Billing code 20612: Ganglion treatmentMedicare rate & RVUs in Oregon
Report this service for needle aspiration, injection, or both when treating a ganglion cyst, such as a dorsal wrist or finger ganglion.
Medicare pays $66.74–$72.07 for 20612 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
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 9 sections
What 20612 covers
This service covers needle aspiration of a ganglion cyst, injection into a ganglion cyst, or both during the same treatment. Ganglia commonly treated include those on the back of the wrist and around the fingers or feet. Orthopedic, hand, podiatric, and other clinicians may perform the procedure in an office or facility setting, often after evaluating a palpable mass or symptoms such as pain or limited motion.
Select the code when the needle procedure targets a ganglion cyst, rather than a joint or bursa. Document the cyst’s location and the treatment performed; distinguish the cyst from a joint or bursal target in the record. The 0-day global period includes same-day preoperative and postoperative care. When this service is performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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.
Where 20612 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $72.07 | $37.56 |
| Rest Of Oregon | $66.74 | $35.80 |
How the 20612 rate is calculated
Each of 20612’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 · 20612
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.68Practice expense 1.26Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 20612
The CMS indicators that decide how 20612 is paid alongside other services.
CMS payment indicators · 20612
Ganglion treatment
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 51 · payment effect
With and without the modifier
20612 without 51 · national office
$67.80
Ganglion treatment
20612-51 · Second procedure: 50%
$33.90
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
20612 compared with similar codes
Compare codes
20612 vs 20600 vs 20605 vs 20610 vs 20611: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 20600Joint aspiration/injection
- 20600 is for aspiration or injection of a small joint or bursa without ultrasound guidance. Choose 20612 when treating a ganglion cyst rather than a joint or bursa.
- 20605Joint procedure
- 20605 applies to an intermediate joint or bursa without ultrasound guidance; it is not the code for a ganglion cyst at a nearby site.
- 20610Joint injection
- 20610 is for a major joint or bursa without ultrasound guidance. A ganglion cyst remains the target distinction for 20612, regardless of proximity to a joint.
- 20611Joint aspiration/injection
- 20611 describes a major joint or bursa procedure with ultrasound guidance. Use 20612 for a ganglion cyst, not merely because ultrasound is used.
20612 billing questions
When should this code be used instead of a joint aspiration code?
Use this code when the needle targets a ganglion cyst. Use the joint or bursa code that matches the target when the procedure is directed into a joint or bursa.
Does this code cover aspiration and injection during the same treatment?
Yes. It covers aspiration, injection, or both when performed to treat a ganglion cyst.
Should modifier 50 be reported for ganglia on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Is same-day evaluation and follow-up included?
The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be paid for this procedure?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
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
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