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20611 CPT Code: Major Joint Injection WITH Ultrasound

Last Updated: February 24, 2026

When a physician uses ultrasound guidance to ensure the precise placement of a needle into a major joint, the correct code is CPT 20611. This code was created to prevent the unbundling of ultrasound guidance.

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2026 Medicare National Fee (20611): Non-Facility (Office): $131.07 · Facility (Hospital): $54.78
✓ 17 Medicare-Approved ICD-10 Diagnoses on file for 20611:

The Golden Rule of 20611

CPT 20611 inherently includes the ultrasound guidance, along with the permanent recording and reporting of the image. You cannot bill CPT 76942 (Ultrasonic guidance for needle placement) alongside 20611. Doing so will trigger an immediate NCCI unbundling denial.

Documentation Requirements

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To support billing 20611, the physician's procedure note must explicitly state that ultrasound was used to guide the needle, and a permanent image of the localized needle placement must be retained in the patient's medical record.

NCCI Edits

If injecting multiple joints, you can use RT and LT modifiers. If injecting a major joint with US (20611) and a small joint without US (20600) on the same day, append Modifier 59 (or XS) to the lesser procedure.

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