Billing code 20606: Joint aspirationMedicare rate & RVUs in Utah
Reports aspiration, injection, or both for an intermediate joint or bursa when ultrasound guides needle placement and the images are recorded and reported.
Medicare pays $90.33 for 20606 in the office in Utah (Utah). 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 20606 covers
This service covers needle aspiration, injection, or both in an intermediate joint or bursa with ultrasound guidance. Typical sites include the wrist, elbow, ankle, acromioclavicular joint, temporomandibular joint, and olecranon bursa. Orthopedic clinicians, rheumatologists, and other qualified practitioners commonly perform it in an office or outpatient setting. The ultrasound guidance, image recording, and reporting are part of the service.
Select the code by the joint or bursa’s size and whether ultrasound guidance is used: this code is for an intermediate site with ultrasound, not a small or major site. The record should identify the treated site, the aspiration or injection performed, and the ultrasound guidance and image documentation. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies a bilateral procedure, which CMS pays at 150%. Assistant-at-surgery payment is restricted; 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.
20606 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $90.33 | $43.87 |
How the 20606 rate is calculated
Each of 20606’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 · 20606
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.98Practice expense 1.72Malpractice 0.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 20606
The CMS indicators that decide how 20606 is paid alongside other services.
CMS payment indicators · 20606
Joint aspiration
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 50 · payment effect
With and without the modifier
20606 without 50 · national office
$94.19
Joint aspiration
20606-50 · Bilateral: 150%
$141.29
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
20606 compared with similar codes
Compare codes
20606 vs 20605 vs 20604 vs 20611 vs 20610: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 20605Joint procedure
- Both describe an intermediate-joint or bursa procedure. Report 20606 when ultrasound guidance with image recording and reporting is used; report 20605 for the procedure without that guidance.
- 20604Joint aspiration or injection
- 20604 is for a small joint or bursa with ultrasound guidance. 20606 is for an intermediate joint or bursa with ultrasound guidance.
- 20611Joint aspiration/injection
- 20611 applies to a major joint or bursa with ultrasound guidance. Use 20606 for an intermediate site instead.
- 20610Joint injection
- 20610 is for a major joint or bursa without ultrasound guidance. 20606 is for an intermediate site and includes ultrasound guidance.
20606 billing questions
How is 20606 different from 20605?
Both apply to an intermediate joint or bursa, but 20606 includes ultrasound guidance with image recording and reporting. Use 20605 when the intermediate-site procedure is performed without ultrasound guidance.
Which sites are considered intermediate for this code?
Common examples include the wrist, elbow, ankle, acromioclavicular joint, temporomandibular joint, and olecranon bursa. Choose the code based on the treated anatomy and whether ultrasound guidance is used.
Can ultrasound guidance be billed separately?
The ultrasound guidance, image recording, and reporting are included in 20606. Document the guidance and images, but do not separately report ultrasound guidance for this same procedure.
What documentation supports 20606?
Record the specific joint or bursa, whether aspiration, injection, or both were performed, and the use of ultrasound guidance. Retain the required image recording and report.
How is a bilateral procedure reported?
CMS identifies 20606 as bilateral when reported with modifier 50 and pays it at 150%. The medical record should support treatment of the corresponding site on both sides.
What happens when 20606 is performed with another procedure?
For multiple procedures in the same session, CMS pays the highest-valued procedure in full and the other procedures at 50%. Same-day preoperative and postoperative care is included in 20606’s 0-day global period.
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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