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See a sample rate comparisonCPT 20604 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Drain Inj Joint Bursa W Us, Arthrocentesis Aspiration And Or Injection Small Joint Or Bursa Eg Fingers Toes With Ultrasound Guidance With Permanent Recording And Reporting
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 20604 |
| Medicaid Fee Schedule | View Medicaid rates for 20604 |
National average reimbursement for CPT 20604 by major payers:
$99.84
$101.53
$110.79
$89.37
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CPT 20604
5 of 25 sample ratesHigher to lower in this preview
Columbia Eye And Specialty Surgery Center Ltd
$2,965.00Published rateWarner Park Surgery Center LLC, Center For Advanced Surgery
Warner Park Surgery Center LLC
$555.00Published rateWalker Surgical Center LLC
$172.50Published rateEvans Procedure Center, LLC
Evans Procedure Center LLC
$93.00Published rateMaryland Aesthetic And Reconstructive Ambulatory Surgical Center LLC
$32.00Published rate
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See a sample payer proposalCPT 20604 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20604 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 20604 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 20600-CPT | Low | Arthrocentesis Aspiration An, Arthrocentesis Aspiration Andor Injection Small Jointbursa Or Ganglion Cyst (Eg Fingers Toes)Arthrocentesis Aspiration Andor Injection Sm All Joint |
| 20604-CPT | Low | Drain Inj Joint Bursa W Us, Arthrocentesis Aspiration And Or Injection Small Joint Or Bursa Eg Fingers Toes With Ultrasound Guidance With Permanent Recording And Reporting |
| 20605-CPT | Low | Drain Inj Joint Bursa W O Us, Arthrocentesis Aspiration And Or Injection Intermediate Joint Or Bursa Eg Temporomandibular Acromioclavicular Wrist Elbow Or Ankle Olecranon Bursa Without Ultrasound Guidance |
| 20610-CPT | Low | Arthrocentesis Aspiration An, Arthrocentesis Aspiration Andor Injection Major Joint Orbursa (Eg Shoulder Hip Knee Joint Subacromial Bursa) Arthrocentesis Aspiration Andor Injection Major Joint Or |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20604 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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