$53.99
Use 20600 for a small-joint or bursa aspiration or injection without ultrasound guidance. 20604 includes ultrasound guidance with permanent recording and reporting.
On this page
CMS RVU26D · Effective 2026-10-01
20604 Joint aspiration or injection Medicare reimbursement rates in New Mexico
Report this service when a clinician aspirates fluid from or injects a small joint or bursa using ultrasound guidance with permanent image recording. Compare 20604 office and facility rates across CMS payment localities in New Mexico.
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 20604 in New Mexico?
New Mexico 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
$83.40
1 of 1 localities have a supported rate.
Payment area: New Mexico
One mapped payment locality.
Facility setting
$39.90
1 of 1 localities have a supported rate.
Payment area: New Mexico
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 20604: Ultrasound-guided small joint aspiration or injection
Report this service when a clinician aspirates fluid from or injects a small joint or bursa using ultrasound guidance with permanent image recording.
An orthopedist, rheumatologist, sports medicine physician, or other qualified clinician uses ultrasound to guide a needle into a small joint or bursa for fluid removal, medication delivery, or both. Common targets include joints of the fingers or toes. The ultrasound guidance, permanent image recording, and reporting are part of the service. It may be performed in an office or facility setting.
Choose this code for a small joint or bursa, rather than an intermediate or major target; document the site, whether aspiration, injection, or both occurred, and the ultrasound guidance and saved images. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. For bilateral services reported with modifier 50, CMS pays 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 20604
- 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 RVU0.87 · 33%
- Practice expense (office) RVU1.63 · 62%
- Malpractice RVU0.11 · 4%
61.2K
Medicare services in 2024 · #706 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.
20604 compared with similar codes
Office rates for New Mexico, from the same CMS release.
$90.23
Both include ultrasound guidance, but 20606 is for an intermediate joint or bursa; 20604 is for a small joint or bursa.
$99.86
Both include ultrasound guidance, but 20611 is for a major joint or bursa; 20604 is for a small joint or bursa.
$64.91
20612 addresses aspiration or injection of a ganglion cyst. Use 20604 for a small joint or bursa rather than a ganglion cyst.
Compare 20604 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
New Mexico →
Office / nonfacility
$83.40
Facility
$39.90
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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 20604 in New Mexico.
PPRRVU2026_Oct_nonQPP.csv
1,767
- Code
- 20604
- Physician work
- 0.87
- Practice expense
- 1.63
- Malpractice
- 0.11
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.87 | × 1.000 | 0.8700 |
| Practice expense | 1.63 | × 0.917 | 1.4947 |
| Malpractice | 0.11 | × 1.201 | 0.1321 |
| Total RVUs | 2.4968 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, New Mexico$83.40
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.87 | 1 |
| Practice expense | 1.63 | 0.917 |
| Malpractice | 0.11 | 1.201 |
(0.87 × 1 + 1.63 × 0.917 + 0.11 × 1.201) × $33.4009 = $83.40
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.87 | 1 |
| Practice expense | 0.21 | 0.917 |
| Malpractice | 0.11 | 1.201 |
(0.87 × 1 + 0.21 × 0.917 + 0.11 × 1.201) × $33.4009 = $39.90
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.
20604 billing questions
How does this differ from 20600?
Both codes address a small joint or bursa. Report 20604 when ultrasound guidance is used and permanently recorded and reported; 20600 is the counterpart without ultrasound guidance.
Can ultrasound guidance be billed separately?
The ultrasound guidance, permanent recording, and reporting are included in 20604. Do not separately report guidance for the same aspiration or injection.
Which joint-size code applies to a wrist injection?
The wrist is an intermediate joint, not a small joint. Use the code matching the intermediate-joint service and whether ultrasound guidance was used.
What documentation supports 20604?
Document the specific small joint or bursa, the aspiration or injection performed, and ultrasound guidance with permanent image recording and reporting.
How is bilateral treatment paid?
When the bilateral procedure is reported with modifier 50, CMS pays 150% under the supplied fee schedule rule.
What happens when this is performed with another procedure?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%.
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.
1,76420560,,Ndl insj w/o njx 1 or 2 musc,A,,0.31,0.42,,0.05,,0.01,0.74,0.37,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76520561,,Ndl insj w/o njx 3+ musc,A,,0.47,0.64,,0.09,,0.03,1.14,0.59,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76620600,,Drain/inj joint/bursa w/o us,A,,0.64,0.96,,0.22,,0.08,1.68,0.94,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76720604,,Drain/inj joint/bursa w/us,A,,0.87,1.63,,0.21,,0.11,2.61,1.19,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76820605,,Drain/inj joint/bursa w/o us,A,,0.66,0.97,,0.22,,0.08,1.71,0.96,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76920606,,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
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097
7704212,NM,05,NEW MEXICO,1.000,0.917,1.201
7813202,NY,01,MANHATTAN,1.064,1.162,1.586
7913202,NY,02,NYC SUBURBS/LONG ISLAND,1.064,1.189,1.857
8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210