CPT code 20527: Palmar cord injection, enzyme injection2026 Medicare rate & RVUs in Montana
Report this service for injecting collagenase into a palmar fascial cord to treat Dupuytren contracture, typically as part of a staged treatment plan.
In Montana, Medicare pays $94.18 for 20527 in the office and $58.44 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Montana 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. Montana pays $94.18. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$94.18
- Los Angeles, CA · California$103.49+$9.31
- Washington, DC area · District of Columbia$106.49+$12.31
- Miami, FL · Florida$106.15+$11.97
- Chicago, IL · Illinois$102.91+$8.73
- Manhattan, NY · New York$108.93+$14.75
- Alaska · Alaska$111.29+$17.11
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Hanford, CACalifornia | $97.09 | $57.92 |
| Madera, CACalifornia | $97.09 | $57.92 |
| Merced, CACalifornia | $97.09 | $57.92 |
| Modesto, CACalifornia | $97.09 | $57.92 |
| Napa, CACalifornia | $110.66 | $63.55 |
| Oxnard, CACalifornia | $102.74 | $60.50 |
| Redding, CACalifornia | $97.09 | $57.92 |
| Rest of CaliforniaCalifornia | $97.09 | $57.92 |
| Riverside, CACalifornia | $99.14 | $59.97 |
| Sacramento, CACalifornia | $101.41 | $59.84 |
| Salinas, CACalifornia | $101.02 | $59.60 |
| San Diego, CACalifornia | $103.07 | $60.32 |
| Marin County, CACalifornia | $116.46 | $66.07 |
| San Francisco, CACalifornia | $116.25 | $65.85 |
| San Benito County, CACalifornia | $119.21 | $67.67 |
| Santa Clara County, CACalifornia | $118.32 | $66.79 |
| San Luis Obispo, CACalifornia | $99.46 | $58.76 |
| Santa Cruz, CACalifornia | $103.78 | $60.36 |
| Santa Maria, CACalifornia | $101.31 | $59.64 |
| Santa Rosa, CACalifornia | $104.79 | $60.91 |
| Stockton, CACalifornia | $97.09 | $57.92 |
| Vallejo, CACalifornia | $110.34 | $63.24 |
| Visalia, CACalifornia | $97.09 | $57.92 |
| Yuba City, CACalifornia | $97.09 | $57.92 |
| ColoradoColorado | $96.72 | $58.69 |
| ConnecticutConnecticut | $100.42 | $61.93 |
| DelawareDelaware | $93.05 | $57.74 |
| Fort Lauderdale, FLFlorida | $100.03 | $63.83 |
| Rest of FloridaFlorida | $94.96 | $60.79 |
| Atlanta, GAGeorgia | $96.45 | $60.14 |
| Rest of GeorgiaGeorgia | $89.46 | $57.58 |
| Hawaii, Guam, HIHawaii | $99.07 | $58.43 |
| IowaIowa | $85.68 | $52.98 |
| IdahoIdaho | $86.44 | $53.56 |
| East St. Louis, ILIllinois | $96.22 | $63.34 |
| Rest of IllinoisIllinois | $92.97 | $60.34 |
| Suburban Chicago, ILIllinois | $100.81 | $64.10 |
| IndianaIndiana | $86.91 | $53.78 |
| KansasKansas | $85.75 | $53.44 |
| KentuckyKentucky | $87.53 | $55.76 |
| New Orleans, LALouisiana | $91.80 | $58.17 |
| Rest of LouisianaLouisiana | $87.59 | $55.96 |
| Metropolitan Boston, MAMassachusetts | $105.53 | $62.85 |
| Rest of MassachusettsMassachusetts | $96.35 | $58.71 |
| Baltimore area, MDMaryland | $100.24 | $61.89 |
| Rest of MarylandMaryland | $94.66 | $58.49 |
| Rest of MaineMaine | $87.38 | $54.50 |
| Southern Maine, MEMaine | $91.35 | $55.94 |
| Detroit, MIMichigan | $96.62 | $62.13 |
| Rest of MichiganMichigan | $90.21 | $57.58 |
| MinnesotaMinnesota | $91.32 | $54.55 |
| Metropolitan Kansas City, MOMissouri | $90.68 | $57.12 |
| Metropolitan St. Louis, MOMissouri | $91.56 | $57.53 |
| Rest of MissouriMissouri | $86.42 | $55.61 |
| MississippiMississippi | $84.87 | $54.10 |
| North CarolinaNorth Carolina | $88.21 | $54.86 |
| North DakotaNorth Dakota | $90.42 | $54.68 |
| NebraskaNebraska | $86.00 | $53.01 |
| New HampshireNew Hampshire | $95.66 | $58.45 |
| Northern New JerseyNew Jersey | $105.50 | $64.04 |
| Rest of New JerseyNew Jersey | $101.19 | $62.16 |
| New MexicoNew Mexico | $90.89 | $58.12 |
| NevadaNevada | $93.19 | $57.41 |
| NYC suburbs and Long Island, NYNew York | $112.14 | $69.65 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $102.23 | $63.10 |
| Queens, NYNew York | $109.12 | $66.88 |
| Rest of New YorkNew York | $89.55 | $55.60 |
| OhioOhio | $89.45 | $56.82 |
| OklahomaOklahoma | $86.88 | $54.96 |
| Portland, OROregon | $99.21 | $59.50 |
| Rest of OregonOregon | $92.09 | $56.49 |
| Metropolitan Philadelphia, PAPennsylvania | $98.26 | $61.06 |
| Rest of PennsylvaniaPennsylvania | $89.32 | $56.51 |
| Puerto RicoPuerto Rico | $94.70 | $58.57 |
| Rhode IslandRhode Island | $95.95 | $59.03 |
| South CarolinaSouth Carolina | $89.05 | $56.03 |
| South DakotaSouth Dakota | $89.98 | $54.24 |
| TennesseeTennessee | $86.24 | $53.75 |
| Austin, TXTexas | $96.73 | $58.92 |
| Beaumont, TXTexas | $88.78 | $56.26 |
| Brazoria, TXTexas | $92.56 | $57.14 |
| Dallas, TXTexas | $93.36 | $57.77 |
| Fort Worth, TXTexas | $92.89 | $57.66 |
| Galveston, TXTexas | $92.98 | $57.49 |
| Houston, TXTexas | $96.45 | $60.96 |
| Rest of TexasTexas | $90.76 | $56.85 |
| UtahUtah | $90.24 | $56.64 |
| VirginiaVirginia | $91.39 | $56.26 |
| Virgin Islands, VIUnited States Virgin Islands | $94.70 | $58.57 |
| VermontVermont | $90.50 | $55.12 |
| Rest of WashingtonWashington | $96.02 | $58.39 |
| King County, WAWashington | $107.18 | $63.32 |
| WisconsinWisconsin | $87.48 | $53.25 |
| West VirginiaWest Virginia | $89.71 | $58.65 |
| WyomingWyoming | $92.54 | $56.80 |
20527 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $111.29 | 1 |
| AL | $84.55 | 1 |
| AR | $83.34 | 1 |
| AZ | $91.57 | 1 |
| CA | $97.09–$119.21 | 29 |
| CO | $96.72 | 1 |
| CT | $100.42 | 1 |
| DC | $106.49 | 1 |
| DE | $93.05 | 1 |
| FL | $94.96–$106.15 | 3 |
| GA | $89.46–$96.45 | 2 |
| GU | $99.07 | 1 |
| HI | $99.07 | 1 |
| IA | $85.68 | 1 |
| ID | $86.44 | 1 |
| IL | $92.97–$102.91 | 4 |
| IN | $86.91 | 1 |
| KS | $85.75 | 1 |
| KY | $87.53 | 1 |
| LA | $87.59–$91.80 | 2 |
| MA | $96.35–$105.53 | 2 |
| MD | $94.66–$106.49 | 3 |
| ME | $87.38–$91.35 | 2 |
| MI | $90.21–$96.62 | 2 |
| MN | $91.32 | 1 |
| MO | $86.42–$91.56 | 3 |
| MS | $84.87 | 1 |
| MT | $94.18 | 1 |
| NC | $88.21 | 1 |
| ND | $90.42 | 1 |
| NE | $86.00 | 1 |
| NH | $95.66 | 1 |
| NJ | $101.19–$105.50 | 2 |
| NM | $90.89 | 1 |
| NV | $93.19 | 1 |
| NY | $89.55–$112.14 | 5 |
| OH | $89.45 | 1 |
| OK | $86.88 | 1 |
| OR | $92.09–$99.21 | 2 |
| PA | $89.32–$98.26 | 2 |
| PR | $94.70 | 1 |
| RI | $95.95 | 1 |
| SC | $89.05 | 1 |
| SD | $89.98 | 1 |
| TN | $86.24 | 1 |
| TX | $88.78–$96.73 | 8 |
| UT | $90.24 | 1 |
| VA | $91.39–$106.49 | 2 |
| VI | $94.70 | 1 |
| VT | $90.50 | 1 |
| WA | $96.02–$107.18 | 2 |
| WI | $87.48 | 1 |
| WV | $89.71 | 1 |
| WY | $92.54 | 1 |
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
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 Montana 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
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.000 | 0.9800 |
| Practice expense | 1.65 | × 1.000 | 1.6500 |
| Malpractice | 0.19 | × 0.998 | 0.1896 |
| Total RVUs | 2.8196 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$94.18
Office: (0.98 × 1 + 1.65 × 1 + 0.19 × 0.998) × $33.4009 = $94.18
Facility: (0.98 × 1 + 0.58 × 1 + 0.19 × 0.998) × $33.4009 = $58.44
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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).
How 20527 has changed in Montana
20527 · Office / nonfacility
$94.18
Effective 2026-10-01
The base rate is $8.27 higher than on 2025-10-01, moving from $85.91 to $94.18 (9.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$85.91changed to$94.18
- 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
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$87.74changed to$85.91
- 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.
March 9, 2024
RVU24AR
$86.31changed to$87.74
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$88.98changed to$86.31
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.44 changed to 1.45
January 1, 2023
RVU23A
$89.13changed to$88.98
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.39 changed to 1.44
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$88.49changed to$89.13
- 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.
January 1, 2021
RVU21A
$89.67changed to$88.49
- 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
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$90.23changed to$89.67
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.21 changed to 1.25
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$90.85changed to$90.23
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.23 changed to 1.21
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$88.90changed to$90.85
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.22 changed to 1.23
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$87.03changed to$88.90
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.21 changed to 1.22
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$87.70changed to$87.03
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.22 changed to 1.21
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$87.27changed to$87.70
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$84.65changed to$87.27
- 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
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$77.08changed to$84.65
- 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
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $77.08
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $94.18 | $58.44 | RVU26D |
| 2026-07-01 | $94.18 | $58.44 | RVU26C |
| 2026-04-01 | $94.18 | $58.44 | RVU26B |
| 2026-01-01 | $94.18 | $58.44 | RVU26A |
| 2025-10-01 | $85.91 | $64.24 | RVU25D |
| 2025-07-01 | $85.91 | $64.24 | RVU25C |
| 2025-04-01 | $85.91 | $64.24 | RVU25B |
| 2025-01-01 | $85.91 | $64.24 | RVU25A |
| 2024-10-01 | $87.74 | $65.44 | RVU24D |
| 2024-07-01 | $87.74 | $65.44 | RVU24C |
| 2024-04-01 | $87.74 | $65.44 | RVU24B |
| 2024-03-09 | $87.74 | $65.44 | RVU24AR |
| 2024-01-01 | $86.31 | $64.37 | RVU24A |
| 2023-10-01 | $88.98 | $66.28 | RVU23D |
| 2023-07-01 | $88.98 | $66.28 | RVU23C |
| 2023-04-01 | $88.98 | $66.28 | RVU23B |
| 2023-01-01 | $88.98 | $66.28 | RVU23A |
| 2022-10-01 | $89.13 | $66.64 | RVU22D |
| 2022-07-01 | $89.13 | $66.64 | RVU22C |
| 2022-04-01 | $89.13 | $66.64 | RVU22B |
| 2022-01-01 | $89.13 | $66.64 | RVU22A |
| 2021-10-01 | $88.49 | $66.51 | RVU21D |
| 2021-07-01 | $88.49 | $66.51 | RVU21C |
| 2021-04-01 | $88.49 | $66.51 | RVU21B |
| 2021-01-01 | $88.49 | $66.51 | RVU21A |
| 2020-10-01 | $89.67 | $70.55 | RVU20D |
| 2020-07-01 | $89.67 | $70.55 | RVU20C |
| 2020-04-01 | $89.67 | $70.55 | RVU20B |
| 2020-01-01 | $89.67 | $70.55 | RVU20A |
| 2019-10-01 | $90.23 | $72.57 | RVU19D |
| 2019-07-01 | $90.23 | $72.57 | RVU19C |
| 2019-04-01 | $90.23 | $72.57 | RVU19B |
| 2019-01-01 | $90.23 | $72.57 | RVU19A |
| 2018-10-01 | $90.85 | $72.85 | RVU18D |
| 2018-07-01 | $90.85 | $72.85 | RVU18C |
| 2018-04-01 | $90.85 | $72.85 | RVU18B |
| 2018-01-01 | $90.85 | $72.85 | RVU18AR1 |
| 2017-10-01 | $88.90 | $71.68 | RVU17D |
| 2017-07-01 | $88.90 | $71.68 | RVU17C |
| 2017-04-01 | $88.90 | $71.68 | RVU17B |
| 2017-01-01 | $88.90 | $71.68 | RVU17A |
| 2016-10-01 | $87.03 | $69.84 | RVU16D |
| 2016-07-01 | $87.03 | $69.84 | RVU16C |
| 2016-04-01 | $87.03 | $69.84 | RVU16B |
| 2016-01-01 | $87.03 | $69.84 | RVU16A |
| 2015-10-01 | $87.70 | $70.09 | RVU15D |
| 2015-07-01 | $87.70 | $70.09 | RVU15C |
| 2015-04-01 | $87.27 | $69.75 | RVU15B |
| 2015-01-01 | $87.27 | $69.75 | RVU15A |
| 2014-10-01 | $84.65 | $67.46 | RVU14D |
| 2014-07-01 | $84.65 | $67.46 | RVU14C |
| 2014-04-01 | $84.65 | $67.46 | RVU14B |
| 2014-01-01 | $84.65 | $67.46 | RVU14A |
| 2013-10-01 | $77.08 | $61.09 | RVU13D |
| 2013-07-01 | $77.08 | $61.09 | RVU13C |
| 2013-04-01 | $77.08 | $61.09 | RVU13B |
| 2013-01-01 | $77.08 | $61.09 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
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
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