How does Blue Cross Blue Shield of Minnesota's rate for CPT 20610 compare to Medicare?

The Blue Cross Blue Shield of Minnesota local median of $293.46 is 426% of Medicare's national non-facility rate of $68.81 for CPT 20610.

Reddenda · Rate Intelligence · San Jose-Sunnyvale-Santa Clara, CA

20610 under Blue Cross Blue Shield of Minnesota, for San Jose-Sunnyvale-Santa Clara, CA providers

Name: Blue Cross Blue Shield of Minnesota rates for CPT 20610 among San Jose-Sunnyvale-Santa Clara, CA providers
Creator: Reddenda

Major joint injection (shoulder, hip, knee) · Local peer median $293.46 · High confidence

$293.46 local peer median. Blue Cross Blue Shield of Minnesota's published rate file lists a local peer median of $293.46 for CPT 20610 (Major joint injection (shoulder, hip, knee)) among 315 indexed providers in San Jose-Sunnyvale-Santa Clara, CA. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $352.03, 20% above the median. A provider billed below this median is being paid less than peers holding the identical Blue Cross Blue Shield of Minnesota contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 315 providers · 315 rate records

P10

$63.53

P25

$63.53

Median

$293.46

P75

$293.46

P90 (target)

$352.03

P10$63.53

P25$63.53

Median (P50)$293.46

P75$293.46

P90 target$352.03

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $57.24 – $352.03

The local peer median for CPT 20610 under Blue Cross Blue Shield of Minnesota for San Jose-Sunnyvale-Santa Clara, CA providers is $293.46, drawn from 315 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Cross Blue Shield of Minnesota to publish this rate
The bottom of the local market (P10) is $63.53 and the top (P90) is $352.03; the median-to-P90 spread is $58.57.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Cross Blue Shield of Minnesota to publish this rate
The lowest published rate in this market is $57.24; the highest is $352.03.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Cross Blue Shield of Minnesota to publish this rate
This benchmark is drawn from 315 individual rate records that Blue Cross Blue Shield of Minnesota itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Cross Blue Shield of Minnesota to publish this rate
Medicare's national non-facility rate for CPT 20610 is $68.81, making the Blue Cross Blue Shield of Minnesota local median 426% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Cross Blue Shield of Minnesota to publish this rate
47.9% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Cross Blue Shield of Minnesota to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

315 providers bill this code to this payer in this metro.

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These are the rates Blue Cross Blue Shield of Minnesota publishes for CPT 20610 (Major joint injection (shoulder, hip, knee)) among San Jose-Sunnyvale-Santa Clara, CA providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Blue Cross Blue Shield of Minnesota's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Cross Blue Shield of Minnesota to publish this rate. Page generated 2026-08-23 23:52 UTC; the live index is queried in real time on every request.