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

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, 2026One payment locality1.5K Medicare services in 2024

In West Virginia, Medicare pays $212.86 for 20520 in the office and $136.52 when it’s performed in a hospital or facility.

$212.86Office (non-facility)
$136.52Hospital or facility
−7.4%vs the national office rate ($229.80)

Check a contract rate as a % of Medicare · 20520 nationwide

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

We’ll open 20520 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in West Virginia
  2. What 20520 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How West Virginia compares for 20520

Across 109 of 109 payment localities, the office rate for 20520 runs from $203.01 in Arkansas to $302.68 in San Benito County, CA. West Virginia pays $212.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

20520 in West Virginia vs other payment areas
  1. West Virginia · this page$212.86
  2. Los Angeles, CA · California$258.40+$45.54
  3. Washington, DC area · District of Columbia$262.45+$49.59
  4. Miami, FL · Florida$250.11+$37.25
  5. Chicago, IL · Illinois$242.70+$29.84
  6. Manhattan, NY · New York$264.79+$51.93
  7. Alaska · Alaska$266.98+$54.12

Other areas in West Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

20520 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$206.01$129.15
ArkansasArkansas$203.01$127.55
ArizonaArizona$223.57$138.45
Bakersfield, CACalifornia$242.71$146.43
Chico, CACalifornia$241.93$145.65
El Centro, CACalifornia$241.97$145.69
Fresno, CACalifornia$241.93$145.65
Hanford, CACalifornia$241.93$145.65

20520 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$203.01

$272.31

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
20520 office rate range by state
State / territoryOffice rate rangeLocalities
AK$266.981
AL$206.011
AR$203.011
AZ$223.571
CA$241.93–$302.6829
CO$238.741
CT$245.171
DC$262.451
DE$227.291
FL$227.34–$250.113
GA$214.36–$234.342
GU$247.781
HI$247.781
IA$210.851
ID$212.331
IL$221.04–$242.704
IN$213.561
KS$210.061
KY$211.381
LA$211.14–$221.642
MA$237.38–$262.182
MD$231.58–$262.453
ME$213.67–$225.042
MI$217.13–$230.422
MN$228.061
MO$207.62–$222.183
MS$205.351
MT$229.781
NC$215.891
ND$224.441
NE$211.951
NH$235.191
NJ$247.77–$259.742
NM$218.411
NV$228.451
NY$219.17–$271.535
OH$216.041
OK$210.781
OR$226.48–$246.132
PA$216.27–$239.172
PR$231.411
RI$235.241
SC$216.361
SD$223.811
TN$211.151
TX$214.85–$238.128
UT$219.341
VA$224.44–$262.452
VI$231.411
VT$223.751
WA$236.87–$267.332
WI$216.881
WV$212.861
WY$227.451

See 20520 in every payment locality

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.

The exact West Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,755

Code
20520
Physician work
1.85
Practice expense
4.76
Malpractice
0.27

GPCI2026.csv

110

Locality
West Virginia
Physician work
1.000
Practice expense
0.869
Malpractice
1.431
Office calculation for 20520 in West Virginia
ComponentRVULocality factorAdjusted
Physician work1.85× 1.0001.8500
Practice expense4.76× 0.8694.1364
Malpractice0.27× 1.4310.3864
Total RVUs6.3728
Conversion factor× 33.4009

Office rate, West Virginia$212.86

Office: (1.85 × 1 + 4.76 × 0.869 + 0.27 × 1.431) × $33.4009 = $212.86

Facility: (1.85 × 1 + 2.13 × 0.869 + 0.27 × 1.431) × $33.4009 = $136.52

Open 20520 in the RVU calculator

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

Codes related to 20520

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 20520
CodeHow it relatesOffice range, West Virginia
Same family
20525Foreign body removal, deep or complicatedSame tissue family, for removal that is deep or complicated.$459.38
Used instead
10120Foreign body removal, simple subcutaneous extractionFor simple foreign body removal when the object is in subcutaneous tissue.$144.54
10121Foreign body removal, complicated subcutaneousFor complicated foreign body removal from subcutaneous tissue.$257.98

How 20520 has changed in West Virginia

20520 · Office / nonfacility

$212.86

Effective 2026-10-01

The base rate is $17.05 higher than on 2025-10-01, moving from $195.81 to $212.86 (8.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $195.81changed to$212.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.90 changed to 1.85
    • Practice expense RVU 4.37 changed to 4.76
    • Malpractice RVU 0.29 changed to 0.27
    • Practice expense GPCI 0.862 changed to 0.869
    • Malpractice GPCI 1.333 changed to 1.431

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $202.08changed to$195.81

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.39 changed to 4.37

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $198.78changed to$202.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $202.45changed to$198.78

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.34 changed to 4.39
    • Malpractice RVU 0.27 changed to 0.29
    • Practice expense GPCI 0.860 changed to 0.862
    • Malpractice GPCI 1.266 changed to 1.333

  5. January 1, 2023

    RVU23A

    $205.51changed to$202.45

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.33 changed to 4.34
    • Practice expense GPCI 0.858 changed to 0.860
    • Malpractice GPCI 1.198 changed to 1.266

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $204.52changed to$205.51

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.24 changed to 4.33

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $200.25changed to$204.52

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.85 changed to 4.24
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.857 changed to 0.858
    • Malpractice GPCI 1.247 changed to 1.198

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $195.20changed to$200.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.71 changed to 3.85
    • Malpractice RVU 0.26 changed to 0.28
    • Malpractice GPCI 1.296 changed to 1.247

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $194.37changed to$195.20

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.69 changed to 3.71

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $191.02changed to$194.37

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.63 changed to 3.69
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.847 changed to 0.857
    • Malpractice GPCI 1.289 changed to 1.296

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $188.78changed to$191.02

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.62 changed to 3.63
    • Practice expense GPCI 0.836 changed to 0.847
    • Malpractice GPCI 1.282 changed to 1.289

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $189.62changed to$188.78

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.61 changed to 3.62
    • Malpractice RVU 0.28 changed to 0.27

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $188.67changed to$189.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $187.22changed to$188.67

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.56 changed to 3.61
    • Malpractice RVU 0.29 changed to 0.28
    • Practice expense GPCI 0.832 changed to 0.836
    • Malpractice GPCI 1.256 changed to 1.282

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $187.62changed to$187.22

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.92 changed to 3.56
    • Malpractice RVU 0.30 changed to 0.29
    • Practice expense GPCI 0.828 changed to 0.832
    • Malpractice GPCI 1.229 changed to 1.256

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $187.62

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$212.86$136.52RVU26D
2026-07-01$212.86$136.52RVU26C
2026-04-01$212.86$136.52RVU26B
2026-01-01$212.86$136.52RVU26A
2025-10-01$195.81$138.65RVU25D
2025-07-01$195.81$138.65RVU25C
2025-04-01$195.81$138.65RVU25B
2025-01-01$195.81$138.65RVU25A
2024-10-01$202.08$141.54RVU24D
2024-07-01$202.08$141.54RVU24C
2024-04-01$202.08$141.54RVU24B
2024-03-09$202.08$141.54RVU24AR
2024-01-01$198.78$139.23RVU24A
2023-10-01$202.45$140.96RVU23D
2023-07-01$202.45$140.96RVU23C
2023-04-01$202.45$140.96RVU23B
2023-01-01$202.45$140.96RVU23A
2022-10-01$205.51$141.67RVU22D
2022-07-01$205.51$141.67RVU22C
2022-04-01$205.51$141.67RVU22B
2022-01-01$205.51$141.67RVU22A
2021-10-01$204.52$141.95RVU21D
2021-07-01$204.52$141.95RVU21C
2021-04-01$204.52$141.95RVU21B
2021-01-01$204.52$141.95RVU21A
2020-10-01$200.25$144.27RVU20D
2020-07-01$200.25$144.27RVU20C
2020-04-01$200.25$144.27RVU20B
2020-01-01$200.25$144.27RVU20A
2019-10-01$195.20$143.62RVU19D
2019-07-01$195.20$143.62RVU19C
2019-04-01$195.20$143.62RVU19B
2019-01-01$195.20$143.62RVU19A
2018-10-01$194.37$144.08RVU18D
2018-07-01$194.37$144.08RVU18C
2018-04-01$194.37$144.08RVU18B
2018-01-01$194.37$144.08RVU18AR1
2017-10-01$191.02$142.39RVU17D
2017-07-01$191.02$142.39RVU17C
2017-04-01$191.02$142.39RVU17B
2017-01-01$191.02$142.39RVU17A
2016-10-01$188.78$140.88RVU16D
2016-07-01$188.78$140.88RVU16C
2016-04-01$188.78$140.88RVU16B
2016-01-01$188.78$140.88RVU16A
2015-10-01$189.62$142.15RVU15D
2015-07-01$189.62$142.15RVU15C
2015-04-01$188.67$141.45RVU15B
2015-01-01$188.67$141.45RVU15A
2014-10-01$187.22$140.42RVU14D
2014-07-01$187.22$140.42RVU14C
2014-04-01$187.22$140.42RVU14B
2014-01-01$187.22$140.42RVU14A
2013-10-01$187.62$138.32RVU13D
2013-07-01$187.62$138.32RVU13C
2013-04-01$187.62$138.32RVU13B
2013-01-01$187.62$138.32RVU13AR

Price 20520 for an earlier date of service

Where the West Virginia rate applies

West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Accoville
  • Addison (Webster Springs)
  • Adrian
  • Albright
  • Alderson
  • Alum Creek
  • Amherstdale
  • Anawalt

Browse all communities in West Virginia

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)
Geographic factors for West VirginiaGPCI2026.csv, line 110 (RVU26D)

Open CMS sourceHow we calculate rates

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