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See a sample rate comparisonCPT 20611 Fee Schedule
Medicare rates as of October 2026
CPT 20611 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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
| 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 | RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $104.21 national non-facility rate (2026) · View Medicare rates for 20611 |
| Medicaid Fee Schedule | $81.245 median of the 8 states in the free preview · View Medicaid rates for 20611 |
National average reimbursement for CPT 20611 by major payers:
$122.09
BCBS / Anthem
$127.10
UnitedHealthcare
$137.49
Aetna
$113.17
Cigna
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CPT 20611
5 of 25 sample ratesHigher to lower in this preview
Heather Kowalski
$773.01Published rateHeather Kowalski
$347.04Published rateDaniel Smith
$174.42Published rateDouglas C Gula Do PA, Midwest Orthopedics And Sports Medicine, Midwest Orthopedics & Sports Medicine
$112.94Published rateCenter For Orthopedic Research And Education, LLC, The Core Institute
$62.29Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 20611 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20611. Select one to see its fee schedule.
| 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 |
| 20606-CPT | Low | Drain Inj Joint Bursa W Us, Arthrocentesis Aspiration And Or Injection Intermediate Joint Or Bursa Eg Temporomandibular Acromioclavicular Wrist Elbow Or Ankle Olecranon Bursa 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 20611. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20611 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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Frequently Asked Questions
CPT 20611 describes 'Arthrocentesis, Aspiration And/Or Injection, Major Joint Or Bursa (Eg, Shoulder, Hip, Knee, Subacromial Bursa); With Ultrasound Guidance, With Permanent Recording And Reporting.' This code is utilized by healthcare providers for encounters that involve moderate-level medical decision-making, frequently encompassing multiple diagnoses or the management of prescriptions.
Several factors influence the fee schedules for codes like CPT 20611. These include government-set Medicare & Medicaid Rates, Private Insurance Rates which are negotiated between providers and insurers, Geographic Location where costs can be higher in urban areas, and Provider Type, as hospital providers may have different rates compared to private practices. For specific fee schedule information tailored to a CPT code and your location, we recommend utilizing the fee schedule lookup tool available on Payerprice.
CPT 20611 is classified as a moderate-complexity code within the Surgery services, specifically for Surgical Procedures on the Musculoskeletal System. Compared to lower-level codes, it typically demands more provider time and involves moderate medical decision-making. This often includes scenarios with multiple diagnoses, medication management, or the interpretation of tests, which generally results in higher reimbursement and necessitates more detailed documentation.