Musculoskeletal Reimbursement

CPT Code
76881 Ultrasound, extremity, non-vascular, real-time with image documentation; complete Participating Amount $118

76882 Ultrasound, extremity, non-vascular, real-time with image documentation; limited, anatomic specific Participating Amount $36

20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia” Participating Amount $60

20551 Injection(s); single tendon origin/insertion Participating Amount $60

20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) Participating Amount $56

20553 Injection(s); single or multiple trigger point(s), 3 or more muscle(s) Participating Amount $65

20604 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound
guidance, with permanent recording and reporting Participating Amount $73

20606 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular,
acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance,
with permanent recording and reporting Participating Amount $81

20611 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee,
subacromial bursa); with ultrasound guidance, with permanent recording and reporting Participating Amount $94

0213T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level Participating Amount $0

0214T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with ultrasound guidance, cervical or thoracic;
second level (List separately in addition to code for primary procedure) Participating Amount $0

0215T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with ultrasound guidance, cervical or thoracic;
third and any additional level(s) (List separately in addition to code for primary procedure) Participating Amount $0

0216T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level Participating Amount $0