CPT code 20551: Tendon injection, tendon origin or insertion2026 Medicare rate & RVUs in California
Injection at one tendon origin or insertion, commonly for focal tendinopathy or enthesopathy, is reported when treatment targets the attachment rather than its sheath.
Medicare pays $62.84–$76.66 for 20551 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 20551 covers
This procedure delivers medication to one tendon origin or insertion to treat a localized condition such as tendinopathy or enthesopathy. A physician or other qualified clinician may perform it in an office or outpatient facility. A familiar example is an injection at the common extensor tendon origin for lateral epicondylitis. The target is the tendon’s attachment, not a tendon sheath or a muscle trigger point.
Report 20551 for one tendon origin or insertion; document the treated site, diagnosis, medication, and clinical rationale. The code includes the injection service, while medication may be separately reportable when applicable coding and payment requirements are met. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services are not paid, and co-surgeon and team-surgery reporting 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.
Where 20551 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$62.84 to $76.66
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $63.08 | $33.06 |
| Chico, CA | $62.84 | $32.82 |
| El Centro, CA | $62.85 | $32.83 |
| Fresno, CA | $62.84 | $32.82 |
| Hanford, CA | $62.84 | $32.82 |
| Los Angeles, CA | $66.67 | $34.27 |
| Madera, CA | $62.84 | $32.82 |
| Marin County, CA | $75.02 | $36.40 |
| Merced, CA | $62.84 | $32.82 |
| Modesto, CA | $62.84 | $32.82 |
| Napa, CA | $71.30 | $35.20 |
| Oxnard, CA | $66.21 | $33.84 |
| Redding, CA | $62.84 | $32.82 |
| Rest of California | $62.84 | $32.82 |
| Riverside, CA | $63.71 | $33.69 |
| Sacramento, CA | $65.54 | $33.68 |
| Salinas, CA | $65.28 | $33.54 |
| San Benito County, CA | $76.66 | $37.17 |
| San Diego, CA | $66.51 | $33.75 |
| San Francisco, CA | $74.93 | $36.31 |
| San Luis Obispo, CA | $64.27 | $33.08 |
| Santa Clara County, CA | $76.29 | $36.80 |
| Santa Cruz, CA | $66.91 | $33.63 |
| Santa Maria, CA | $65.44 | $33.51 |
| Santa Rosa, CA | $67.56 | $33.93 |
| Stockton, CA | $62.84 | $32.82 |
| Vallejo, CA | $71.17 | $35.07 |
| Visalia, CA | $62.84 | $32.82 |
| Yuba City, CA | $62.84 | $32.82 |
How the 20551 rate is calculated
Each of 20551’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 · 20551
RVUs × geographic indexes × conversion factor
Work0.73
0.73 RVUs× 1.000 GPCI
Practice expense1.00
1.00 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
1.8100
Conversion factor
$33.4009
Medicare rate
$60.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20551
The CMS indicators that decide how 20551 is paid alongside other services.
CMS payment indicators · 20551
Tendon injection, tendon origin or insertion
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 51 · payment effect
With and without the modifier
20551 without 51 · national office
$60.46
Tendon injection, tendon origin or insertion
20551-51 · Second procedure: 50%
$30.23
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
20551 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20550Tendon sheath injectionSingle tendon sheath, ligament, or aponeurosis
- Choose 20551 for a tendon origin or insertion; choose 20550 when the injection is into a tendon sheath or ligament.
- 20552Trigger point injectionOne or two muscles
- 20552 is for trigger-point injection involving one or two muscles, not injection at a tendon attachment.
- 20553Trigger point injectionThree or more muscles
- 20553 is for trigger-point injection involving three or more muscles; 20551 targets one tendon origin or insertion.
20551 billing questions
How is 20551 different from 20550?
Use 20551 when the injection targets a tendon origin or insertion. Code 20550 describes an injection into a tendon sheath or ligament.
Can 20551 be used for a trigger-point injection?
No. Trigger-point injections are reported with 20552 or 20553 according to the number of muscles treated; 20551 targets a tendon attachment.
What documentation supports 20551?
Record the specific tendon origin or insertion, the condition treated, and the medication administered. The note should make clear that the target was the attachment rather than a tendon sheath or trigger point.
How should multiple injections at the same tendon attachment be counted?
The code describes treatment of one tendon origin or insertion, not the number of needle passes or medication aliquots. Document each distinct treated target and follow applicable unit-reporting requirements.
Can modifier 50 be reported for bilateral tendon injections?
Modifier 50 is inappropriate for 20551 under the CMS descriptor and anatomy rule. Follow applicable reporting requirements for separately documented sides.
How does CMS handle same-session procedures and assistants?
When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Assistant-at-surgery services are not paid; co-surgeon and team-surgery reporting are not permitted.
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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