Tennessee · 20610

Aspiration And/or Injection Of Fluid From Large Joint in Tennessee

Tennessee Medicare Avg
$43.72
9% below national avg
National Medicare Avg
$48.22
All states combined
Billed Charge (TN)
$242.80
What providers submit
Est. Commercial (TN)
$128.16
National avg: $145.10
Est. Cash / Self-Pay (TN)
$111.48
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

133.7K
Services in TN
3.1K
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Tennessee

Provider Medicare Services
Calendine, Cory MD $49.95 1.1K
Mihalko, Marc M.D. $47.59 1.0K

Tennessee Pricing in Context

In Tennessee, CPT code 20610 (Aspiration And/or Injection Of Fluid From Large Joint) carries an average Medicare payment of $43.72 — 9% below the national benchmark of $48.22. 3.1K providers across the state submitted claims for this procedure in 2023, performing 133.7K total services. Individual payments in TN ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Tennessee is $242.80, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Tennessee sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Musculoskeletal Surgery procedures, the estimated commercial insurance price in Tennessee lands near $128.16, with self-pay cash prices typically around $111.48. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Aspiration And/or Injection Of Fluid From Large Joint cost in Tennessee?

The average Medicare payment for Aspiration And/or Injection Of Fluid From Large Joint in Tennessee is $43.72, which is 9% below the national average of $48.22. Providers in TN typically bill $242.80 for this procedure.

What does Aspiration And/or Injection Of Fluid From Large Joint cost with insurance in Tennessee?

With commercial insurance in Tennessee, Aspiration And/or Injection Of Fluid From Large Joint costs an estimated $128.16. Without insurance, the estimated cash price is $111.48. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Aspiration And/or Injection Of Fluid From Large Joint in Tennessee?

3.1K providers in Tennessee billed Medicare for Aspiration And/or Injection Of Fluid From Large Joint in 2023, performing 133.7K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Aspiration And/or Injection Of Fluid From Large Joint cheaper in Tennessee than the national average?

Yes — Aspiration And/or Injection Of Fluid From Large Joint costs 9% below the national average in Tennessee. The state average Medicare payment is $43.72 compared to $48.22 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial