What does Blue Shield of California pay for CPT 20610 in Los Angeles-Long Beach-Anaheim, CA?

The local peer median for CPT 20610 under Blue Shield of California in Los Angeles-Long Beach-Anaheim, CA is $54.18, based on 3428 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 20610 under Blue Shield of California in Los Angeles-Long Beach-Anaheim, CA?

The P90, the top of the local market and Reddenda's target rate, is $149.

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

The Blue Shield of California local median of $54.18 is 79% of Medicare's national non-facility rate of $68.81 for CPT 20610.

Reddenda · Rate Intelligence · Los Angeles-Long Beach-Anaheim, CA

20610 under Blue Shield of California in Los Angeles-Long Beach-Anaheim, CA

Name: Blue Shield of California rates for CPT 20610 in Los Angeles-Long Beach-Anaheim, CA
Creator: Reddenda

Major joint injection (shoulder, hip, knee) · Local peer median $54.18 · High confidence

$54.18 local peer median. In the Los Angeles-Long Beach-Anaheim, CA market, Blue Shield of California pays a local peer median of $54.18 for CPT 20610 (Major joint injection (shoulder, hip, knee)), based on 3428 providers in Reddenda's index of Blue Shield of California's own published in-network rates. The top of the local market, the P90 target, is $149, 175% above the median. A provider billed below the local median is being paid less than peers holding the identical Blue Shield of California contract in Los Angeles-Long Beach-Anaheim, CA for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 3428 providers · 3428 rate records

P10

$46.06

P25

$46.60

Median

$54.18

P75

$88.61

P90 (target)

$149

P10$46.06

P25$46.60

Median (P50)$54.18

P75$88.61

P90 target$149

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $37.79 – $253.63

The local peer median for CPT 20610 under Blue Shield of California in Los Angeles-Long Beach-Anaheim, CA is $54.18, drawn from 3428 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Shield of California to publish this rate
The bottom of the local market (P10) is $46.06 and the top (P90) is $149; the median-to-P90 spread is $94.82.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Shield of California to publish this rate
The lowest published rate in this market is $37.79; the highest is $253.63.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Shield of California to publish this rate
This benchmark is drawn from 3428 individual rate records that Blue Shield of California itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Shield of California to publish this rate
Medicare's national non-facility rate for CPT 20610 is $68.81, making the Blue Shield of California local median 79% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Blue Shield of California to publish this rate
16.7% 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 Shield of California 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)

3428 providers bill this code to this payer in this metro.

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This is the local market for CPT 20610 (Major joint injection (shoulder, hip, knee)) under Blue Shield of California in Los Angeles-Long Beach-Anaheim, CA. 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 Shield of California'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 Shield of California to publish this rate. Page generated 2026-08-23 23:50 UTC; the live index is queried in real time on every request.