CPT 20610 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 20610 by major payers:
$83.67
$87.35
$94.35
$107.22
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 20610 | ||||||
United | 20610 | $60.00 | 1760938559 - PHYSICAL THERAPY ATHLETIC CENTER LLC | 813077472 - (FL) PHYSICAL THERAPY ATHLETIC CENTER LLC | FL | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 20610 | $52.27 | 1003167206 - BARBARA BUCKLEY | 591575766 - (FL) CORTEZ FOOT & ANKLE SPECIALISTS, P.A. | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 20610 | $73.40 | 1134252349 - BRYAN BOTNER | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 20610 | $123.00 | 1982954640 - BAKERSFIELD SPECIALTY SURGERY CENTER, PC | 454955212 - (CA) BAKERSFIELD SPECIALTY SURGERY CENTER PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $230.00 | 1992238661 - OPTIMUM SURGICAL CENTER, LLC, NASCENT PARADISE VALLEY SURGICAL CENTER | 814730990 - (AZ) OPTIMUM SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $500.00 | 1376716316 - CPM SURGERY CENTER LLC | 261382311 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $688.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $232.61 | 1508220542 - VIN SHEN BAN | 770465765 | CA | Neurological Surgery Physician (207T00000X) |
United | 20610 | $69.00 | 1275574154 - DOCTORS SURGERY CENTER OF TEXARKANA, DOCTOR'S SURGERY CENTER | 710796220 - (AR) DOCTORS SURGERY CENTER OF TEXARKANA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $52.91 | 1164535753 - JOSE DIAZ | 562656591 - (FL) JOSE JUAN DIAZ DO PA | FL | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 20610 | $63.00 | 1427028919 - CASCADE ENDOSCOPY CENTER, LLC, CASCADE ENDOSCOPY CENTER | 931331197 - (OR) CASCADE ENDOSCOPY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $152.00 | 1578221479 - SKIN CANCER AND LASER SURGERY CENTER LLC | 854119523 - (IN) SKIN CANCER AND LASER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $100.00 | 1760847792 - OCALA FL ORTHOPAEDIC ASC LLC | 472831130 - (FL) OCALA FL ORTHOPAEDIC ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20610 | $61.56 | 1356322986 - GEORGE IBARS | 261179038 - (FL) CONSULTANTS IN NEUROLOGICAL SURGERY, LLP | FL | Neurological Surgery Physician (207T00000X) |
United | 20610 | $381.00 | 1427422799 - WEBSTER AMBULATORY SUGERY CENTER LP, SUNSET HILLS SURGERY CENTER | 205953387 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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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 |
|---|---|---|
| 20550-CPT | Low | Inj Tendon Sheath Lig Trigger Pnt Gangli |
| 20553-CPT | Low | Injection(S); Tendon Sheath, Ligament; Single Or Multiple Trigger Point(S), Three Or More Muscles |
| 20600-CPT | Low | Arthrocentesis Aspiration And/Or Injection; Smalljoint Bursa(Eg Fingers Toes);Without Ultrasound Guidance (Desc Revised 1/1/15) |
| 20610-CPT | Low | Arthrocentesis Aspiration And/Or Injection; Majorjoint Or Bursa (Eg Shoulder Hip Knee Joint Su Bacromial Bursa); Without Ultrasound Guidance (Desc Revised 1/1/2015) |
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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