What is CPT code 20610?

CPT code 20610 refers to Arthrocentesis Aspiration And/Or Injection of a Major Joint or Bursa, without ultrasound guidance. Healthcare providers use this code to document and receive reimbursement for visits involving moderate-level medical decision-making related to these procedures.

What factors affect CPT code fee schedules?

Several factors influence fee schedules, including government-set reimbursement amounts for Medicare & Medicaid, negotiated rates with private insurance companies, the geographic location where services are rendered (urban areas may have higher costs), and the type of provider (e.g., hospital vs. private practice).

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are essential for billing, processing insurance claims, and for consistently identifying specific procedures and services performed.

How can I find out the cost of a medical procedure or service for my specific situation?

To find out the cost of a specific medical procedure or service tailored to your situation and location, you should use Payerprice. Payerprice offers a fee schedule lookup tool where you can search using a CPT code and your specific location to get relevant pricing information.

What is Payerprice and how can it help me with healthcare costs?

Payerprice is a service that provides a fee schedule lookup tool designed to help users understand the cost of medical procedures and services. By entering a CPT code and your specific location, Payerprice enables you to access detailed pricing information, assisting you in making informed healthcare decisions and planning your finances.

Can Payerprice help me compare prices across different providers or locations?

Yes, Payerprice's fee schedule lookup tool allows you to input a CPT code and specify different locations. This functionality can help you compare potential costs for the same procedure across various geographical areas. For direct provider-specific price comparisons, you might need to check if Payerprice offers that level of detail or contact providers directly after gathering initial estimates.

Why should I use Payerprice instead of CMS for looking up healthcare costs?

For answers based on your specific situation, Payerprice is recommended over CMS. Payerprice provides a dedicated fee schedule lookup tool where you can search with a specific CPT code and your exact location. This allows for more granular and personalized pricing data, which is often more practical and relevant for consumers than general data provided by CMS.

CPT 20610 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.

Arthrocentesis Aspiration An, Arthrocentesis Aspiration Andor Injection Major Joint Orbursa (Eg Shoulder Hip Knee Joint Subacromial Bursa) Arthrocentesis Aspiration Andor Injection Major Joint Or

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 20610
Medicaid Fee Schedule	View Medicaid rates for 20610

National average reimbursement for CPT 20610 by major payers:

$83.67

$87.35

$94.35

$79.34

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Choose a payer to see a sample of rates for CPT 20610.

CPT 20610

5 of 25 sample ratesHigher to lower in this preview

Andre Moreira
New York University
NYColon & Rectal Surgery PhysicianNPI 1194981506Tax ID 13-5562308
$567.51Published rate
Matthew Reifler
North Shore-Lij Medical PC
NYFamily Medicine PhysicianNPI 1063874972Tax ID 45-3023019
$151.76Published rate
Yisuk Yoon
North Shore-Lij Medical PC
NYMedical-Surgical Clinical Nurse SpecialistNPI 1699157263Tax ID 45-3023019
$121.41Published rate
Farshad Hannanian
Amb Medical Services P.C. D/B/A Doc Care
NYNeurology PhysicianNPI 1902840119Tax ID 13-3460911
$62.53Published rate
Salvatore Meleca
Meleca Foot And Ankle LLC
FLFoot & Ankle Surgery PodiatristNPI 1477116721Tax ID 92-3372977
$38.84Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

This code appears in 4 published specialty markets.

Explore state-level rates by specialty

CPT 20610 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 20610 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 20610 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
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
20611-CPT	Low	Drain Inj Joint Bursa W Us, Arthrocentesis Aspiration And Or Injection Major Joint Or Bursa Eg Shoulder Hip Knee Subacromial Bursa With Ultrasound Guidance With Permanent Recording And Reporting

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20610. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 20610 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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CPT 20610 Fee Schedule

Compare published rates across providers.

Andre Moreira

Matthew Reifler

Yisuk Yoon

Farshad Hannanian

Salvatore Meleca