Musculoskeletal Payment Information

The following chart provides payment information that is based on the national unadjusted Medicare physician fee schedule for the ultrasound services discussed. Payment will vary by geographic region.

The information provided below is intended to assist providers in determining appropriate codes and the other information for reimbursement purposes. It represents the information available to United Medical Instruments as of January 2013. Subsequent guidance might alter the information provided. United Medical Instruments disclaims any responsibility to update the information provided. It is the provider’s responsibility to determine and submit appropriate codes, modifiers, and claims for the services rendered. Before filing any claims, providers should verify current requirements and policies with the applicable payer.

Musculoskeletal  Ultrasound and Procedural CPT Codes and Descriptions

Ultrasound Evaluation
CPT Code
Code Description Non
Facility*
Facility** Professional
Payment
Technical
Payment
76881 Ultrasound, extremity, non-vascular, real-time with image documentation; complete $124.52 $124.52 $30.96 $93.56
76882 Limited ultrasound, extremity, non-vascular, real time with image documentation $35.38 $35.38 $23.82 $11.57
76942 U/S guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation $208.56 $208.56 $32.66 $175.90

 

Procedures
CPT Code
Code Description Non
Facility*
Facility** Professional
Payment
Technical
Payment
10022 Fine needle aspiration; with imaging guidance $141.20 $64.64 n/a n/a
20552 Injection (s), Single to multiple trigger point(s) one or two muscle(s) $55.80 $38.11 n/a n/a
20553 Injection (s), Single to multiple trigger point(s) three or more muscle(s) $64.98 $42.87 n/a n/a
20600 Arthrocentesis, aspiration and/or injections; small joint or bursa (e.g. fingers, toes) $47.29 $35.04 n/a n/a
20605 Arthrocentesis, aspiration and/or injections; intermediate joint or bursa (e.g. temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa) $65.66 $52.74 n/a n/a
20610 Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g. shoulder, hip, knee joint, subacromial bursa) $60.56 $45.93 n/a n/a
21073 Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care) $401.81 $260.62 n/a n/a

* Non Facility: Includes all other settings.
** Facility: Includes hospitals (inpatient, outpatient, and emergency department), ambulatory surgical centers (ASCs), and skilled nursing facilities (SNFs).

CPT™ five digit codes, nomenclature and other data are Copyright 2010 American Medical Association. All rights reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.

Deficit Reduction Act of 2005 Adjustment has not been figured into the above global fees.