$48.46
27096 is for an image-guided intra-articular SI joint injection. 20552 is for trigger-point injections into one or two muscles, not an image-guided joint injection.
On this page
CMS RVU26D · Effective 2026-10-01
27096 SI joint injection Medicare reimbursement rates in Kentucky
Reports an image-guided injection into the sacroiliac joint for diagnostic or therapeutic care when medication is delivered within the joint. Compare 27096 office and facility rates across CMS payment localities in Kentucky.
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 27096 in Kentucky?
Kentucky 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
$161.65
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$71.08
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Pain management
About 27096: Image-guided sacroiliac joint injection
Reports an image-guided injection into the sacroiliac joint for diagnostic or therapeutic care when medication is delivered within the joint.
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.
CMS billing rules for 27096
- 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 RVU1.44 · 27%
- Practice expense (office) RVU3.68 · 70%
- Malpractice RVU0.14 · 3%
306.9K
Medicare services in 2024 · #306 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.
27096 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$220.29
64451 addresses nerves supplying the SI joint; 27096 delivers medication into the joint space itself.
$64.14
20610 applies to aspiration or injection of a major joint or bursa, such as the hip or knee. 27096 specifically describes an image-guided SI joint injection.
Compare 27096 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
Kentucky →
Office / nonfacility
$161.65
Facility
$71.08
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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 27096 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,750
- Code
- 27096
- Physician work
- 1.44
- Practice expense
- 3.68
- Malpractice
- 0.14
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.44 | × 1.000 | 1.4400 |
| Practice expense | 3.68 | × 0.889 | 3.2715 |
| Malpractice | 0.14 | × 0.915 | 0.1281 |
| Total RVUs | 4.8396 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$161.65
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.44 | 1 |
| Practice expense | 3.68 | 0.889 |
| Malpractice | 0.14 | 0.915 |
(1.44 × 1 + 3.68 × 0.889 + 0.14 × 0.915) × $33.4009 = $161.65
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.44 | 1 |
| Practice expense | 0.63 | 0.889 |
| Malpractice | 0.14 | 0.915 |
(1.44 × 1 + 0.63 × 0.889 + 0.14 × 0.915) × $33.4009 = $71.08
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.
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 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.
2,74727091,,Removal of hip prosthesis,A,,23.74,14.26,NA,14.26,,5.03,43.03,43.03,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,74827093,,Injection for hip x-ray,A,,1.27,5.54,,0.31,,0.15,6.96,1.73,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,74927095,,Injection for hip x-ray,A,,1.46,8.07,,0.41,,0.22,9.75,2.09,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,75027096,,Inject sacroiliac joint,A,,1.44,3.68,,0.63,,0.14,5.26,2.21,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,75127097,,Revision of hip tendon,A,,9.04,8.32,NA,8.32,,1.92,19.28,19.28,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,75227098,,Transfer tendon to pelvis,A,,9.09,8.68,NA,8.68,,1.93,19.70,19.70,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,75327100,,Transfer of abdominal muscle,A,,11.07,9.87,NA,9.87,,2.36,23.30,23.30,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631