$54.47
Use 20600 for aspiration or injection of a small joint or bursa, rather than an intermediate site such as the wrist, elbow, or ankle.
On this page
CMS RVU26D · Effective 2026-10-01
20605 Joint procedure Medicare reimbursement rates in Vermont
Report this service for aspiration and/or injection of an intermediate joint or bursa, such as the wrist, elbow, ankle, or acromioclavicular joint, without ultrasound guidance. Compare 20605 office and facility rates across CMS payment localities in Vermont.
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 20605 in Vermont?
Vermont 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
$55.47
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$30.67
1 of 1 localities have a supported rate.
Payment area: Vermont
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 20605: Intermediate joint aspiration or injection
Report this service for aspiration and/or injection of an intermediate joint or bursa, such as the wrist, elbow, ankle, or acromioclavicular joint, without ultrasound guidance.
Orthopedists, rheumatologists, sports medicine clinicians, and other qualified practitioners use this service to withdraw fluid from or inject medication into an intermediate joint or bursa. Common targets include the wrist, elbow, ankle, acromioclavicular joint, and temporomandibular joint. It is performed in settings such as an office, clinic, or hospital outpatient department when the clinical need calls for treatment or fluid sampling at one of these sites without ultrasound guidance.
Select the code based on the treated site and whether aspiration, injection, or both are performed; document the specific joint or bursa, laterality, procedure, and clinical reason. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard reduction to the others. For bilateral treatment 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 20605
- 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 RVU0.66 · 39%
- Practice expense (office) RVU0.97 · 57%
- Malpractice RVU0.08 · 5%
352.7K
Medicare services in 2024 · #280 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.
20605 compared with similar codes
Office rates for Vermont, from the same CMS release.
$91.64
Both codes address intermediate joints or bursae; 20606 is for procedures performed with ultrasound guidance, while 20605 is without it.
$66.27
Use 20610 for a major joint or bursa, not an intermediate site. Both codes describe procedures performed without ultrasound guidance.
$101.26
20611 is for aspiration or injection at a major joint or bursa with ultrasound guidance; 20605 is for an intermediate site without ultrasound.
Compare 20605 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
Vermont →
Office / nonfacility
$55.47
Facility
$30.67
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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 20605 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
1,768
- Code
- 20605
- Physician work
- 0.66
- Practice expense
- 0.97
- Malpractice
- 0.08
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.66 | × 1.000 | 0.6600 |
| Practice expense | 0.97 | × 0.990 | 0.9603 |
| Malpractice | 0.08 | × 0.506 | 0.0405 |
| Total RVUs | 1.6608 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$55.47
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.66 | 1 |
| Practice expense | 0.97 | 0.99 |
| Malpractice | 0.08 | 0.506 |
(0.66 × 1 + 0.97 × 0.99 + 0.08 × 0.506) × $33.4009 = $55.47
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.66 | 1 |
| Practice expense | 0.22 | 0.99 |
| Malpractice | 0.08 | 0.506 |
(0.66 × 1 + 0.22 × 0.99 + 0.08 × 0.506) × $33.4009 = $30.67
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.
20605 billing questions
How does this differ from codes for small or major joints?
Choose the code level based on the joint or bursa treated. This code is for intermediate sites such as the wrist, elbow, ankle, acromioclavicular joint, or temporomandibular joint.
Can this code be reported when ultrasound guides the procedure?
No. For ultrasound-guided aspiration or injection of an intermediate joint or bursa, use 20606 instead.
What should the procedure note identify?
Document the specific joint or bursa, side, whether fluid was aspirated or medication injected, and the clinical reason for the procedure.
How is bilateral treatment reported under the CMS rule?
Report bilateral treatment with modifier 50; CMS pays 150% for the bilateral procedure.
Does the code include the injected medication?
The code describes the aspiration or injection procedure, not a particular drug. It does not by itself identify or report the medication administered.
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.
1,76520561,,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
1,77120610,,Drain/inj joint/bursa w/o us,A,,0.77,1.16,,0.29,,0.13,2.06,1.19,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817