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CPT code 20527: Palmar cord injection, enzyme injection2026 Medicare rate & RVUs in Washington, DC area

Report this service for injecting collagenase into a palmar fascial cord to treat Dupuytren contracture, typically as part of a staged treatment plan.

CMS RVU26DEffective Oct 1, 2026One payment locality8.8K Medicare services in 2024

In Washington, DC area, Medicare pays $106.49 for 20527 in the office and $64.38 when it’s performed in a hospital or facility.

$106.49Office (non-facility)
$64.38Hospital or facility
+13.1%vs the national office rate ($94.19)

Check a contract rate as a % of Medicare · 20527 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 20527 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 20527 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 20527 covers

A clinician injects collagenase into a palpable cord of thickened palmar fascia causing Dupuytren contracture. Hand surgeons and other clinicians who treat hand disorders commonly perform the injection in an office or outpatient setting. The enzyme weakens the targeted cord; a separate manipulation may be performed at a later visit to help extend the affected finger. Document the cord and hand treated, the contracture findings, and the injection performed.

Report 20527 for the injection service, not for the later manipulation. When collagenase is supplied and separately reportable, the drug is reported with its applicable drug code and units. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgery and team-surgery payment 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 Washington, DC area compares for 20527

Across 109 of 109 payment localities, the office rate for 20527 runs from $83.34 in Arkansas to $119.21 in San Benito County, CA. Washington, DC area pays $106.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

20527 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$106.49
  2. Los Angeles, CA · California$103.49−$3.00
  3. Miami, FL · Florida$106.15−$0.34
  4. Chicago, IL · Illinois$102.91−$3.58
  5. Manhattan, NY · New York$108.93+$2.44
  6. Alaska · Alaska$111.29+$4.80
  7. Alabama · Alabama$84.55−$21.94

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

20527 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$83.34$52.64
ArizonaArizona$91.57$56.94
Bakersfield, CACalifornia$97.62$58.45
Chico, CACalifornia$97.09$57.92
El Centro, CACalifornia$97.12$57.95
Fresno, CACalifornia$97.09$57.92
Hanford, CACalifornia$97.09$57.92
Madera, CACalifornia$97.09$57.92

20527 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.

$83.34

$111.29

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

View every state and territory as a table
20527 office rate range by state
State / territoryOffice rate rangeLocalities
AK$111.291
AL$84.551
AR$83.341
AZ$91.571
CA$97.09–$119.2129
CO$96.721
CT$100.421
DC$106.491
DE$93.051
FL$94.96–$106.153
GA$89.46–$96.452
GU$99.071
HI$99.071
IA$85.681
ID$86.441
IL$92.97–$102.914
IN$86.911
KS$85.751
KY$87.531
LA$87.59–$91.802
MA$96.35–$105.532
MD$94.66–$106.493
ME$87.38–$91.352
MI$90.21–$96.622
MN$91.321
MO$86.42–$91.563
MS$84.871
MT$94.181
NC$88.211
ND$90.421
NE$86.001
NH$95.661
NJ$101.19–$105.502
NM$90.891
NV$93.191
NY$89.55–$112.145
OH$89.451
OK$86.881
OR$92.09–$99.212
PA$89.32–$98.262
PR$94.701
RI$95.951
SC$89.051
SD$89.981
TN$86.241
TX$88.78–$96.738
UT$90.241
VA$91.39–$106.492
VI$94.701
VT$90.501
WA$96.02–$107.182
WI$87.481
WV$89.711
WY$92.541

See 20527 in every payment locality

How the 20527 rate is calculated

Each of 20527’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 · 20527

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.98

0.98 RVUs× 1.000 GPCI

Practice expense1.65

1.65 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

2.8200

Conversion factor

$33.4009

Medicare rate

$94.19

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,758

Code
20527
Physician work
0.98
Practice expense
1.65
Malpractice
0.19

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 20527 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0541.0329
Practice expense1.65× 1.1781.9437
Malpractice0.19× 1.1130.2115
Total RVUs3.1881
Conversion factor× 33.4009

Office rate, Washington, DC area$106.49

Office: (0.98 × 1.054 + 1.65 × 1.178 + 0.19 × 1.113) × $33.4009 = $106.49

Facility: (0.98 × 1.054 + 0.58 × 1.178 + 0.19 × 1.113) × $33.4009 = $64.38

Open 20527 in the RVU calculator

Payment rules and modifiers for 20527

The CMS indicators that decide how 20527 is paid alongside other services.

CMS payment indicators · 20527

Palmar cord injection, enzyme injection

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

20527 without 50 · national office

$94.19

Palmar cord injection, enzyme injection

20527-50 · Bilateral: 150%

$141.29

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 20527

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

Codes related to 20527
CodeHow it relatesOffice range, Washington, DC area
Often billed with
J0775Collagenase injection, per 0.01 mgDrug code for collagenase clostridium histolyticum when separately reportable.No office rate
Used instead
26040Palm contracture release, percutaneous techniquePercutaneous palmar fasciotomy is a procedural treatment option for Dupuytren contracture.No office rate
26121Palmar fasciectomy, palm onlyPalmar fasciectomy is a surgical treatment option rather than enzyme injection.No office rate
26123Dupuytren release, palm and one digitPalmar and finger fasciectomy with single-digit release is a surgical treatment option.No office rate

How 20527 has changed in Washington, DC area

20527 · Office / nonfacility

$106.49

Effective 2026-10-01

The base rate is $8.43 higher than on 2025-10-01, moving from $98.06 to $106.49 (8.6%).

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

    $98.06changed to$106.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.00 changed to 0.98
    • Practice expense RVU 1.48 changed to 1.65
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $100.11changed to$98.06

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.45 changed to 1.48
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $98.47changed to$100.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $102.95changed to$98.47

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.44 changed to 1.45
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $104.44changed to$102.95

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.39 changed to 1.44
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $103.54changed to$104.44

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.37 changed to 1.39
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $101.24changed to$103.54

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.25 changed to 1.37
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $98.39changed to$101.24

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.21 changed to 1.25
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $99.15changed to$98.39

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.23 changed to 1.21

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $98.58changed to$99.15

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.22 changed to 1.23
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $98.08changed to$98.58

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.21 changed to 1.22
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $98.87changed to$98.08

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.22 changed to 1.21

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $98.38changed to$98.87

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $95.33changed to$98.38

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.20 changed to 1.22
    • Malpractice RVU 0.14 changed to 0.18
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $86.29changed to$95.33

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.10 changed to 1.20
    • Malpractice RVU 0.15 changed to 0.14
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $86.29

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$106.49$64.38RVU26D
2026-07-01$106.49$64.38RVU26C
2026-04-01$106.49$64.38RVU26B
2026-01-01$106.49$64.38RVU26A
2025-10-01$98.06$72.22RVU25D
2025-07-01$98.06$72.22RVU25C
2025-04-01$98.06$72.22RVU25B
2025-01-01$98.06$72.22RVU25A
2024-10-01$100.11$73.52RVU24D
2024-07-01$100.11$73.52RVU24C
2024-04-01$100.11$73.52RVU24B
2024-03-09$100.11$73.52RVU24AR
2024-01-01$98.47$72.32RVU24A
2023-10-01$102.95$75.39RVU23D
2023-07-01$102.95$75.39RVU23C
2023-04-01$102.95$75.39RVU23B
2023-01-01$102.95$75.39RVU23A
2022-10-01$104.44$76.64RVU22D
2022-07-01$104.44$76.64RVU22C
2022-04-01$104.44$76.64RVU22B
2022-01-01$104.44$76.64RVU22A
2021-10-01$103.54$76.37RVU21D
2021-07-01$103.54$76.37RVU21C
2021-04-01$103.54$76.37RVU21B
2021-01-01$103.54$76.37RVU21A
2020-10-01$101.24$77.88RVU20D
2020-07-01$101.24$77.88RVU20C
2020-04-01$101.24$77.88RVU20B
2020-01-01$101.24$77.88RVU20A
2019-10-01$98.39$77.11RVU19D
2019-07-01$98.39$77.11RVU19C
2019-04-01$98.39$77.11RVU19B
2019-01-01$98.39$77.11RVU19A
2018-10-01$99.15$77.46RVU18D
2018-07-01$99.15$77.46RVU18C
2018-04-01$99.15$77.46RVU18B
2018-01-01$99.15$77.46RVU18AR1
2017-10-01$98.58$77.82RVU17D
2017-07-01$98.58$77.82RVU17C
2017-04-01$98.58$77.82RVU17B
2017-01-01$98.58$77.82RVU17A
2016-10-01$98.08$77.37RVU16D
2016-07-01$98.08$77.37RVU16C
2016-04-01$98.08$77.37RVU16B
2016-01-01$98.08$77.37RVU16A
2015-10-01$98.87$77.65RVU15D
2015-07-01$98.87$77.65RVU15C
2015-04-01$98.38$77.27RVU15B
2015-01-01$98.38$77.27RVU15A
2014-10-01$95.33$74.66RVU14D
2014-07-01$95.33$74.66RVU14C
2014-04-01$95.33$74.66RVU14B
2014-01-01$95.33$74.66RVU14A
2013-10-01$86.29$67.14RVU13D
2013-07-01$86.29$67.14RVU13C
2013-04-01$86.29$67.14RVU13B
2013-01-01$86.29$67.14RVU13AR

Price 20527 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

20527 billing questions

When should 20527 be chosen instead of a palmar fasciectomy code?

Use 20527 for enzyme injection into a palmar fascial cord. A fasciectomy code describes surgical removal of diseased fascia, not injection treatment.

Is the post-injection finger manipulation included in 20527?

No. The manipulation is a separate service, commonly reported with 26341 when performed after collagenase injection; it is typically done at a later visit.

Can the collagenase drug be reported separately?

When the drug is separately reportable, report it with the applicable drug code, such as J0775, using units based on the amount administered. The 20527 service represents the injection procedure.

What documentation supports reporting 20527?

Document the Dupuytren contracture, the targeted palmar fascial cord and hand, and the collagenase injection performed. Record the drug and amount administered when needed to support separate drug reporting.

How is 20527 reported when both hands are treated?

CMS lists bilateral reporting with modifier 50, paid at 150%. Document the injection on each side.

Does 20527 have a postoperative global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

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 20527PPRRVU2026_Oct_nonQPP.csv, line 1,758 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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