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Code Reality Check

20610 reimbursement rate: Major joint injection (shoulder, hip, knee)

Major joint injection (shoulder, hip, knee) (CPT 20610) pays a median $184.18 in Wisconsin and $60.03 in Kentucky, against a Medicare anchor of $68.59. 51 of 51 states clear the publication floor.

spread 3.1x top to bottom Medicare anchor $68.59 51/51 states published

The 50-state spread

as of 2026-07-15
StateMedianvs MedicareBandRate pointsTier
Wisconsin$184.182.69x$78–$359 · P90 $574170,871Benchmark
Alaska$165.802.42x$91–$310 · P90 $4313,031Benchmark
South Dakota$132.391.93x$64–$182 · P90 $2329,138Benchmark
Nebraska$126.171.84x$75–$142 · P90 $16914,651Benchmark
Minnesota$121.741.77x$65–$222 · P90 $34358,012Benchmark
Oregon$118.261.72x$80–$164 · P90 $21430,133Benchmark
Iowa$116.851.70x$80–$191 · P90 $45920,381Benchmark
Massachusetts$105.861.54x$61–$211 · P90 $27398,912Benchmark
Montana$104.441.52x$82–$164 · P90 $3816,544Benchmark
North Dakota$103.671.51x$61–$183 · P90 $2327,778Benchmark
Connecticut$102.031.49x$64–$192 · P90 $25239,148Benchmark
Wyoming$99.141.45x$64–$146 · P90 $3042,359Benchmark
Colorado$95.141.39x$65–$180 · P90 $22940,627Benchmark
Mississippi$94.721.38x$58–$139 · P90 $20113,866Benchmark
South Carolina$94.431.38x$73–$125 · P90 $16554,726Benchmark
California$93.341.36x$67–$202 · P90 $303317,253Benchmark
Utah$92.831.35x$60–$142 · P90 $16027,001Benchmark
New Hampshire$91.581.34x$57–$132 · P90 $18431,099Benchmark
North Carolina$90.301.32x$70–$112 · P90 $172205,888Benchmark
Pennsylvania$90.121.31x$62–$123 · P90 $177131,069Benchmark
Idaho$89.971.31x$53–$133 · P90 $15213,750Benchmark
District of Columbia$89.651.31x$57–$129 · P90 $20510,158Benchmark
Illinois$89.131.30x$63–$123 · P90 $197111,169Benchmark
Alabama$87.071.27x$58–$104 · P90 $15320,427Benchmark
Washington$86.981.27x$63–$147 · P90 $18643,982Benchmark
New Mexico$86.911.27x$64–$124 · P90 $15611,173Benchmark
Georgia$86.851.27x$59–$134 · P90 $195339,347Benchmark
New York$86.471.26x$57–$116 · P90 $204676,455Benchmark
Hawaii$83.211.21x$69–$101 · P90 $1959,068Benchmark
Kansas$82.701.21x$65–$102 · P90 $12519,729Benchmark
Michigan$82.201.20x$60–$106 · P90 $16459,828Benchmark
West Virginia$79.361.16x$61–$115 · P90 $14623,501Benchmark
New Jersey$78.991.15x$50–$113 · P90 $19471,349Benchmark
Tennessee$78.901.15x$57–$108 · P90 $15753,756Benchmark
Rhode Island$77.651.13x$53–$102 · P90 $13913,342Benchmark
Maine$77.401.13x$52–$112 · P90 $14335,546Benchmark
Missouri$77.121.12x$49–$109 · P90 $176203,432Benchmark
Louisiana$76.661.12x$48–$104 · P90 $13224,190Benchmark
Vermont$73.831.08x$42–$105 · P90 $1606,219Benchmark
Maryland$72.911.06x$60–$126 · P90 $20240,953Benchmark
Arkansas$71.871.05x$50–$104 · P90 $14016,518Benchmark
Ohio$71.291.04x$48–$107 · P90 $182339,936Benchmark
Virginia$67.700.99x$51–$98 · P90 $130107,524Benchmark
Oklahoma$67.510.98x$45–$92 · P90 $11716,283Benchmark
Delaware$67.470.98x$49–$107 · P90 $1436,231Benchmark
Arizona$66.880.98x$59–$112 · P90 $20830,747Benchmark
Texas$65.940.96x$51–$96 · P90 $140136,942Benchmark
Indiana$65.530.96x$48–$94 · P90 $140198,261Benchmark
Florida$65.410.95x$46–$100 · P90 $156129,391Benchmark
Nevada$62.730.91x$48–$96 · P90 $14113,440Benchmark
Kentucky$60.030.88x$41–$89 · P90 $12784,988Benchmark
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).

Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.

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Cite this page

Source: Reddenda Code Reality Check, CPT 20610. Reddenda. https://reddenda.health/code/20610/
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Derivation federally mandated TiC MRFs, verified to provider identity4,150,122 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0
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