Reimbursement
$50.77
Threshold
N/A
2026 Status
Active
What is CPT Code 20611?
CPT 20611 is defined as: Arthrocentesis, aspiration, and/or injection of a major joint or bursa (e.g., shoulder, hip, knee joint, or subacromial bursa) performed with ultrasound guidance. This procedure includes the permanent recording and reporting of the ultrasound images. It is used to drain fluid (aspiration) for diagnostic purposes or to inject therapeutic agents (e.g., corticosteroids, viscosupplementation) to treat inflammation and pain.
This code is primarily used for Specialist services. It falls under the category of Surgery / Musculoskeletal System and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
0.95
Physician Effort
PE (Non-Fac)
0.5
Practice Expense
Malpractice
Risk Factor
Total RVU
1.52
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
efficiency adjustment
Subject to -2.5% Efficiency Adjustment. CMS has reduced the Work RVU component, assuming that the widespread adoption of bedside ultrasound has made the procedure faster and more efficient for the physician.
conversion factor
Payments are based on the 2026 Non-QP rate of $33.40.
pe allocation
Independent clinics (POS 11) retain better margins than hospital-based settings due to the 2026 indirect cost redistribution.
Administrative Framework
Global Period
000 (0 Days)
Place of Service
NCCI Exclusions
Key Modifiers
Operational Requirements
ultrasound bundling
CPT 20611 includes ultrasound guidance. Do NOT bill 76942 separately. If ultrasound is not used, bill 20610 instead.
image archiving
Permanent recording of the ultrasound images is required for billing 20611. Failure to archive images may result in a downgrade to 20610 during an audit.
drug billing
Therapeutic agents (e.g., Hyalgan, Synvisc, Steroids) are not included and must be billed using the appropriate J-code.
report requirement
The procedure note must include a specific description of the ultrasound findings and the needle placement.
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
Work RVU reduced by 2.5% efficiency adjustment. Do not bill 76942 with this code.
Common Clinical Scenarios
No clinical examples provided.
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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