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.
On this page
CMS RVU26D · Effective 2026-10-01
20612 Ganglion treatment Medicare reimbursement rates in Pennsylvania
Report this service for needle aspiration, injection, or both when treating a ganglion cyst, such as a dorsal wrist or finger ganglion. Compare 20612 office and facility rates across CMS payment localities in Pennsylvania.
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 20612 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$64.19–$70.52
2 of 2 localities have a supported rate.
Facility setting
$35.67–$38.18
2 of 2 localities have a supported rate.
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 20612: Ganglion cyst aspiration or injection
Report this service for needle aspiration, injection, or both when treating a ganglion cyst, such as a dorsal wrist or finger ganglion.
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.
CMS billing rules for 20612
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU0.68 · 33%
- Practice expense (office) RVU1.26 · 62%
- Malpractice RVU0.09 · 4%
25.9K
Medicare services in 2024 · #1036 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.
20612 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
20605 applies to an intermediate joint or bursa without ultrasound guidance; it is not the code for a ganglion cyst at a nearby site.
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.
20611 describes a major joint or bursa procedure with ultrasound guidance. Use 20612 for a ganglion cyst, not merely because ultrasound is used.
Compare 20612 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$70.52
Facility
$38.18
Rest Of Pennsylvania →
Office / nonfacility
$64.19
Facility
$35.67
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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 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.
