20611

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

Medicare pricing data for 23,716 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.0 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Aspiration and/or injection of fluid large joint using ultrasound guidance (HCPCS code 20611) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $103.41, but hospitals typically charge $430.77 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$20.68

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $103.41, your out-of-pocket cost would be approximately $20.68. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$103.41
Average Hospital Charge
$430.77
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$430.77
Medicare Allowed$103.41
Medicare Payment$78.77

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $78.77 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$120$6221,725130,675+16.4%
New Jersey$120$93778738,497+15.7%
Alaska$116$688691,642+12.3%
Connecticut$111$47830611,479+7.0%
California$110$3712,298140,008+6.8%
Maryland$110$30150321,915+6.6%
District of Columbia$107$259581,670+3.1%
Illinois$106$4361,08360,429+2.5%
Pennsylvania$104$36696433,305+0.3%
Colorado$103$38055713,097-0.3%
Puerto Rico$103$15644774-0.6%
Massachusetts$101$53660623,442-2.0%
Delaware$101$302542,489-2.2%
Florida$101$3391,60476,644-2.5%
Washington$101$32155316,258-2.7%
Texas$100$4421,65057,726-3.0%
New Hampshire$100$5231494,603-3.1%
Hawaii$100$369593,325-3.8%
Arizona$99$34868933,398-4.2%
North Carolina$98$33664118,667-5.0%
Virginia$98$34158633,087-5.3%
Oregon$97$32936210,796-6.1%
Georgia$96$41762317,568-6.7%
South Carolina$96$37541023,164-7.4%
Alabama$96$26930511,865-7.4%
Ohio$96$32273828,590-7.4%
Oklahoma$96$2271558,971-7.5%
Indiana$95$35639611,251-7.9%
Rhode Island$95$4781034,307-7.9%
Kansas$95$3432165,629-8.1%
Nevada$95$48722913,563-8.5%
Michigan$95$30785633,510-8.6%
Arkansas$93$2431414,193-9.7%
Minnesota$93$58361014,706-9.9%
New Mexico$93$3311252,784-10.0%
Missouri$91$35343612,786-11.7%
Maine$90$2601052,956-12.7%
Kentucky$90$2722234,821-12.9%
Louisiana$89$3332264,190-13.8%
Tennessee$89$35955120,889-14.1%
Mississippi$88$46816610,511-14.7%
Iowa$87$3731866,588-16.3%
Wisconsin$85$73653111,176-18.0%
Utah$85$2892859,629-18.2%
Nebraska$83$2721193,123-19.4%
Montana$83$228721,708-19.6%
Wyoming$83$451471,413-19.6%
West Virginia$82$340632,518-20.4%
Idaho$78$2602174,243-24.3%
Vermont$75$196391,478-27.0%
North Dakota$75$387682,387-27.3%
South Dakota$73$2661102,949-29.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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