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See a sample rate comparisonCPT 20612 Fee Schedule
CPT 20612 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Treatment Of Fluid Sac (Cyst), Procedure To Remove Thick Fluid From A Ganglion (Near A Joint Or Tendon) Or Bone Cyst (Fluid-Filled Sac). The Area Is Injected With Medication To Help Shrink Or Remove The Cyst.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11Office 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5441 - Level 1 Nerve Injections |
| Surgery Center Payment (ASC) | P3 - Office-based; paid from physician fee schedule practice expense |
| Add-on Codes | 77002 |
| Common Revenue Codes | 03610450Sign up to view all 13 |
| Medicare Fee Schedule | View Medicare rates for 20612 |
| Medicaid Fee Schedule | $52.885 median of the 8 states in the free previewView Medicaid rates for 20612 |
National average reimbursement for CPT 20612 by major payers:
$81.70
BCBS / Anthem
$80.80
UnitedHealthcare
$87.91
Aetna
$71.09
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20612.
CPT 20612
5 of 25 sample ratesHigher to lower in this preview
Indiana Endoscopy Centers LLC, Indiana Endoscopy Center West
$4,613.00Published rateSurgical Elite Of Avondale, LLC
Surgical Elite Of Avondale LLC
$574.00Published rateHanover Surgicenter, L.L.C.
$300.00Published rateCarolina Interventional Pain Institute, LLC, Carolina Interventional Pain Institute, LLC
Carolina Interventional Pain Institute LLC
$108.00Published rateSamantha Sollman
Deaconess Hospital Inc
$48.38Published rate
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See a sample payer proposalCPT 20612 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20612. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 20550-CPT | Inject(S); Sngle Tndon Sheath Or Ligamnt Aponeurosis, Injection(S); Single Tendon Sheath Or Ligament Aponeurosis (Eg Plan |
| 20600-CPT | Arthrocentesis Aspiration An, Arthrocentesis Aspiration Andor Injection Small Jointbursa Or Ganglion Cyst (Eg Fingers Toes)Arthrocentesis Aspiration Andor Injection Sm All Joint |
| 20610-CPT | Arthrocentesis Aspiration An, Arthrocentesis Aspiration Andor Injection Major Joint Orbursa (Eg Shoulder Hip Knee Joint Subacromial Bursa) Arthrocentesis Aspiration Andor Injection Major Joint Or |
| 20612-CPT | Treatment Of Fluid Sac (Cyst), Procedure To Remove Thick Fluid From A Ganglion (Near A Joint Or Tendon) Or Bone Cyst (Fluid-Filled Sac). The Area Is Injected With Medication To Help Shrink Or Remove The Cyst. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20612. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20612 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
What APC is CPT 20612 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20612 to APC 5441 (Level 1 Nerve Injections). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20612 in an ambulatory surgery center?
CMS lists CPT 20612 with ASC payment indicator P3: Office-based; paid from physician fee schedule practice expense.
Which add-on codes are billed with CPT 20612?
CMS add-on code edits list CPT 20612 as a primary code for these add-on codes: 77002.
Which revenue codes are billed with CPT 20612?
Hospital price transparency files list CPT 20612 under these revenue codes: including 0361, 0450, 0761, 0510 and 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.