CPT 20611 Surgery - Musculoskeletal

How Much Does Drain/inj joint/bursa w/us Cost?

Drain/inj joint/bursa w/us (CPT 20611) costs $50 at Medicare rates. Hospital outpatient rate: $314.

Cost Comparison by Payer

How much Drain/inj joint/bursa w/us costs across different settings and payers

Medicare
Facility rate
$50
Hospital Outpatient
OPPS rate
$314
Surgery Center
ASC rate
$64
Medicare (Facility)
$50
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$104
Non-facility setting
Hospital Outpatient
$314
OPPS rate
Surgery Center (ASC)
$64
Ambulatory surgery center

Drain/inj joint/bursa w/us Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $67 $162 — $250
AL — ALABAMA $47 $123 — $189
AR — ARKANSAS $47 $121 — $187
AZ — ARIZONA $49 $133 — $204
CA — BAKERSFIELD $50 $143 — $219
CA — CHICO $50 $142 — $219
CA — EL CENTRO $50 $142 — $219
CA — FRESNO $50 $142 — $219
CA — HANFORD-CORCORAN $50 $142 — $219
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $52 $151 — $233
CA — MADERA $50 $142 — $219
CA — MERCED $50 $142 — $219
CA — MODESTO $50 $142 — $219
CA — NAPA $53 $163 — $250
CA — OXNARD-THOUSAND OAKS-VENTURA $51 $150 — $231
CA — REDDING $50 $142 — $219
CA — REST OF CALIFORNIA $50 $142 — $219
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $51 $144 — $222
CA — SACRAMENTO-ROSEVILLE-FOLSOM $51 $149 — $229
CA — SALINAS $51 $148 — $228
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $51 $151 — $232
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $55 $171 — $264
CA — SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) $55 $171 — $263
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) $56 $175 — $270
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $56 $174 — $268

How to Reduce Your Cost for Drain/inj joint/bursa w/us

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($104) differs from the facility rate ($50). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $47 to $67 depending on location. Commercial rates vary even more.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $64, compared to $314 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

1.07
Work RVU
0.29
Practice Expense RVU
0.14
Malpractice RVU
3.12
Total RVU

Payment = Total RVU (3.12) x CF ($33.40) = $104

Frequently Asked Questions

How much does Drain/inj joint/bursa w/us cost?

The Medicare facility rate for Drain/inj joint/bursa w/us is $50. In a hospital outpatient setting, the rate is $314. At an ambulatory surgery center, the rate is $64. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Drain/inj joint/bursa w/us cost without insurance?

Without insurance, the cost of Drain/inj joint/bursa w/us can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Drain/inj joint/bursa w/us?

Most commercial health insurance plans and Medicare cover Drain/inj joint/bursa w/us when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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