Billing code 20610: Joint injectionMedicare rate & RVUs
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.
Medicare pays $68.81 for 20610 nationally in the office and $39.75 in a hospital or facility. Local office rates run $61.24–$86.75.
Medicare rate · 20610
Joint injection
Swap in your local Medicare rate.
- Work RVUs
- 0.77
- Total RVUs
- 2.06
- Global days
- 000
National rate · 2026
$68.81
Office setting, before claim adjustments.
See every locality for 20610 → · Billed by an NP, PA or therapist? →
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 10 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.
Where 20610 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$61.24 to $86.75
109 of 109 payment localities
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
Swap in your local Medicare rate.
Work 0.77Practice expense 1.16Malpractice 0.13
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 20610
The CMS indicators that decide how 20610 is paid alongside other services.
CMS payment indicators · 20610
Joint injection
| 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
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).
20610 compared with similar codes
Compare codes
20610 vs 20611 vs 20605 vs 20612 vs 20552: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 20611Joint aspiration/injection
- Choose 20611 when ultrasound guidance is used and images are permanently recorded with a written report. A procedure performed without ultrasound, or without the required ultrasound documentation, is reported with 20610.
- 20605Joint procedure
- Site size decides the code. Knee, shoulder, hip, and their major bursae are 20610; wrist, elbow, ankle, and olecranon bursa are 20605.
- 20612Ganglion treatment
- 20612 is for aspirating or injecting a ganglion cyst, typically at the wrist or foot, rather than entering a joint space or bursa.
- 20552Trigger point injection
- 20552 describes trigger point injections into one or two muscles; 20610 requires treatment of a major joint or bursa.
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
Fee sheets
Put 20610 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →