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See a sample rate comparisonCPT 20615 Fee Schedule
Medicare rates as of October 2026
CPT 20615 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Treatment Of Fluid Sac (Cyst), Treatment Of A Ganglion (Near A Joint Or Tendon) Or Bone Cyst (Fluid-Filled Sac). A Sample Of Fluid Is Withdrawn From The Cyst Then Medicine Is Injected Into It.
| 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 5071 - Level 1 Excision/ Biopsy/ Incision and Drainage |
| Surgery Center Payment (ASC) | P3 - Office-based; paid from physician fee schedule practice expense |
| Add-on Codes | 77002 |
| Common Revenue Codes | 03610360Sign up to view all 3 |
| Medicare Fee Schedule | $249.51 national non-facility rate (2026)View Medicare rates for 20615 |
| Medicaid Fee Schedule | $200.615 median of the 8 states in the free previewView Medicaid rates for 20615 |
National average reimbursement for CPT 20615 by major payers:
$309.30
BCBS / Anthem
$318.79
UnitedHealthcare
$339.69
Aetna
$278.89
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20615.
CPT 20615
5 of 25 sample ratesHigher to lower in this preview
Greater Dayton Surgery Center LLC
Greater Dayton Surgery Center
$4,351.00Published rateSsm St. Joseph Surgery Center, LLC, The Surgery Center At St. Joseph Medical Park
Ssm St Joseph Surgery Center LLC
$1,183.00Published rateTreasure Coast Asc, LLC, Treasure Coast Center For Surgery
$893.00Published rateAtlantic Gastro Surgicenter, LLC, T/A Access
Atlantic Gastro Surgicenter LLC
$400.00Published rateLakeforest Ambulatory Surgery Center, District Heights Ambulatory Surgery Center
Lakeforest Ambulatory Surgery Center
$184.00Published rate
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See a sample payer proposalCPT 20615 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20615. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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 |
| 20611-CPT | 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 |
| 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. |
| 20615-CPT | Treatment Of Fluid Sac (Cyst), Treatment Of A Ganglion (Near A Joint Or Tendon) Or Bone Cyst (Fluid-Filled Sac). A Sample Of Fluid Is Withdrawn From The Cyst Then Medicine Is Injected Into It. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20615. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20615 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 20615 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20615 to APC 5071 (Level 1 Excision/ Biopsy/ Incision and Drainage). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20615 in an ambulatory surgery center?
CMS lists CPT 20615 with ASC payment indicator P3: Office-based; paid from physician fee schedule practice expense.
Which add-on codes are billed with CPT 20615?
CMS add-on code edits list CPT 20615 as a primary code for these add-on codes: 77002.
Which revenue codes are billed with CPT 20615?
Hospital price transparency files list CPT 20615 under these revenue codes: 0361, 0360 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.