CPT 20610: Major Joint Injection/Aspiration
CPT 20610 reports arthrocentesis, aspiration, and/or injection of a major joint or bursa (shoulder, hip, knee, subacromial bursa) without ultrasound guidance. It is the workhorse code for orthopedic and rheumatology joint injections. In 2026 Medicare pays about $68.81 non-facility and $39.75 facility, with a 000 global period.
- Code type
- Surgical - arthrocentesis/injection, major joint or bursa
- 2026 non-facility
- $68.81
- 2026 facility
- $39.75
- Global period
- 000 days
What is CPT 20610 used for?
CPT 20610 reports arthrocentesis, aspiration, and/or injection of a major joint or bursa without ultrasound guidance. Major joints under this code are the shoulder, hip, knee, and the subacromial bursa. It covers draining fluid, injecting a therapeutic drug such as a corticosteroid or hyaluronic acid, or doing both in the same visit through the same needle stick.
If ultrasound guidance is used and documented with a permanent image, you report 20611 instead. Smaller joints use different codes: 20605 for intermediate joints and 20600 for small joints. Choosing 20610 comes down to which joint and whether imaging guidance was used.
How much does 20610 pay in 2026?
Under the 2026 Medicare fee schedule, 20610 allows about $68.81 non-facility and $39.75 facility. The office rate is higher because the practice absorbs the tray, needle, and clinical staff expense.
| Setting | 2026 Medicare allowed |
|---|---|
| Non-facility (office) | ~$68.81 |
| Facility (hospital outpatient) | ~$39.75 |
Example: a rheumatologist injects a patient's right knee with triamcinolone in the office. You bill 20610-RT at about $68.81, plus J3301 for the drug units. Run your own locality-adjusted figure through the Medicare fee calculator.
How do you bill the injected drug and waste?
The procedure code never includes the medication. Report the drug on its own line with the correct HCPCS J-code and the exact units given. When a single-use vial is partially discarded, Medicare requires the discarded amount on a separate line so the whole vial is accounted for:
- Bill 20610 for the injection with the correct laterality modifier.
- Bill the administered drug units on a J-code line (for example J3301).
- Bill any discarded single-use-vial drug on a second line with modifier JW; use modifier JZ when there is zero waste.
Which modifiers matter for 20610?
Because injections are side-specific, laterality drives clean payment. Use LT or RT for a single side. When both the left and right of the same joint are injected in one visit, append modifier 50 for the bilateral procedure rather than reporting 20610 twice. If the same joint on the same side is injected twice at the same session, that is still one unit.
With a 000 global period, an office visit on the same date can be reported using modifier 25 when a significant, separately identifiable evaluation is documented beyond the injection. Related codes include 20552 for trigger point injections and the broader NCCI edits that govern bundling.
Frequently asked questions
In 2026 the national non-facility allowed amount is about $68.81, and the facility rate is about $39.75. The office (non-facility) rate is higher because the practice supplies the tray, needle, and staff. Medicare pays 80 percent and the patient or secondary plan owes the 20 percent coinsurance after the deductible.
Yes. 20610 pays only for the procedure. Report the medication separately with its HCPCS J-code (for example J3301 for triamcinolone), billing the number of units administered. If you discard part of a single-use vial, report the wasted amount on a second line with modifier JW, and JZ when there is no waste, so the record is complete.
20610 has a 000-day global period, meaning no post-operative days are bundled. A significant, separately identifiable E/M service on the same date can be billed with modifier 25 when the documentation supports work beyond the injection itself.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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