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20600 vs 20605: Small vs Intermediate Joint Injections

Last Updated: January 29, 2026

While 20610 covers major joints (shoulders, knees, hips), smaller joints have their own specific CPT codes based on anatomic size. Using the wrong code will result in an immediate anatomic denial.

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2026 Medicare National Fee (20600): Non-Facility (Office): $69.75 · Facility (Hospital): $34.90

20600: Small Joints

CPT 20600 is for small joints or bursae. This strictly includes the fingers and toes (e.g., PIP, DIP, MCP, MTP joints).

20605: Intermediate Joints

CPT 20605 is for intermediate joints or bursae. This includes the wrist, elbow, ankle, temporomandibular joint (TMJ), and acromioclavicular (AC) joint.

Ultrasound Variants (20604 and 20606)

If ultrasound guidance is used, you must use the corresponding US-inclusive codes rather than billing 76942 separately:

NCCI Edits

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Not sure if these codes bundle? Check the latest Medicare NCCI database updates before you bill.

If injecting multiple fingers (e.g., right index and right middle finger), use the appropriate F-modifiers (e.g., F6, F7) to differentiate the digits on the claim.

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