How much does Medicare pay for CPT 20611?

Medicare allowed an average of $101.93 per service and paid $77.17 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $449.41, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 20611?

Aspiration and/or injection of fluid large joint using ultrasound guidance. It was billed 1,011,304 times to 557,036 Medicare beneficiaries by 8,929 providers in 2024.

Does 20611 pay differently in an office than a hospital?

Yes. The allowed amount averaged $103.96 in an office setting and $62.17 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 20611 most?

Orthopedic Surgery, with 315,383 services from 1,994 clinicians. Next are Sports Medicine, Physician Assistant, Physical Medicine and Rehabilitation.

CPT 20611

Aspiration and/or injection of fluid large joint using ultrasound guidance

$101.93Medicare-allowed amount per service, averaged across 1,011,304 services

Providers submitted

$449.41

Asking price, not received

Medicare allowed

$101.93

The fee schedule figure

Medicare paid

$77.17

Balance is patient coinsurance

Providers submitted an average of $449.41 for this code and Medicare allowed $101.93 — 4.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $77.17 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $103.96
Hospital / facility: $62.17

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 962,272 services were billed in an office setting and 49,033 in a facility.

Services: 1,011,304
Beneficiaries: 557,036
Providers billing it: 8,929
Total allowed: $103,082,217

What Medicare pays for CPT 20611

Across 1,011,304 services billed by 8,929 providers to 557,036 beneficiaries, Medicare allowed an average of $101.93 per service. That is 1.8 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 20611

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	315,383	171,225	$108.30	1,994
Sports Medicine	153,540	89,649	$98.59	1,019
Physician Assistant	125,480	73,858	$89.66	1,397
Physical Medicine and Rehabilitation	117,212	64,506	$103.93	1,251
Family Practice	95,306	53,403	$100.53	787
Rheumatology	53,049	22,846	$108.33	405
Nurse Practitioner	37,864	18,829	$86.90	426
Pain Management	24,128	14,333	$105.30	459
Internal Medicine	23,338	9,413	$108.39	170
Anesthesiology	15,095	8,475	$104.39	289
Interventional Pain Management	13,229	7,710	$106.92	240
Emergency Medicine	10,470	5,785	$96.80	90
Diagnostic Radiology	7,383	6,502	$75.75	198
Osteopathic Manipulative Medicine	4,023	1,645	$105.17	26
Hand Surgery	3,955	2,894	$108.00	54

20611 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	148,767	$109.05	$73.04	925
New York	120,940	$116.78	$77.76	785
Florida	84,354	$99.44	$72.37	643
Illinois	57,805	$102.03	$73.75	410
Texas	55,642	$99.73	$76.50	583
New Jersey	42,157	$117.06	$80.66	370
Pennsylvania	36,693	$101.08	$76.42	351
Arizona	33,429	$98.86	$75.04	303
Virginia	32,591	$97.25	$70.96	227
Michigan	31,090	$93.45	$68.85	318
Ohio	27,194	$93.44	$71.79	293
Massachusetts	24,660	$98.71	$69.42	188
South Carolina	23,323	$94.75	$74.72	164
Maryland	20,480	$109.74	$77.33	197
Tennessee	20,190	$88.98	$73.09	201
North Carolina	18,395	$96.96	$75.96	211
Georgia	16,360	$96.92	$74.40	210
Washington	15,601	$100.49	$70.97	178
Minnesota	15,520	$94.07	$70.50	203
Nevada	12,983	$95.69	$71.56	97
Colorado	12,732	$100.26	$73.23	195
Alabama	11,557	$94.17	$78.58	138
Missouri	11,355	$90.13	$70.52	146
Indiana	10,871	$96.27	$77.03	138
Connecticut	10,687	$109.62	$77.12	107
Wisconsin	10,654	$85.51	$67.25	161
Mississippi	10,314	$86.85	$72.20	73
Oregon	9,632	$98.32	$73.28	131
Oklahoma	9,574	$94.89	$76.50	60
Utah	8,076	$87.77	$64.18	110
Iowa	6,701	$88.09	$69.32	79
Kansas	5,239	$88.80	$71.68	64
New Hampshire	4,978	$99.11	$73.30	47
Arkansas	4,727	$94.45	$78.18	45
Kentucky	4,121	$91.10	$72.46	71
Idaho	3,857	$77.01	$61.07	69
Rhode Island	3,765	$92.98	$69.23	43
Louisiana	3,723	$87.09	$69.09	72
Maine	3,435	$88.11	$66.77	38
Hawaii	3,401	$99.66	$69.69	20
Nebraska	3,041	$85.40	$69.61	29
South Dakota	2,731	$78.03	$58.72	40
New Mexico	2,657	$88.79	$67.44	36
North Dakota	2,296	$70.12	$51.95	21
West Virginia	2,162	$76.79	$59.19	17
Montana	2,160	$82.78	$60.78	28
Delaware	2,141	$97.69	$75.05	17
District of Columbia	1,504	$103.88	$71.38	15
Vermont	1,417	$73.77	$57.03	10
Alaska	1,412	$118.10	$72.00	16
Wyoming	1,393	$81.60	$58.18	17
Puerto Rico	448	$100.42	$75.38	14
Guam	293	$101.04	$73.16	3
AE	47	$128.93	$86.86	1
U.S. Virgin Islands	30	$94.94	$60.09	1

Related codes

20610Aspiration and/or injection of fluid from large joint$65.03
20600Aspiration and/or injection of fluid from small joint$47.60
20605Aspiration and/or injection of fluid from medium joint$50.73
20604Aspiration and/or injection of fluid from small joint$75.96
20606Aspiration and/or injection of fluid from medium joint$85.99
20680Removal of deep implant from bone$686.12
20612Aspiration and/or injection of cyst of tendon$59.89

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.