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CPT code 20526: Injection, carpal tunnel treatment2026 Medicare rate & RVUs in Alabama

Report this service when medication is injected into the carpal tunnel to treat symptoms associated with median nerve compression at the wrist.

CMS RVU26DEffective Oct 1, 2026One payment locality81.5K Medicare services in 2024

In Alabama, Medicare pays $79.24 for 20526 in the office and $45.34 when it’s performed in a hospital or facility.

$79.24Office (non-facility)
$45.34Hospital or facility
−10.1%vs the national office rate ($88.18)

Check a contract rate as a % of Medicare · 20526 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 20526 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 20526 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 20526 covers

A clinician injects medication, commonly a corticosteroid, into the carpal tunnel to treat symptoms such as pain, tingling, or numbness associated with median nerve compression. The service is typically performed by a physician or other qualified practitioner in an office or outpatient facility. The injection targets the carpal tunnel; it is not an injection into a tendon sheath or a surgical release of the tunnel.

Report the code for the treated wrist and document the indication, side, and injection performed. For treatment of both wrists, modifier 50 is paid at 150% under the CMS bilateral rule. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. The 0-day global period includes same-day preoperative and postoperative care. CMS does not pay an assistant at surgery for this service; 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 Alabama compares for 20526

Across 109 of 109 payment localities, the office rate for 20526 runs from $78.12 in Arkansas to $111.81 in San Benito County, CA. Alabama pays $79.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

20526 in Alabama vs other payment areas
  1. Alabama · this page$79.24
  2. Los Angeles, CA · California$97.00+$17.76
  3. Washington, DC area · District of Columbia$99.69+$20.45
  4. Miami, FL · Florida$98.98+$19.74
  5. Chicago, IL · Illinois$96.01+$16.77
  6. Manhattan, NY · New York$101.86+$22.62
  7. Alaska · Alaska$104.36+$25.12

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

Every other payment area

20526 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$78.12$44.84
ArizonaArizona$85.76$48.21
Bakersfield, CACalifornia$91.51$49.05
Chico, CACalifornia$91.04$48.57
El Centro, CACalifornia$91.06$48.60
Fresno, CACalifornia$91.04$48.57
Hanford, CACalifornia$91.04$48.57
Madera, CACalifornia$91.04$48.57

20526 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.

$78.12

$104.36

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

View every state and territory as a table
20526 office rate range by state
State / territoryOffice rate rangeLocalities
AK$104.361
AL$79.241
AR$78.121
AZ$85.761
CA$91.04–$111.8129
CO$90.621
CT$93.971
DC$99.691
DE$87.141
FL$88.76–$98.983
GA$83.68–$90.242
GU$92.881
HI$92.881
IA$80.351
ID$81.041
IL$86.87–$96.014
IN$81.481
KS$80.391
KY$81.951
LA$81.99–$85.902
MA$90.26–$98.862
MD$88.64–$99.693
ME$81.89–$85.622
MI$84.41–$90.262
MN$85.681
MO$80.89–$85.703
MS$79.501
MT$88.171
NC$82.661
ND$84.811
NE$80.661
NH$89.591
NJ$94.72–$98.782
NM$85.021
NV$87.281
NY$83.90–$104.805
OH$83.721
OK$81.371
OR$86.28–$92.962
PA$83.62–$91.952
PR$88.661
RI$89.861
SC$83.391
SD$84.411
TN$80.841
TX$83.12–$90.608
UT$84.491
VA$85.63–$99.692
VI$88.661
VT$84.861
WA$89.96–$100.432
WI$82.071
WV$83.841
WY$86.701

See 20526 in every payment locality

How the 20526 rate is calculated

Each of 20526’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 · 20526

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.92

0.92 RVUs× 1.000 GPCI

Practice expense1.55

1.55 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

2.6400

Conversion factor

$33.4009

Medicare rate

$88.18

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

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,757

Code
20526
Physician work
0.92
Practice expense
1.55
Malpractice
0.17

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 20526 in Alabama
ComponentRVULocality factorAdjusted
Physician work0.92× 1.0000.9200
Practice expense1.55× 0.8751.3562
Malpractice0.17× 0.5660.0962
Total RVUs2.3725
Conversion factor× 33.4009

Office rate, Alabama$79.24

Office: (0.92 × 1 + 1.55 × 0.875 + 0.17 × 0.566) × $33.4009 = $79.24

Facility: (0.92 × 1 + 0.39 × 0.875 + 0.17 × 0.566) × $33.4009 = $45.34

Open 20526 in the RVU calculator

Payment rules and modifiers for 20526

The CMS indicators that decide how 20526 is paid alongside other services.

CMS payment indicators · 20526

Injection, carpal tunnel treatment

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

20526 without 50 · national office

$88.18

Injection, carpal tunnel treatment

20526-50 · Bilateral: 150%

$132.27

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 20526

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

Codes related to 20526
CodeHow it relatesOffice range, Alabama
Used instead
64721Carpal tunnel release, median nerve at carpal tunnelCarpal tunnel release is a surgical treatment option rather than an injection.$432.34
Often billed with
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationMay accompany a separately documented ultrasound-guided needle placement service.$58.41
J3301Triamcinolone injection, per 10 mgMay identify triamcinolone administered during the injection when separately reportable.No office rate

How 20526 has changed in Alabama

20526 · Office / nonfacility

$79.24

Effective 2026-10-01

The base rate is $6.51 higher than on 2025-10-01, moving from $72.73 to $79.24 (9.0%).

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

    $72.73changed to$79.24

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.94 changed to 0.92
    • Practice expense RVU 1.40 changed to 1.55
    • Malpractice RVU 0.16 changed to 0.17
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $74.17changed to$72.73

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.37 changed to 1.40
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $72.96changed to$74.17

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $76.29changed to$72.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.34 changed to 1.37
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575

  5. January 1, 2023

    RVU23A

    $78.83changed to$76.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.32 changed to 1.34
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $77.29changed to$78.83

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.27 changed to 1.32
    • Malpractice RVU 0.16 changed to 0.18

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $74.90changed to$77.29

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.15 changed to 1.27
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $72.00changed to$74.90

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.10 changed to 1.15
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $72.24changed to$72.00

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.11 changed to 1.10

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$72.24

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$79.24$45.34RVU26D
2026-07-01$79.24$45.34RVU26C
2026-04-01$79.24$45.34RVU26B
2026-01-01$79.24$45.34RVU26A
2025-10-01$72.73$50.53RVU25D
2025-07-01$72.73$50.53RVU25C
2025-04-01$72.73$50.53RVU25B
2025-01-01$72.73$50.53RVU25A
2024-10-01$74.17$51.61RVU24D
2024-07-01$74.17$51.61RVU24C
2024-04-01$74.17$51.61RVU24B
2024-03-09$74.17$51.61RVU24AR
2024-01-01$72.96$50.77RVU24A
2023-10-01$76.29$53.67RVU23D
2023-07-01$76.29$53.67RVU23C
2023-04-01$76.29$53.67RVU23B
2023-01-01$76.29$53.67RVU23A
2022-10-01$78.83$55.78RVU22D
2022-07-01$78.83$55.78RVU22C
2022-04-01$78.83$55.78RVU22B
2022-01-01$78.83$55.78RVU22A
2021-10-01$77.29$55.60RVU21D
2021-07-01$77.29$55.60RVU21C
2021-04-01$77.29$55.60RVU21B
2021-01-01$77.29$55.60RVU21A
2020-10-01$74.90$55.65RVU20D
2020-07-01$74.90$55.65RVU20C
2020-04-01$74.90$55.65RVU20B
2020-01-01$74.90$55.65RVU20A
2019-10-01$72.00$54.68RVU19D
2019-07-01$72.00$54.68RVU19C
2019-04-01$72.00$54.68RVU19B
2019-01-01$72.00$54.68RVU19A
2018-10-01$72.24$54.62RVU18D
2018-07-01$72.24$54.62RVU18C
2018-04-01$72.24$54.62RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 20526 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

20526 billing questions

When should I choose this code instead of 20550?

Use 20526 when the medication is injected into the carpal tunnel. Code 20550 describes an injection into a tendon sheath or ligament, such as for a tendon-related condition.

Can I report this code for injections in both wrists?

Yes. Report the bilateral service with modifier 50; CMS pays it at 150% under the bilateral rule.

Is same-day follow-up care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

How does the multiple procedure reduction affect this service?

When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%.

Can an assistant or co-surgeon be reported?

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

Can the medication be reported separately?

The procedure code describes the injection service. The administered drug may be separately reported with an applicable drug code when reporting requirements are met.

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 20526PPRRVU2026_Oct_nonQPP.csv, line 1,757 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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