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: October 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

Check Rates

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

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 Check Rates
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 Check Rates
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 Check Rates
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 Check Rates

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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 20610) and we'll show you how you compare in 15 minutes or less.

Schedule a Demo