FeeBase
Log inGet started
Menu

CPT code 20527: Palmar cord injection, enzyme injection2026 Medicare rate & RVUs in Virginia

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 Virginia, Medicare pays $91.39 for 20527 in the office and $56.26 when it’s performed in a hospital or facility.

$91.39Office (non-facility)
$56.26Hospital or facility
−3.0%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 Virginia
  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 Virginia 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. Virginia pays $91.39. The RVUs are the same everywhere; the geographic indexes change the dollars.

20527 in Virginia vs other payment areas
  1. Virginia · this page$91.39
  2. Los Angeles, CA · California$103.49+$12.10
  3. Washington, DC area · District of Columbia$106.49+$15.10
  4. Miami, FL · Florida$106.15+$14.76
  5. Chicago, IL · Illinois$102.91+$11.52
  6. Manhattan, NY · New York$108.93+$17.54
  7. Alaska · Alaska$111.29+$19.90

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

Every other payment area

20527 in every other Medicare payment locality
Payment localityOfficeFacility
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

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 20527 in Virginia
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense1.65× 0.9831.6219
Malpractice0.19× 0.7060.1341
Total RVUs2.7361
Conversion factor× 33.4009

Office rate, Virginia$91.39

Office: (0.98 × 1 + 1.65 × 0.983 + 0.19 × 0.706) × $33.4009 = $91.39

Facility: (0.98 × 1 + 0.58 × 0.983 + 0.19 × 0.706) × $33.4009 = $56.26

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, Virginia
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 Virginia

20527 · Office / nonfacility

$91.39

Effective 2026-10-01

The base rate is $7.48 higher than on 2025-10-01, moving from $83.91 to $91.39 (8.9%).

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

    $83.91changed to$91.39

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $85.62changed to$83.91

    • 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.

  3. March 9, 2024

    RVU24AR

    $84.23changed to$85.62

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $87.52changed to$84.23

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.44 changed to 1.45
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $88.37changed to$87.52

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.39 changed to 1.44
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $87.78changed to$88.37

    • 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

    $86.66changed to$87.78

    • 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
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $84.93changed to$86.66

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.21 changed to 1.25
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $85.54changed to$84.93

    • 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

    $84.61changed to$85.54

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.22 changed to 1.23
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $83.70changed to$84.61

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.21 changed to 1.22
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $84.36changed to$83.70

    • 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

    $83.94changed to$84.36

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $81.85changed to$83.94

    • 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
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $74.32changed to$81.85

    • 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
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $74.32

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$91.39$56.26RVU26D
2026-07-01$91.39$56.26RVU26C
2026-04-01$91.39$56.26RVU26B
2026-01-01$91.39$56.26RVU26A
2025-10-01$83.91$62.59RVU25D
2025-07-01$83.91$62.59RVU25C
2025-04-01$83.91$62.59RVU25B
2025-01-01$83.91$62.59RVU25A
2024-10-01$85.62$63.68RVU24D
2024-07-01$85.62$63.68RVU24C
2024-04-01$85.62$63.68RVU24B
2024-03-09$85.62$63.68RVU24AR
2024-01-01$84.23$62.64RVU24A
2023-10-01$87.52$65.04RVU23D
2023-07-01$87.52$65.04RVU23C
2023-04-01$87.52$65.04RVU23B
2023-01-01$87.52$65.04RVU23A
2022-10-01$88.37$65.98RVU22D
2022-07-01$88.37$65.98RVU22C
2022-04-01$88.37$65.98RVU22B
2022-01-01$88.37$65.98RVU22A
2021-10-01$87.78$65.91RVU21D
2021-07-01$87.78$65.91RVU21C
2021-04-01$87.78$65.91RVU21B
2021-01-01$87.78$65.91RVU21A
2020-10-01$86.66$67.71RVU20D
2020-07-01$86.66$67.71RVU20C
2020-04-01$86.66$67.71RVU20B
2020-01-01$86.66$67.71RVU20A
2019-10-01$84.93$67.51RVU19D
2019-07-01$84.93$67.51RVU19C
2019-04-01$84.93$67.51RVU19B
2019-01-01$84.93$67.51RVU19A
2018-10-01$85.54$67.80RVU18D
2018-07-01$85.54$67.80RVU18C
2018-04-01$85.54$67.80RVU18B
2018-01-01$85.54$67.80RVU18AR1
2017-10-01$84.61$67.64RVU17D
2017-07-01$84.61$67.64RVU17C
2017-04-01$84.61$67.64RVU17B
2017-01-01$84.61$67.64RVU17A
2016-10-01$83.70$66.81RVU16D
2016-07-01$83.70$66.81RVU16C
2016-04-01$83.70$66.81RVU16B
2016-01-01$83.70$66.81RVU16A
2015-10-01$84.36$67.05RVU15D
2015-07-01$84.36$67.05RVU15C
2015-04-01$83.94$66.72RVU15B
2015-01-01$83.94$66.72RVU15A
2014-10-01$81.85$65.00RVU14D
2014-07-01$81.85$65.00RVU14C
2014-04-01$81.85$65.00RVU14B
2014-01-01$81.85$65.00RVU14A
2013-10-01$74.32$58.70RVU13D
2013-07-01$74.32$58.70RVU13C
2013-04-01$74.32$58.70RVU13B
2013-01-01$74.32$58.70RVU13AR

Price 20527 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 20527 pays in Virginia?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 20527 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist