CPT code 20552: Trigger point injection, one or two muscles2026 Medicare rate & RVUs in Washington, DC area

Report 20552 for injection treatment of one or more myofascial trigger points located in one or two muscles, such as trapezius muscles.

CMS RVU26DEffective Oct 1, 2026One payment locality237.4K Medicare services in 2024

In Washington, DC area, Medicare pays $58.18 for 20552 in the office and $39.30 when it’s performed in a hospital or facility.

$58.18Office (non-facility)
$39.30Hospital or facility
+12.4%vs the national office rate ($51.77)

Check a contract rate as a % of Medicare · 20552 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 20552 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 20552 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 20552 covers

A clinician injects medication into one or more palpable, symptomatic trigger points in one or two muscles to treat myofascial pain. Common sites include cervical or lumbar paraspinal muscles and the trapezius. The service is often performed in an office or outpatient setting by clinicians treating musculoskeletal or pain conditions. The code describes the number of muscles treated, not the number of trigger points or needle placements; dry needling without injection is a different service.

Choose 20552 when the documented injection treatment involves one or two muscles; use the three-or-more-muscle code when that threshold is met. Record the treated muscles, trigger-point findings, injection sites, and medication administered. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon or team-surgery reporting is 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 20552

Across 109 of 109 payment localities, the office rate for 20552 runs from $46.68 in Arkansas to $65.44 in San Benito County, CA. Washington, DC area pays $58.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

20552 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$58.18
  2. Los Angeles, CA · California$57.00−$1.18
  3. Miami, FL · Florida$56.50−$1.68
  4. Chicago, IL · Illinois$55.09−$3.09
  5. Manhattan, NY · New York$59.05+$0.87
  6. Alaska · Alaska$63.23+$5.05
  7. Alabama · Alabama$47.25−$10.93

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

Every other payment area

20552 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$46.68$32.91
ArizonaArizona$50.56$35.03
Bakersfield, CACalifornia$53.96$36.39
Chico, CACalifornia$53.74$36.17
El Centro, CACalifornia$53.76$36.18
Fresno, CACalifornia$53.74$36.17
Hanford, CACalifornia$53.74$36.17
Madera, CACalifornia$53.74$36.17

20552 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.

$46.68

$63.23

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

View every state and territory as a table
20552 office rate range by state
State / territoryOffice rate rangeLocalities
AK$63.231
AL$47.251
AR$46.681
AZ$50.561
CA$53.74–$65.4429
CO$53.311
CT$54.851
DC$58.181
DE$51.311
FL$51.71–$56.503
GA$49.19–$52.752
GU$54.631
HI$54.631
IA$47.981
ID$48.291
IL$50.65–$55.094
IN$48.521
KS$47.921
KY$48.461
LA$48.45–$50.432
MA$53.13–$57.832
MD$52.13–$58.183
ME$48.64–$50.662
MI$49.63–$52.392
MN$50.941
MO$47.84–$50.433
MS$47.261
MT$51.771
NC$49.051
ND$50.381
NE$48.161
NH$52.631
NJ$55.43–$57.772
NM$49.911
NV$51.411
NY$49.67–$60.455
OH$49.351
OK$48.251
OR$50.96–$54.632
PA$49.34–$53.762
PR$52.041
RI$52.851
SC$49.291
SD$50.221
TN$48.141
TX$49.08–$53.178
UT$49.851
VA$50.61–$58.182
VI$52.041
VT$50.341
WA$52.98–$58.782
WI$48.981
WV$49.101
WY$51.161

See 20552 in every payment locality

How the 20552 rate is calculated

Each of 20552’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 · 20552

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.64

0.64 RVUs× 1.000 GPCI

Practice expense0.84

0.84 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

1.5500

Conversion factor

$33.4009

Medicare rate

$51.77

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

1,761

Code
20552
Physician work
0.64
Practice expense
0.84
Malpractice
0.07

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 20552 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.64× 1.0540.6746
Practice expense0.84× 1.1780.9895
Malpractice0.07× 1.1130.0779
Total RVUs1.7420
Conversion factor× 33.4009

Office rate, Washington, DC area$58.18

Office: (0.64 × 1.054 + 0.84 × 1.178 + 0.07 × 1.113) × $33.4009 = $58.18

Facility: (0.64 × 1.054 + 0.36 × 1.178 + 0.07 × 1.113) × $33.4009 = $39.30

Open 20552 in the RVU calculator

Payment rules and modifiers for 20552

The CMS indicators that decide how 20552 is paid alongside other services.

CMS payment indicators · 20552

Trigger point injection, one or two muscles

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)0The 150% bilateral adjustment doesn’t apply.
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 51 · payment effect

With and without the modifier

20552 without 51 · national office

$51.77

Trigger point injection, one or two muscles

20552-51 · Second procedure: 50%

$25.89

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%).

When to use modifier 51

How 20552 has changed in Washington, DC area

20552 · Office / nonfacility

$58.18

Effective 2026-10-01

The base rate is $0.58 higher than on 2025-10-01, moving from $57.60 to $58.18 (1.0%).

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

    $57.60changed to$58.18

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.66 changed to 0.64
    • 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

    $59.66changed to$57.60

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $58.69changed to$59.66

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $61.51changed to$58.69

    • Conversion factor 33.8872 changed to 32.7442
    • 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

    $64.03changed to$61.51

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.09 changed to 0.08
    • 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

    $64.56changed to$64.03

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $66.15changed to$64.56

    • Conversion factor 36.0896 changed to 34.8931
    • 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

    $64.52changed to$66.15

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.07 changed to 0.09
    • 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

    $64.45changed to$64.52

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $64.34changed to$64.45

    • Conversion factor 35.8887 changed to 35.9996
    • 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

    $64.29changed to$64.34

    • Conversion factor 35.8043 changed to 35.8887
    • 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

    $64.06changed to$64.29

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.06 changed to 0.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $63.74changed to$64.06

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $63.59changed to$63.74

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.83 changed to 0.84
    • Malpractice RVU 0.07 changed to 0.06
    • 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

    $63.34changed to$63.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.91 changed to 0.83
    • 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: $63.34

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$58.18$39.30RVU26D
2026-07-01$58.18$39.30RVU26C
2026-04-01$58.18$39.30RVU26B
2026-01-01$58.18$39.30RVU26A
2025-10-01$57.60$39.09RVU25D
2025-07-01$57.60$39.09RVU25C
2025-04-01$57.60$39.09RVU25B
2025-01-01$57.60$39.09RVU25A
2024-10-01$59.66$40.62RVU24D
2024-07-01$59.66$40.62RVU24C
2024-04-01$59.66$40.62RVU24B
2024-03-09$59.66$40.62RVU24AR
2024-01-01$58.69$39.95RVU24A
2023-10-01$61.51$41.77RVU23D
2023-07-01$61.51$41.77RVU23C
2023-04-01$61.51$41.77RVU23B
2023-01-01$61.51$41.77RVU23A
2022-10-01$64.03$43.50RVU22D
2022-07-01$64.03$43.50RVU22C
2022-04-01$64.03$43.50RVU22B
2022-01-01$64.03$43.50RVU22A
2021-10-01$64.56$43.86RVU21D
2021-07-01$64.56$43.86RVU21C
2021-04-01$64.56$43.86RVU21B
2021-01-01$64.56$43.86RVU21A
2020-10-01$66.15$45.00RVU20D
2020-07-01$66.15$45.00RVU20C
2020-04-01$66.15$45.00RVU20B
2020-01-01$66.15$45.00RVU20A
2019-10-01$64.52$43.67RVU19D
2019-07-01$64.52$43.67RVU19C
2019-04-01$64.52$43.67RVU19B
2019-01-01$64.52$43.67RVU19A
2018-10-01$64.45$43.62RVU18D
2018-07-01$64.45$43.62RVU18C
2018-04-01$64.45$43.62RVU18B
2018-01-01$64.45$43.62RVU18AR1
2017-10-01$64.34$43.59RVU17D
2017-07-01$64.34$43.59RVU17C
2017-04-01$64.34$43.59RVU17B
2017-01-01$64.34$43.59RVU17A
2016-10-01$64.29$43.58RVU16D
2016-07-01$64.29$43.58RVU16C
2016-04-01$64.29$43.58RVU16B
2016-01-01$64.29$43.58RVU16A
2015-10-01$64.06$43.27RVU15D
2015-07-01$64.06$43.27RVU15C
2015-04-01$63.74$43.06RVU15B
2015-01-01$63.74$43.06RVU15A
2014-10-01$63.59$43.35RVU14D
2014-07-01$63.59$43.35RVU14C
2014-04-01$63.59$43.35RVU14B
2014-01-01$63.59$43.35RVU14A
2013-10-01$63.34$42.14RVU13D
2013-07-01$63.34$42.14RVU13C
2013-04-01$63.34$42.14RVU13B
2013-01-01$63.34$42.14RVU13AR

Price 20552 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

20552 billing questions

Does the number of trigger points determine whether to report 20552?

No. The distinction is based on the number of muscles injected: 20552 covers one or two muscles, regardless of the number of trigger points treated.

When should 20553 be reported instead?

Use 20553 when injection treatment involves three or more muscles. Document the muscles treated so the code selection is supported.

Can dry needling be reported as 20552?

No. 20552 describes trigger-point injection treatment; needle insertion without injection is represented by the dry-needling codes.

Should modifier 50 be added for bilateral trigger points?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.

What documentation supports reporting 20552?

Document the symptomatic trigger points, the one or two muscles treated, injection sites, and the medication administered.

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 20552PPRRVU2026_Oct_nonQPP.csv, line 1,761 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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