$62.89
Use 20610 when the major joint is injected or aspirated by landmarks, or when ultrasound guidance was used but not permanently recorded and reported. 20611 requires recorded and reported ultrasound guidance.
On this page
CMS RVU26D · Effective 2026-10-01
20611 Joint aspiration/injection Medicare reimbursement rates in Iowa
Needle aspiration, injection, or both into a major joint or bursa, such as the knee, shoulder, or hip, under ultrasound guidance with a recorded image and report. Compare 20611 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 20611 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$95.97
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$46.46
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Musculoskeletal procedure
About 20611: Ultrasound-guided major joint or bursa aspiration or injection
Needle aspiration, injection, or both into a major joint or bursa, such as the knee, shoulder, or hip, under ultrasound guidance with a recorded image and report.
This service covers aspiration or injection of a major joint or bursa, typically the knee, shoulder, hip, or subacromial bursa, with real-time ultrasound used to direct the needle. Common indications include corticosteroid or viscosupplement injection for osteoarthritis, aspiration of a knee effusion to evaluate for gout or infection, and subacromial injection for impingement. Orthopedists, sports medicine physicians, rheumatologists, physiatrists, and advanced practice providers perform it, mainly in offices.
Ultrasound guidance is built into the code, so a separate guidance code is not reported. Documentation should identify the joint or bursa, laterality, drug and dose or fluid volume removed, and include permanent recording and reporting of the ultrasound guidance. Without that recording and reporting, the unguided major joint code applies. The 0-day global period includes same-day preoperative and postoperative care; a significant, separately identifiable E/M service needs modifier 25. Bilateral procedures reported with modifier 50 are paid at 150%. For multiple procedures in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 20611
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.07 · 34%
- Practice expense (office) RVU1.91 · 61%
- Malpractice RVU0.14 · 4%
1.1M
Medicare services in 2024 · #136 by national volume
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.
20611 compared with similar codes
Office rates for Iowa, from the same CMS release.
$86.89
20606 is for intermediate sites like the wrist, elbow, ankle, or olecranon bursa under ultrasound guidance. Choose 20611 for major sites such as the knee, shoulder, hip, or subacromial bursa.
$59.83
76942 is ultrasound needle guidance billed with procedures that do not include imaging guidance. It is not added to 20611 because guidance is included.
$80.33
20604 covers small joints and bursae, such as finger or toe joints, with ultrasound guidance; 20611 covers major joints and bursae.
Compare 20611 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$95.97
Facility
$46.46
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 20611 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,772
- Code
- 20611
- Physician work
- 1.07
- Practice expense
- 1.91
- Malpractice
- 0.14
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.07 | × 1.000 | 1.0700 |
| Practice expense | 1.91 | × 0.915 | 1.7476 |
| Malpractice | 0.14 | × 0.397 | 0.0556 |
| Total RVUs | 2.8732 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$95.97
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.07 | 1 |
| Practice expense | 1.91 | 0.915 |
| Malpractice | 0.14 | 0.397 |
(1.07 × 1 + 1.91 × 0.915 + 0.14 × 0.397) × $33.4009 = $95.97
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.07 | 1 |
| Practice expense | 0.29 | 0.915 |
| Malpractice | 0.14 | 0.397 |
(1.07 × 1 + 0.29 × 0.915 + 0.14 × 0.397) × $33.4009 = $46.46
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
20611 billing questions
Can 76942 be reported with 20611 for the ultrasound guidance?
No. Ultrasound guidance is included in 20611, so 76942 is not separately reported for the same procedure. If guidance was used but not permanently recorded and reported, report 20610 instead.
How are bilateral knee injections under ultrasound reported?
Report 20611 with modifier 50 on one line for Medicare, which pays the bilateral procedure at 150%. Document guidance, images, and the drug for each side.
Is the injected drug included?
When the practice supplies the drug, it may be billed separately with the appropriate HCPCS code, such as J3301 for triamcinolone acetonide. Match HCPCS units to the documented administered dose.
When can an office visit be billed on the same day?
A significant, separately identifiable E/M service beyond the routine pre-injection assessment may be reported with modifier 25. Same-day preoperative and postoperative care for the injection is included in the 0-day global period.
Which joints qualify as major joints for this code?
Major sites include the knee, shoulder, hip, and subacromial bursa. The wrist, elbow, ankle, and olecranon bursa are intermediate sites; finger and toe joints are small sites.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,76920606,,Drain/inj joint/bursa w/us,A,,0.98,1.72,,0.24,,0.12,2.82,1.34,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7702060F,,Pt intrvwd on/before dx mdd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77120610,,Drain/inj joint/bursa w/o us,A,,0.77,1.16,,0.29,,0.13,2.06,1.19,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77220611,,Drain/inj joint/bursa w/us,A,,1.07,1.91,,0.29,,0.14,3.12,1.50,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77320612,,Aspirate/inj ganglion cyst,A,,0.68,1.26,,0.33,,0.09,2.03,1.10,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77420615,,Treatment of bone cyst,A,,2.27,4.95,,1.80,,0.25,7.47,4.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77520650,,Insert and remove bone pin,A,,2.22,4.87,,2.19,,0.38,7.47,4.79,0,010,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136