CPT 20606
Global 000 ActiveDrain/inj joint/bursa w/us
CPT 20606 Billing & Documentation Guide
CPT code 20606 (Drain/inj joint/bursa w/us) is classified under Surgery (Musculoskeletal) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.98, a non-facility practice expense RVU of 1.72, and a malpractice RVU of 0.12, a total non-facility RVU of 2.82 and facility RVU of 1.34. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $96.79, though rates vary from $84.15 to $121.32 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 20606, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 20606 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 20606 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 20606
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.98 | 0.98 |
| Practice Expense RVU | 1.72 | 0.24 |
| Malpractice RVU | 0.12 | 0.12 |
| Total RVU | 2.82 | 1.34 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 20606
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $104.06 | $45.56 | $98.4 - $121.32 | 29 |
| Florida | $98.18 | $48.58 | $93.68 - $102.67 | 3 |
| Georgia | $92.39 | $45.22 | $88.76 - $96.01 | 2 |
| Illinois | $96.02 | $48.26 | $91.45 - $99.9 | 4 |
| Michigan | $92.32 | $45.91 | $89.71 - $94.93 | 2 |
| North Carolina | $88.89 | $42.77 | $88.89 - $88.89 | 1 |
| New York | $103.82 | $48.68 | $90.13 - $110.58 | 5 |
| Ohio | $89.22 | $44.09 | $89.22 - $89.22 | 1 |
| Pennsylvania | $93.59 | $45.17 | $89.26 - $97.91 | 2 |
| Texas | $93.2 | $44.53 | $88.74 - $97.13 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 20606
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 20606 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00400 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01380 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0232T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0481T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 20606
What does CPT code 20606 mean? +
CPT code 20606 represents: Drain/inj joint/bursa w/us. It's in the Surgery (Musculoskeletal) category with a global period of 000.
What is the Medicare reimbursement for CPT 20606? +
The 2026 Medicare national average non-facility payment for CPT 20606 is $96.79. Rates range from $84.15 to $121.32 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 20606? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 20606? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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