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

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 Baltimore area, MD, Medicare pays $100.24 for 20527 in the office and $61.89 when it’s performed in a hospital or facility.

$100.24Office (non-facility)
$61.89Hospital or facility
+6.4%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 Baltimore area, MD
  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 Baltimore area, MD 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. Baltimore area, MD pays $100.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

20527 in Baltimore area, MD vs other payment areas
  1. Baltimore area, MD · this page$100.24
  2. Rest of Maryland · Maryland$94.66−$5.58
  3. Los Angeles, CA · California$103.49+$3.25
  4. Washington, DC area · District of Columbia$106.49+$6.25
  5. Miami, FL · Florida$106.15+$5.91
  6. Chicago, IL · Illinois$102.91+$2.67
  7. Manhattan, NY · New York$108.93+$8.69

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

Every other payment area

20527 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$111.29$73.23
AlabamaAlabama$84.55$53.28
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

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 Baltimore area, MD 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

60

Locality
Baltimore area, MD
Physician work
1.016
Practice expense
1.073
Malpractice
1.237
Office calculation for 20527 in Baltimore area, MD
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0160.9957
Practice expense1.65× 1.0731.7704
Malpractice0.19× 1.2370.2350
Total RVUs3.0012
Conversion factor× 33.4009

Office rate, Baltimore area, MD$100.24

Office: (0.98 × 1.016 + 1.65 × 1.073 + 0.19 × 1.237) × $33.4009 = $100.24

Facility: (0.98 × 1.016 + 0.58 × 1.073 + 0.19 × 1.237) × $33.4009 = $61.89

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, Baltimore area, MD
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 Baltimore area, MD

20527 · Office / nonfacility

$100.24

Effective 2026-10-01

The base rate is $8.02 higher than on 2025-10-01, moving from $92.22 to $100.24 (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

    $92.22changed to$100.24

    • 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 1.020 changed to 1.016
    • Practice expense GPCI 1.078 changed to 1.073
    • Malpractice GPCI 1.309 changed to 1.237

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $94.26changed to$92.22

    • 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

    $92.73changed to$94.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $96.18changed to$92.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.44 changed to 1.45
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.087 changed to 1.078
    • Malpractice GPCI 1.311 changed to 1.309

  5. January 1, 2023

    RVU23A

    $96.93changed to$96.18

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.39 changed to 1.44
    • Work GPCI 1.028 changed to 1.024
    • Practice expense GPCI 1.096 changed to 1.087
    • Malpractice GPCI 1.313 changed to 1.311

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $96.05changed to$96.93

    • 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

    $94.90changed to$96.05

    • 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 1.026 changed to 1.028
    • Practice expense GPCI 1.095 changed to 1.096
    • Malpractice GPCI 1.304 changed to 1.313

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $93.02changed to$94.90

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.21 changed to 1.25
    • Work GPCI 1.023 changed to 1.026
    • Malpractice GPCI 1.295 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $93.71changed to$93.02

    • 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

    $92.70changed to$93.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.22 changed to 1.23
    • Practice expense GPCI 1.096 changed to 1.095
    • Malpractice GPCI 1.238 changed to 1.295

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $91.76changed to$92.70

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.21 changed to 1.22
    • Practice expense GPCI 1.097 changed to 1.096
    • Malpractice GPCI 1.181 changed to 1.238

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $92.49changed to$91.76

    • 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

    $92.03changed to$92.49

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $89.86changed to$92.03

    • 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 1.025 changed to 1.023
    • Malpractice GPCI 1.194 changed to 1.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $82.15changed to$89.86

    • 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 1.027 changed to 1.025
    • Malpractice GPCI 1.206 changed to 1.194

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $82.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$100.24$61.89RVU26D
2026-07-01$100.24$61.89RVU26C
2026-04-01$100.24$61.89RVU26B
2026-01-01$100.24$61.89RVU26A
2025-10-01$92.22$68.86RVU25D
2025-07-01$92.22$68.86RVU25C
2025-04-01$92.22$68.86RVU25B
2025-01-01$92.22$68.86RVU25A
2024-10-01$94.26$70.22RVU24D
2024-07-01$94.26$70.22RVU24C
2024-04-01$94.26$70.22RVU24B
2024-03-09$94.26$70.22RVU24AR
2024-01-01$92.73$69.08RVU24A
2023-10-01$96.18$71.50RVU23D
2023-07-01$96.18$71.50RVU23C
2023-04-01$96.18$71.50RVU23B
2023-01-01$96.18$71.50RVU23A
2022-10-01$96.93$72.28RVU22D
2022-07-01$96.93$72.28RVU22C
2022-04-01$96.93$72.28RVU22B
2022-01-01$96.93$72.28RVU22A
2021-10-01$96.05$71.96RVU21D
2021-07-01$96.05$71.96RVU21C
2021-04-01$96.05$71.96RVU21B
2021-01-01$96.05$71.96RVU21A
2020-10-01$94.90$73.95RVU20D
2020-07-01$94.90$73.95RVU20C
2020-04-01$94.90$73.95RVU20B
2020-01-01$94.90$73.95RVU20A
2019-10-01$93.02$73.68RVU19D
2019-07-01$93.02$73.68RVU19C
2019-04-01$93.02$73.68RVU19B
2019-01-01$93.02$73.68RVU19A
2018-10-01$93.71$74.00RVU18D
2018-07-01$93.71$74.00RVU18C
2018-04-01$93.71$74.00RVU18B
2018-01-01$93.71$74.00RVU18AR1
2017-10-01$92.70$73.82RVU17D
2017-07-01$92.70$73.82RVU17C
2017-04-01$92.70$73.82RVU17B
2017-01-01$92.70$73.82RVU17A
2016-10-01$91.76$72.91RVU16D
2016-07-01$91.76$72.91RVU16C
2016-04-01$91.76$72.91RVU16B
2016-01-01$91.76$72.91RVU16A
2015-10-01$92.49$73.17RVU15D
2015-07-01$92.49$73.17RVU15C
2015-04-01$92.03$72.81RVU15B
2015-01-01$92.03$72.81RVU15A
2014-10-01$89.86$71.00RVU14D
2014-07-01$89.86$71.00RVU14C
2014-04-01$89.86$71.00RVU14B
2014-01-01$89.86$71.00RVU14A
2013-10-01$82.15$64.61RVU13D
2013-07-01$82.15$64.61RVU13C
2013-04-01$82.15$64.61RVU13B
2013-01-01$82.15$64.61RVU13AR

Price 20527 for an earlier date of service

Where the Baltimore area, MD rate applies

Baltimore area, MD is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in Maryland. Some span more than one payment area; confirm with the service ZIP.

  • Baltimore
  • Aberdeen
  • Aberdeen Proving Ground
  • Abingdon
  • Annapolis
  • Annapolis Neck
  • Arbutus
  • Arden on the Severn

Browse all communities in Maryland

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 Baltimore area, MDGPCI2026.csv, line 60 (RVU26D)

Open CMS sourceHow we calculate rates

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