Medical billers use CPT Code 20610 to show that a patient had a major joint injection or fluid removal from a big joint like the knee, shoulder, or hip without using ultrasound pictures during the medical procedure. This means the doctor put a needle into the joint to take fluid out or put medicine in to help with pain or swelling.
For example, if a patient has a painful knee with swelling and the doctor injects medicine directly into the knee joint to reduce the pain, they would use CPT Code 20610 to bill the insurance company of the patient for that procedure.
CPT Code 20610 Description
CPT 20610 stands for arthrocentesis, aspiration and/or injection of a major joint or bursa without ultrasound guidance. A bursa is a little fluid-filled sac near a joint that also can be injected or drained.
In simpler words, CPT 20610 is used when a big joint is treated by a needle for draining fluid, injecting medicine, or both and no ultrasound machine is used while doing it.
How CPT Code 20610 is Reimbursed
Medicare and many other private insurance companies do pay for CPT 20610 when it’s medically needed. That means if a doctor does the procedure for a valid health reason, Medicare Part B will pay a fixed amount based on the Medicare Physician Fee Schedule 2026. The exact number can change each year and depends on where the doctor works (office or hospital), but it is generally about $60–$70 for the doctor’s service in a regular office setting.
Medicare splits the payment roughly like this:
- Medicare pays about 80% of the allowed amount.
- The patient may owe the rest (usually 20%) unless they have extra insurance.
Does CPT Code 20610 Need Modifiers?
Yes, CPT 20610 often needs modifiers to show extra information on the medical bill. Here is what each modifier means and when it is used:
Modifier 50: Used for bilateral procedures
Use modifier 50 when the doctor performs CPT 20610 on both left and right joints during the same visit.
For example, injections in both shoulders or both knees.
Modifier 51: Used for multiple procedures
This modifier 51 is used when the doctor performs more than one different procedure during the same visit.
For example, the doctor performs a knee injection (20610) and a separate unrelated procedure like a wound repair. Modifier 51 tells the payer it was not the only service performed in that visit.
Modifier 59: Used for separate/distinct joint injections
Use Modifier 59 when injections are done on different joints, and each one needs to be billed separately.
For example, the doctor injects the right knee and the left shoulder. Modifier 59 shows these injections are separate services on separate joints, not duplicates.
Modifier RT: Used for the right side
Use Modifier RT when the injection is performed on the right joint.
For example, right knee injection → 20610-RT. This ensures the claim clearly shows right-sided treatment.
Modifier LT: Used for the left side
Use Modifier LT when the injection is performed on the left joint.
For example, left shoulder injection → 20610-LT. This makes it clear that the service was done on the left side.
Modifier 76: Used for repeat procedure by the same doctor
Use Modifier 76 when the same provider repeats the same injection on the same day for a medical reason.
For example, the doctor injects the knee, the patient returns later the same day, and the doctor needs to repeat the procedure. Modifier 76 proves it is a second medically necessary injection.
Modifier 77: Used for repeat procedure by another doctor
Use Modifier 77 when a different provider repeats the same injection on the same day.
For example, doctor A injects the knee in the morning, and Doctor B repeats the procedure that afternoon. Modifier 77 tells the insurer the service was done twice, but by different clinicians.
Modifier 78: Used for related return to the procedure room
Use this when the patient returns during the post-op period for a related problem that needs another procedure.
For example, after a previous joint aspiration, the patient returns with a related swelling issue that requires another procedure. Not used often for 20610, but still valid.
Modifier 79: Used for unrelated procedure during post-op period
Use Modifier 79 when the injection is unrelated to the procedure the patient is healing from.
For example, the patient is in the post-op period for back surgery but needs a knee injection. Modifier 79 proves the services are unrelated.
Modifier 22: Used for increased procedural service
Use Modifier 22 when the injection requires much more work than usual and it is fully documented.
For example, severe swelling or abnormal anatomy makes the procedure harder. Modifier 22 tells the insurer the service required extra skill, time, or difficulty.
Modifier 25: Used for significant, separate E/M visit on the same day
Use Modifier 25 when the doctor performs a separate and significant office visit in addition to the injection.
For example, the patient comes for knee pain. The doctor performs a full exam, creates a treatment plan, and performs the injection. Modifier 25 proves the office visit was medically necessary and not part of the procedure.
Modifier 24: Used for unrelated E/M visit during post-op period
Use Modifier 24 when the patient is in the post-op period for another procedure, but needs an office visit for a different, unrelated problem.
For example, the patient is healing from shoulder surgery but comes in for hip pain, and a hip injection is done. Modifier 24 proves the visit is not connected to the previous surgery.
CPT Code 20610 Medicare Reimbursement 2026
Medicare updates payment every year. For 2026, doctors will use the Medicare Physician Fee Schedule to see how much Medicare pays for 20610. Nationally, it’s usually around $60 to $70 for the service in a doctor’s office, but it can change by region and if you’re in a hospital or surgery center.
This payment is set by Medicare policies and can change each year based on new rules.
Difference Between CPT 20610 and 20611
The main difference is whether the doctor used ultrasound pictures while doing the injection.
- 20610 is for major joints (like knees) without ultrasound guidance.
- 20611 is almost the same procedure but done with ultrasound guidance and recording.
Medicare Guidelines for CPT 20610
Medicare says:
- One unit of 20610 is for one joint treated.
- If more than one joint is done at the same time, you must use modifiers correctly.
- You cannot report more than one unit per joint, even if both aspiration and injection were done.
- You can report an office visit CPT 99213 only if it is a separate issue and not just part of the injection visit, and you use modifier 25 on the visit code.
Do You Want Full Reimbursement for CPT Code 20610?
- To get full payment for CPT 20610:
- Use the correct code.
- Add the correct modifier for the joint and situation.
- Document clearly that the procedure was medically needed.
- Report any separate office visit only with the right modifier.
If you do this, insurers like Medicare are much more likely to pay correctly. However, if you are not getting what you have earned, click here, we will help you to connect the best medical billers.
FAQs
The answers to your questions:
Can CPT code 20610 be billed with 99213?
Yes, only if there was a separate office visit, and you use modifier 25 on the office visit.
Does CPT code 20610 include fluoroscopy?
No. Fluoroscopy or other imaging isn’t part of the code; if imaging guidance is done, a different code or guidance code may be needed.
Can you bill CPT code 20610 twice?
You normally cannot bill it twice for the same joint. You can bill multiple units only if separate joints are treated.
What does CPT code 20610 mean?
It means a joint injection or fluid removal procedure on a major joint done without ultrasound guidance.
Does CPT code 20610 have a global period?
Medicare treats it as having no significant global period — doctors bill what they do on the date of service. Reimbursement rules vary by insurer.