Knee and Joint Injections in Medicare: Texas vs the U.S., 2019 to 2024
By Innovare Tx Regenerative & Wellness Clinic · Published November 12, 2026 · Public data, not medical advice
Texas clinicians billed Original Medicare for 363,512 injections into, or fluid draws from, a large joint or bursa in 2024, 10.6% fewer than in 2019, while the number of Texans in Original Medicare Part B fell 15.5%. Per 1,000 of those enrollees, the rate rose from 190.8 to 201.9, below the national 211.1. Patient visits with a hyaluronic acid (gel) injection fell 24.4% in Texas over the same years.
These are counts of billed procedures from Medicare claims. They do not show whether any injection helped, and they do not include platelet-rich plasma (PRP) or other orthobiologic injections, which are billed under different codes.
Key numbers
- large-joint injection and fluid-draw procedures billed by Texas clinicians to Original Medicare, 2024 (406,482 in 2019)
- 363,512large-joint injection and fluid-draw procedures billed by Texas clinicians to Original Medicare, 2024 (406,482 in 2019)Source: CMS Physician & Other Practitioners by Geography and Service, CPT 20610 + 20611
- procedures per 1,000 Texans in Original Medicare Part B, 2024, against 211.1 nationally
- 201.9procedures per 1,000 Texans in Original Medicare Part B, 2024, against 211.1 nationallySource: CMS; Medicare Monthly Enrollment
- of Texas procedures used ultrasound guidance in 2024 (15.5% in 2019); nationally 18.1%
- 16.5%of Texas procedures used ultrasound guidance in 2024 (15.5% in 2019); nationally 18.1%Source: CMS, CPT 20611 share of 20610 + 20611
- patient visits with a hyaluronic acid injection in Texas, 2024, down from 113,630 in 2019
- 85,853patient visits with a hyaluronic acid injection in Texas, 2024, down from 113,630 in 2019Source: CMS, hyaluronan J-codes, distinct patient-days
- paid by Medicare in Texas in 2024: $18.9 million for the procedures and $19.4 million for hyaluronic acid products
- $38.3 millionpaid by Medicare in Texas in 2024: $18.9 million for the procedures and $19.4 million for hyaluronic acid productsSource: CMS, average Medicare payment x services
- Texas
- United States
Texas = procedures billed by clinicians whose practice address is in Texas, divided by Texans in Original Medicare Part B. Medicare Advantage is not included.
| Year | Texas procedures | Texas per 1,000 | Ultrasound-guided (TX) | Texas hyaluronic acid visits | TX hyaluronic acid per 1,000 | U.S. per 1,000 | U.S. hyaluronic acid per 1,000 |
|---|---|---|---|---|---|---|---|
| 2019 | 406,482 | 190.8 | 15.5% | 113,630 | 53.3 | 202.1 | 48.7 |
| 2020 | 346,329 | 166.0 | 16.0% | 92,434 | 44.3 | 169.9 | 40.4 |
| 2021 | 376,052 | 190.4 | 15.8% | 104,055 | 52.7 | 192.7 | 47.5 |
| 2022 | 368,177 | 193.2 | 16.1% | 98,321 | 51.6 | 199.7 | 49.4 |
| 2023 | 361,630 | 197.9 | 16.0% | 89,227 | 48.8 | 206.8 | 50.2 |
| 2024 | 363,512 | 201.9 | 16.5% | 85,853 | 47.7 | 211.1 | 49.0 |
| Year | Texas: procedures | Texas: hyaluronic acid products | U.S.: procedures | U.S.: hyaluronic acid products |
|---|---|---|---|---|
| 2019 | $19.7 million | $35.7 million | $325.8 million | $509.2 million |
| 2020 | $17.5 million | $32.5 million | $277.9 million | $450.0 million |
| 2021 | $20.0 million | $39.8 million | $320.4 million | $566.3 million |
| 2022 | $19.2 million | $32.5 million | $316.9 million | $485.8 million |
| 2023 | $18.9 million | $20.5 million | $316.5 million | $325.7 million |
| 2024 | $18.9 million | $19.4 million | $312.9 million | $302.1 million |
| Year | Texas: Original Medicare Part B | Texas: Medicare Advantage share | U.S.: Original Medicare Part B | U.S.: Medicare Advantage share |
|---|---|---|---|---|
| 2019 | 2,130,295 | 40.0% | 33,076,778 | 37.3% |
| 2020 | 2,086,648 | 42.7% | 32,244,894 | 39.9% |
| 2021 | 1,975,334 | 46.5% | 30,841,830 | 43.1% |
| 2022 | 1,905,730 | 49.1% | 29,655,517 | 45.8% |
| 2023 | 1,827,791 | 51.9% | 28,623,931 | 48.3% |
| 2024 | 1,800,124 | 53.4% | 27,982,142 | 50.1% |
Download the data (CSV) · Free to reuse under CC BY 4.0 with credit to Innovare Tx Regenerative & Wellness Clinic.
What the data show
- The count of procedures fell from 406,482 in 2019 to 363,512 in 2024, with the low point in 2020 (346,329). Over the same years, the share of Texas Medicare enrollees in Medicare Advantage or other plans rose from 40.0% to 53.4%. Those patients' claims are not in this data, so the rate per Original Medicare enrollee is the fairer comparison.
- Per 1,000 Texans in Original Medicare Part B, procedures rose from 190.8 in 2019 to 201.9 in 2024. The national rate rose from 202.1 to 211.1.
- Ultrasound-guided procedures (CPT 20611) made up 16.5% of the Texas total in 2024, up from 15.5% in 2019. Nationally the share rose faster, from 14.3% to 18.1%.
- 90.6% of Texas procedures in 2024 were done in a non-facility setting, which CMS says is generally an office, rather than a hospital or other facility.
- Patient visits with a hyaluronic acid injection fell 24.4% in Texas from 2019 to 2024, against 14.9% nationally. Per 1,000 Original Medicare Part B enrollees, Texas went from 53.3, above the national 48.7, to 47.7, below the national 49.0.
- Medicare's payments for hyaluronic acid products billed by Texas clinicians fell from $35.7 million in 2019 to $19.4 million in 2024, a larger drop than the drop in visits.
What this means for you and your family
- Joint injections are a routine part of care for people with Medicare in Texas, at roughly 1 procedure for every 5 people in Original Medicare each year. Your own need for one depends on an exam and, often, imaging.
- These counts say nothing about how well any injection works. Guideline bodies differ on some of them. Ask your clinician what is being injected, what the evidence says for your joint, and what Medicare or your plan will pay.
- If you have Medicare Advantage, your plan's rules apply, and your claims are not in these numbers.
- Our knee injection series uses insurance-covered injections such as cortisone and hyaluronic acid, with your benefits checked first. PRP and BMAC are separate, cash-pay procedures that are considered investigational and are not FDA approved for any specific orthopedic condition.
Method
Source: CMS Medicare Physician & Other Practitioners by Geography and Service, data years 2019 to 2024. It covers claims paid under Medicare Part B for people in Original (fee-for-service) Medicare; Medicare Advantage claims are not included.
Procedures: CPT 20610 (injection into or fluid draw from a major joint or bursa, such as the knee, hip or shoulder, without ultrasound guidance) and CPT 20611 (the same with ultrasound guidance). We add the dataset's office and facility rows and count services (Tot_Srvcs). In Texas in 2024, distinct patient-days for these codes (in the CSV) were 2.1% lower than services, because one patient can have more than one of these services on the same day.
Hyaluronic acid: every HCPCS J-code described as "Hyaluronan or derivative ... for intra-articular injection" (J7318, J7320, J7321, J7322, J7323, J7324, J7325, J7326, J7327, J7328, J7329, J7331, J7332 in 2024), combined across products. Because these codes are billed in different units, we count Tot_Bene_Day_Srvcs, which CMS defines as the "Number of distinct Medicare beneficiary/per day services." Each count is one patient on one day.
Texas means clinicians whose practice is in Texas. CMS describes the state field as "The state name where the provider is located, as reported in NPPES." U.S. figures are the dataset's national rows.
Payments: the average Medicare payment ("Average amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item service.") times the number of services, added up. Payments for the procedure and for the hyaluronic acid product are billed and paid separately.
Rates: services divided by the number of people in Original Medicare with Part B in Texas or the United States for that year (CMS Medicare Monthly Enrollment, annual figure), times 1,000.
Limits
- The data covers Original Medicare only. More than half of Texans on Medicare were in Medicare Advantage or other plans in 2024, and their injections are not counted.
- Procedures are counted where the clinician practices; enrollees are counted where they live. People who cross state lines for care can shift the rates.
- CPT 20610 and 20611 include injections of any medicine, such as corticosteroids or hyaluronic acid, and fluid draws, and cover joints other than the knee.
- CMS leaves out any row "derived from 10 or fewer beneficiaries" to protect privacy. For these codes, the state rows still add up to within 0.1% of the national totals in every year.
- Payments are for the clinician's claim only. The dataset covers Part B claims from clinicians, not institutional claims, so a hospital's separate facility payment is not included.
- Platelet-rich plasma (PRP), bone marrow concentrate and other orthobiologic injections are billed under other codes and are not included.
Sources
- CMS, Medicare Physician & Other Practitioners - by Geography and Service. Data years 2019 to 2024 (2024 data released May 2026).
- CMS, Medicare Physician & Other Practitioners by Geography and Service data dictionary. October 2021.
- CMS, Medicare Monthly Enrollment. Annual figures, 2019 to 2024 (release with data through July 2026).
Cite this study
Innovare Tx Regenerative & Wellness Clinic. "Knee and Joint Injections in Medicare: Texas vs the U.S., 2019 to 2024." November 12, 2026. https://innovaretx.com/research/joint-injections-texas-medicare. Data: CMS Medicare Physician & Other Practitioners by Geography and Service; CMS Medicare Monthly Enrollment.
The table above is available as a CSV file under a Creative Commons Attribution 4.0 license. Questions about the data: contact@innovaretx.com.
More from our research and data section · Related: Knee injection series · Knee pain · Arthritis and joint pain
Also in our research: GLP-1 Medicine Use in Texas Medicare, 2019 to 2024 · Obesity and Arthritis Across Dallas-Fort Worth Cities · Weight and Joint Health Statistics: Dallas-Fort Worth
Questions about a knee or joint injection?
Book an evaluation at our Addison clinic. We check your insurance benefits first and explain which injections your plan covers.