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

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 Delaware, Medicare pays $87.14 for 20526 in the office and $48.86 when it’s performed in a hospital or facility.

$87.14Office (non-facility)
$48.86Hospital or facility
−1.2%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 Delaware
  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 Delaware 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. Delaware pays $87.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

20526 in Delaware vs other payment areas
  1. Delaware · this page$87.14
  2. Los Angeles, CA · California$97.00+$9.86
  3. Washington, DC area · District of Columbia$99.69+$12.55
  4. Miami, FL · Florida$98.98+$11.84
  5. Chicago, IL · Illinois$96.01+$8.87
  6. Manhattan, NY · New York$101.86+$14.72
  7. Alaska · Alaska$104.36+$17.22

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

Every other payment area

20526 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$79.24$45.34
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

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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 20526 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.92× 1.0050.9246
Practice expense1.55× 0.9881.5314
Malpractice0.17× 0.8990.1528
Total RVUs2.6088
Conversion factor× 33.4009

Office rate, Delaware$87.14

Office: (0.92 × 1.005 + 1.55 × 0.988 + 0.17 × 0.899) × $33.4009 = $87.14

Facility: (0.92 × 1.005 + 0.39 × 0.988 + 0.17 × 0.899) × $33.4009 = $48.86

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, Delaware
Used instead
64721Carpal tunnel release, median nerve at carpal tunnelCarpal tunnel release is a surgical treatment option rather than an injection.$476.66
Often billed with
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationMay accompany a separately documented ultrasound-guided needle placement service.$63.61
J3301Triamcinolone injection, per 10 mgMay identify triamcinolone administered during the injection when separately reportable.No office rate

How 20526 has changed in Delaware

20526 · Office / nonfacility

$87.14

Effective 2026-10-01

The base rate is $6.63 higher than on 2025-10-01, moving from $80.51 to $87.14 (8.2%).

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

    $80.51changed to$87.14

    • 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
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $82.18changed to$80.51

    • 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

    $80.84changed to$82.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $83.53changed to$80.84

    • 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
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $85.15changed to$83.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.32 changed to 1.34
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $83.43changed to$85.15

    • 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

    $82.41changed to$83.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.15 changed to 1.27
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $80.96changed to$82.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.10 changed to 1.15
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $81.24changed to$80.96

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

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $80.86changed to$81.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.10 changed to 1.11
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $80.50changed to$80.86

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.09 changed to 1.10
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $81.16changed to$80.50

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.10 changed to 1.09

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $80.76changed to$81.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $78.33changed to$80.76

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.08 changed to 1.10
    • Malpractice RVU 0.13 changed to 0.16
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $77.12changed to$78.33

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.17 changed to 1.08
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $77.12

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$87.14$48.86RVU26D
2026-07-01$87.14$48.86RVU26C
2026-04-01$87.14$48.86RVU26B
2026-01-01$87.14$48.86RVU26A
2025-10-01$80.51$55.16RVU25D
2025-07-01$80.51$55.16RVU25C
2025-04-01$80.51$55.16RVU25B
2025-01-01$80.51$55.16RVU25A
2024-10-01$82.18$56.42RVU24D
2024-07-01$82.18$56.42RVU24C
2024-04-01$82.18$56.42RVU24B
2024-03-09$82.18$56.42RVU24AR
2024-01-01$80.84$55.50RVU24A
2023-10-01$83.53$57.59RVU23D
2023-07-01$83.53$57.59RVU23C
2023-04-01$83.53$57.59RVU23B
2023-01-01$83.53$57.59RVU23A
2022-10-01$85.15$58.63RVU22D
2022-07-01$85.15$58.63RVU22C
2022-04-01$85.15$58.63RVU22B
2022-01-01$85.15$58.63RVU22A
2021-10-01$83.43$58.47RVU21D
2021-07-01$83.43$58.47RVU21C
2021-04-01$83.43$58.47RVU21B
2021-01-01$83.43$58.47RVU21A
2020-10-01$82.41$60.30RVU20D
2020-07-01$82.41$60.30RVU20C
2020-04-01$82.41$60.30RVU20B
2020-01-01$82.41$60.30RVU20A
2019-10-01$80.96$61.13RVU19D
2019-07-01$80.96$61.13RVU19C
2019-04-01$80.96$61.13RVU19B
2019-01-01$80.96$61.13RVU19A
2018-10-01$81.24$61.06RVU18D
2018-07-01$81.24$61.06RVU18C
2018-04-01$81.24$61.06RVU18B
2018-01-01$81.24$61.06RVU18AR1
2017-10-01$80.86$60.99RVU17D
2017-07-01$80.86$60.99RVU17C
2017-04-01$80.86$60.99RVU17B
2017-01-01$80.86$60.99RVU17A
2016-10-01$80.50$60.57RVU16D
2016-07-01$80.50$60.57RVU16C
2016-04-01$80.50$60.57RVU16B
2016-01-01$80.50$60.57RVU16A
2015-10-01$81.16$61.16RVU15D
2015-07-01$81.16$61.16RVU15C
2015-04-01$80.76$60.85RVU15B
2015-01-01$80.76$60.85RVU15A
2014-10-01$78.33$58.62RVU14D
2014-07-01$78.33$58.62RVU14C
2014-04-01$78.33$58.62RVU14B
2014-01-01$78.33$58.62RVU14A
2013-10-01$77.12$56.52RVU13D
2013-07-01$77.12$56.52RVU13C
2013-04-01$77.12$56.52RVU13B
2013-01-01$77.12$56.52RVU13AR

Price 20526 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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