Summary & Overview
CPT 20612: Aspiration/Injection of Ganglion Cyst
CPT code 20612 represents aspiration and/or injection of a ganglion cyst — a common, fluid-filled mass that arises from a tendon or joint, most often in the hand or wrist. The procedure is a frequently used nonoperative treatment when the cyst causes pain or restricts movement. Nationally, this code is relevant across outpatient settings where minor soft-tissue procedures are performed and affects clinical workflows, billing practices, and payer coverage policies for musculoskeletal ambulatory care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and service profile for 20612, an outline of common payer coverage considerations, and operational benchmarks relevant to claims submission and site-of-service selection. The content highlights where 20612 fits in the care pathway for symptomatic ganglion cysts and what billing teams should track when preparing claims.
This summary prepares clinicians, practice managers, and medical billing professionals to locate 20612 within procedure coding hierarchies, understand the typical delivery settings for the service, and anticipate payer-focused documentation and coding needs. Data not available in the input will be explicitly noted in detailed sections.
Billing Code Overview
CPT code 20612 describes aspiration and/or injection of a ganglion cyst, a fluid-filled mass arising from a tendon or joint, most commonly in the hand or wrist and also seen in the foot or ankle. The procedure involves removing cyst fluid (aspiration) and may include injection of an agent to collapse or sclerose the cyst.
Service type: Minor procedural aspiration/injection for soft-tissue cyst
Typical site of service: Outpatient clinic or office, ambulatory surgical center, or emergency department, with the hand or wrist being the most common anatomical location for the treated ganglion cyst.
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand–dominant woman presents to an outpatient orthopedic hand clinic with a 3-month history of a small, soft, fluctuant lump on the dorsal wrist overlying the scapholunate region. She reports intermittent aching with wrist extension and occasional paresthesia when leaning on the wrist. On exam the lesion is mobile, transilluminates, and is most consistent with a dorsal wrist ganglion. Conservative measures (activity modification, splinting, NSAIDs) provided minimal relief. The clinician reviews risks and benefits and performs in-office aspiration of the ganglion cyst under sterile technique with local anesthesia, evacuating gelatinous fluid and applying a compressive dressing. The procedure is documented with indication, consent, laterality (right wrist), technique, amount and appearance of fluid removed, any imaging guidance if used, and post-procedure instructions. Typical site of service is an ambulatory surgical center or outpatient clinic procedure room. Common payors for coverage and billing include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | When procedure is performed on the right wrist or hand |
LT |