CPT code 20520: Foreign body removal, muscle or tendon, simple2026 Medicare rate & RVUs in Missouri

Removal of a foreign object from muscle or a tendon sheath when the extraction is simple, rather than deep or complicated.

CMS RVU26DEffective Oct 1, 20263 payment localities1.5K Medicare services in 2024

Medicare pays $207.62–$222.18 for 20520 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.

$207.62–$222.18Office (non-facility)
$131.90–$138.56Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Missouri
  2. What 20520 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 20520 covers

This service covers straightforward extraction of a foreign object located in muscle or a tendon sheath. A physician or other qualified practitioner may perform it in an office, emergency department, or outpatient procedure setting. Examples include removing a retained splinter or fragment when the object is in the specified tissue and can be removed without a deep or complicated procedure. The tissue location and degree of difficulty distinguish this service from removal of an object confined to subcutaneous tissue.

Report the service when the operative or procedure note supports both the muscle or tendon-sheath location and a simple removal. Document the object’s location and the work needed to extract it; use the deep or complicated family level when those circumstances are supported instead. The service has a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 20520 pays more and less in Missouri

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$207.62 to $222.18

$207.62$214.90$222.18
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
20520 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Kansas City, MO$219.89$137.41
Metropolitan St. Louis, MO$222.18$138.56
Rest of Missouri$207.62$131.90

How the 20520 rate is calculated

Each of 20520’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 20520

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.85

1.85 RVUs× 1.000 GPCI

Practice expense4.76

4.76 RVUs× 1.000 GPCI

Malpractice0.27

0.27 RVUs× 1.000 GPCI

Adjusted RVUs

6.8800

Conversion factor

$33.4009

Medicare rate

$229.80

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 20520

20520 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20520

Foreign body removal, muscle or tendon, simple

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 20520

Foreign body removal, muscle or tendon, simple

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

20520 without 51 · national office

$229.80

Foreign body removal, muscle or tendon, simple

20520-51 · Second procedure: 50%

$114.90

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

20520 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 20520

    Foreign body removal, muscle or tendon, simple1.85 wRVU

    $229.80

  • 20525

    Foreign body removal, deep or complicated3.45 wRVU

    $497.01+$267.21

  • 10120

    Foreign body removal, simple subcutaneous extraction1.19 wRVU

    $157.32−$72.48

  • 10121

    Foreign body removal, complicated subcutaneous2.67 wRVU

    $275.22+$45.42

How to choose

20525Foreign body removalDeep or complicated
Both concern foreign bodies in muscle or a tendon sheath. Choose 20525 when the removal is deep or complicated rather than simple.
10120Foreign body removalSimple subcutaneous extraction
This code is for a simple removal from muscle or a tendon sheath; 10120 is for a simple removal from subcutaneous tissue.
10121Foreign body removalComplicated subcutaneous
Use this code for simple removal from muscle or a tendon sheath. Code 10121 describes complicated removal from subcutaneous tissue.

20520 billing questions

How do I distinguish this code from 20525?

Use this code for a simple removal from muscle or a tendon sheath. Use 20525 when the removal is deep or complicated.

What if the foreign object is only in subcutaneous tissue?

Consider 10120 for a simple removal from subcutaneous tissue or 10121 for a complicated removal. The tissue location, not just the object type, guides code selection.

Can the access incision be billed separately?

Do not separately report an incision that is simply the access needed to remove the foreign object. The service is the removal, with the operative note supporting its location and complexity.

Should modifier 50 be appended for removal on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Are postoperative visits separately payable during the global period?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 20520PPRRVU2026_Oct_nonQPP.csv, line 1,755 (RVU26D)

Open CMS sourceHow we calculate rates

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