Summary & Overview
CPT 20615: Aspiration and Injection for Bone Cyst
CPT code 20615 covers nonsurgical aspiration and injection of a bone cyst, a minimally invasive procedure used to evacuate cyst fluid and introduce an agent to obliterate the lesion. This intervention is commonly used for benign, fluid-filled cysts in the metaphysis of long bones and can reduce the need for more invasive surgery. Nationally, procedures coded with CPT code 20615 are relevant to orthopedics, interventional radiology, and outpatient procedural services because they affect care pathways, resource use, and site-of-service decisions. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on the procedure and typical sites of service, payer coverage considerations, and what to expect in terms of coding application. The publication summarizes benchmarks where available, highlights common billing and coding themes, and outlines policy and reimbursement topics that influence utilization and site-of-care choices. Data not available in the input is noted where payer-specific rates or diagnosis pairings are required but not provided.
Billing Code Overview
CPT code 20615 describes nonsurgical management of a bone cyst by aspiration and injection. The procedure involves removing fluid from a benign, fluid-filled sac in the metaphysis of long bones and injecting a sclerosant or other agent to destroy the cyst lining and promote healing.
Service type: Minimally invasive, image-guided aspiration and injection of a bone cyst.
Typical site of service: Ambulatory surgical center or hospital outpatient department, and in some cases an office or clinic setting when imaging and sterile technique are available.
Clinical & Coding Specifications
Clinical Context
A 12-year-old male presents with intermittent left proximal humerus pain after a minor fall. Radiographs show a uniloculated, lytic lesion consistent with a simple bone cyst in the proximal humeral metaphysis. The orthopedic surgeon schedules an outpatient, image-guided aspiration and steroid (or sclerosing agent) injection to decompress and obliterate the cyst. The procedure is performed under fluoroscopic or ultrasound guidance in an ambulatory surgery center (ASC) or hospital outpatient department (HOPD) with conscious sedation. The clinical workflow includes pre-procedure informed consent and surgical site marking, sedation and sterile preparation, image localization, percutaneous aspiration of cyst contents, possible curettage of the cavity with saline irrigation, and injection of the sclerosing agent (e.g., methylprednisolone acetate or bone substitute) through a percutaneous needle or small cannula. Post-procedure imaging confirms adequate cavity collapse and absence of extravasation. The patient is recovered in PACU, given activity restrictions and follow-up imaging at 6–12 weeks to assess healing and need for repeat intervention.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s professional portion if imaging guidance or interpretation is billed separately. |