CPT 20611 · professional fee

Drain/inj joint/bursa w/us (CPT 20611): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 20611, from their published in-network rate files.

Orthopedic surgerySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$117

P10 to P90: $69 to $225

vs Medicare

233%

facility rate $50.10

Payer spread

1.79×

UHC $161 vs Aetna $90

State spread

3.7×

AK $336 to TX $90

5,050 sampled providers6,135 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

UnitedHealthcare has the highest median for CPT 20611 in the files analyzed, at $161, 79% above Aetna ($90), the lowest of the 4 payers shown.

The state spread is 3.7×: Alaska has the highest median at $336 and Texas the lowest at $90, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 233% of the Medicare facility rate ($50.10), which ranks 21st of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $39) and widest within Blue Cross Blue Shield ($64).

This is a top-10 code for orthopedic surgery by Medicare allowed dollars, so it carries real revenue weight for that specialty.

The Medicare comparison uses the facility rate: the non-facility rate ($104.21) is 2.1× higher because it includes device or supply cost that professional-fee contracts do not.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
UnitedHealthcare	$161	$126	$217	+38%	1	4,256	322% of Medicare
Cigna	$111	$92	$140	-5%	2	3,993	222% of Medicare
Blue Cross Blue Shield	$108	$86	$150	-7%	3	3,928	216% of Medicare
Aetna	$90	$70	$109	-23%	4	3,032	180% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare facility ($50.10)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$336	+188%	Aetna	BCBS	65
2	Wisconsin	$195	+67%	UHC	Aetna	92
3	Nebraska	$181	+56%	UHC	Aetna	95
4	Wyoming	$170	+46%	UHC	Cigna	65
5	North Dakota	$152	+30%	UHC	Aetna	46
6	Washington	$146	+25%	UHC	Aetna	101
7	Connecticut	$142	+21%	UHC	Aetna	114
8	South Dakota	$140	+20%	UHC	BCBS	97
9	Oregon	$140	+20%	UHC	Aetna	92
10	North Carolina	$140	+20%	UHC	Aetna	128
11	Minnesota	$139	+20%	UHC	Aetna	102
12	District of Columbia	$139	+19%	UHC	BCBS	35
13	Georgia	$138	+18%	UHC	Aetna	124
14	New Jersey	$135	+16%	UHC	Aetna	95
15	Massachusetts	$133	+14%	UHC	Aetna	111
15	Iowa	$133	+14%	UHC	Aetna	104
17	South Carolina	$133	+14%	UHC	Aetna	106
18	Mississippi	$130	+11%	BCBS	Cigna	112
19	New Hampshire	$128	+10%	UHC	Aetna	118
20	Hawaii	$128	+10%	UHC	BCBS	69
21	Tennessee	$127	+9%	UHC	Aetna	115
22	Rhode Island	$118	+2%	UHC	Aetna	98
23	Idaho	$117	+1%	UHC	Cigna	120
24	Pennsylvania	$117	+1%	UHC	Aetna	103
25	New York	$117	+0%	UHC	Aetna	111
26	Colorado	$115	-1%	UHC	Aetna	106
27	Maine	$111	-4%	UHC	Aetna	94
28	Delaware	$110	-5%	BCBS	Aetna	59
29	Vermont	$108	-7%	UHC	BCBS	35
30	Maryland	$105	-10%	UHC	BCBS	105
31	Arkansas	$105	-10%	UHC	Aetna	119
32	Louisiana	$103	-11%	UHC	BCBS	103
33	Illinois	$102	-13%	UHC	Cigna	104
34	Ohio	$102	-13%	UHC	Aetna	110
35	Missouri	$101	-13%	UHC	Aetna	112
36	West Virginia	$101	-13%	UHC	BCBS	88
37	Virginia	$101	-13%	UHC	BCBS	105
38	Arizona	$100	-14%	UHC	BCBS	99
39	California	$100	-14%	UHC	Aetna	109
40	Nevada	$98	-16%	BCBS	Aetna	108
41	Utah	$96	-17%	UHC	BCBS	96
42	Alabama	$96	-18%	UHC	BCBS	118
43	Michigan	$95	-18%	UHC	Aetna	103
44	Oklahoma	$94	-19%	UHC	Aetna	100
45	Kentucky	$94	-19%	UHC	BCBS	124
46	New Mexico	$93	-20%	UHC	BCBS	104
47	Indiana	$93	-20%	UHC	BCBS	115
48	Kansas	$93	-20%	UHC	Aetna	107
49	Montana	$93	-21%	UHC	BCBS	79
50	Florida	$92	-22%	UHC	Aetna	108
51	Texas	$90	-23%	UHC	Aetna	122

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 20611?

In the files we analyzed, UnitedHealthcare, at a median of $161 across 4,256 sampled providers. Aetna is lowest at $90, 79% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 233% of the 2026 Medicare facility rate of $50.10.

Which state has the highest median for CPT 20611?

Alaska has the highest median at $336; Texas has the lowest at $90.

Is this the surgeon, physician or facility payment?

These are professional (physician) fees only. Facility, device and implant payments are priced separately and are not included.

How current is this data?

It is the August 2026 snapshot of each payer's in-network rate file. Sources and filters are listed in the methodology below.

Methodology

How these numbers are calculated

Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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