.97RVU22A
2021-10-01$172.68$85.31RVU21D
2021-07-01$172.68$85.31RVU21C
2021-04-01$172.68$85.31RVU21B
2021-01-01$172.68$85.31RVU21A
2020-10-01$169.08$87.27RVU20D
2020-07-01$169.08$87.27RVU20C
2020-04-01$169.08$87.27RVU20B
2020-01-01$169.08$87.27RVU20A
2019-10-01$167.25$87.20RVU19D
2019-07-01$167.25$87.20RVU19C
2019-04-01$167.25$87.20RVU19B
2019-01-01$167.25$87.20RVU19A
2018-10-01$165.97$87.83RVU18D
2018-07-01$165.97$87.83RVU18C
2018-04-01$165.97$87.83RVU18B
2018-01-01$165.97$87.83RVU18AR1
2017-10-01$165.80$87.82RVU17D
2017-07-01$165.80$87.82RVU17C
2017-04-01$165.80$87.82RVU17B
2017-01-01$165.80$87.82RVU17A
2016-10-01$168.67$88.94RVU16D
2016-07-01$168.67$88.94RVU16C
2016-04-01$168.67$88.94RVU16B
2016-01-01$168.67$88.94RVU16A
2015-10-01$168.15$88.87RVU15D
2015-07-01$168.15$88.87RVU15C
2015-04-01$167.31$88.43RVU15B
2015-01-01$167.31$88.43RVU15A
2014-10-01$169.35$88.29RVU14D
2014-07-01$169.35$88.29RVU14C
2014-04-01$169.35$88.29RVU14B
2014-01-01$169.35$88.29RVU14A
2013-10-01$175.05$86.61RVU13D
2013-07-01$175.05$86.61RVU13C
2013-04-01$175.05$86.61RVU13B
2013-01-01$175.05$86.61RVU13AR

Price 27096 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

27096 billing questions

When should 27096 be chosen over 20552?

Use 27096 for an image-guided injection into the sacroiliac joint itself. Code 20552 describes trigger-point injections into one or two muscles, including situations where an SI-region injection is performed without image guidance.

Can imaging guidance be billed separately?

No. Fluoroscopic or CT guidance is included in 27096, as is arthrography when performed.

How is bilateral SI joint injection reported?

Report modifier 50 when both sacroiliac joints are treated. CMS pays the bilateral procedure at 150%.

What documentation supports 27096?

Document the clinical indication, side and joint treated, imaging method and needle placement, and the medication or contrast injected. The record should support that the needle entered the joint rather than only nearby soft tissue.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery reporting are not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard 50% multiple-procedure reduction.

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 27096PPRRVU2026_Oct_nonQPP.csv, line 2,750 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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