CPT code 20553: Trigger point injection, three or more muscles2026 Medicare rate & RVUs in Fort Worth, TX

Reports medication injection into trigger points in three or more muscles to treat myofascial pain during a single session.

CMS RVU26DEffective Oct 1, 2026One payment locality286.4K Medicare services in 2024

In Fort Worth, TX, Medicare pays $59.20 for 20553 in the office and $40.43 when it’s performed in a hospital or facility.

$59.20Office (non-facility)
$40.43Hospital or facility
−1.0%vs the national office rate ($59.79)

Check a contract rate as a % of Medicare · 20553 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 20553 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Fort Worth, TX
  2. What 20553 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 20553 covers

This service treats myofascial pain by placing a needle into trigger points in three or more muscles and injecting medication at the identified sites. A trigger point is a tender, taut area within muscle associated with the patient’s symptoms; the target is muscle rather than a tendon sheath or tendon attachment. Physicians and other qualified practitioners commonly perform these injections in office-based pain, rehabilitation, primary care, or orthopedic settings.

Select the code by the number of muscles treated, not the number of trigger points or needle passes: 20553 covers three or more muscles, while 20552 covers one or two. Document the muscles and sites treated, relevant examination findings, and the procedure performed. 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 others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons and team surgery 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 Fort Worth, TX compares for 20553

Across 109 of 109 payment localities, the office rate for 20553 runs from $53.88 in Arkansas to $75.70 in San Benito County, CA. Fort Worth, TX pays $59.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

20553 in Fort Worth, TX vs other payment areas
  1. Fort Worth, TX · this page$59.20
  2. Austin, TX · Texas$61.43+$2.23
  3. Beaumont, TX · Texas$56.65−$2.55
  4. Brazoria, TX · Texas$59.10−$0.10
  5. Dallas, TX · Texas$59.50+$0.30
  6. Galveston, TX · Texas$59.29+$0.09
  7. Houston, TX · Texas$60.76+$1.56

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

Every other payment area

20553 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$57.86$39.79
Los Angeles, CACalifornia$65.88$43.36
Washington, DC areaDistrict of Columbia$67.23$44.81
Miami, FLFlorida$65.22$45.40
Chicago, ILIllinois$63.58$44.45
Manhattan, NYNew York$68.22$46.09
AlaskaAlaska$72.91$52.63
AlabamaAlabama$54.54$37.88

20553 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.

$53.88

$72.91

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

View every state and territory as a table
20553 office rate range by state
State / territoryOffice rate rangeLocalities
AK$72.911
AL$54.541
AR$53.881
AZ$58.391
CA$62.10–$75.7029
CO$61.591
CT$63.361
DC$67.231
DE$59.251
FL$59.69–$65.223
GA$56.77–$60.922
GU$63.151
HI$63.151
IA$55.391
ID$55.761
IL$58.44–$63.584
IN$56.021
KS$55.321
KY$55.931
LA$55.91–$58.222
MA$61.37–$66.842
MD$60.21–$67.233
ME$56.16–$58.512
MI$57.28–$60.482
MN$58.861
MO$55.20–$58.223
MS$54.541
MT$59.781
NC$56.631
ND$58.201
NE$55.611
NH$60.801
NJ$64.03–$66.742
NM$57.611
NV$59.371
NY$57.36–$69.825
OH$56.961
OK$55.691
OR$58.86–$63.132
PA$56.96–$62.082
PR$60.111
RI$61.041
SC$56.901
SD$58.011
TN$55.571
TX$56.65–$61.438
UT$57.551
VA$58.45–$67.232
VI$60.111
VT$58.141
WA$61.20–$67.952
WI$56.561
WV$56.651
WY$59.091

See 20553 in every payment locality

How the 20553 rate is calculated

Each of 20553’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 · 20553

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.73

0.73 RVUs× 1.000 GPCI

Practice expense0.98

0.98 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

1.7900

Conversion factor

$33.4009

Medicare rate

$59.79

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Fort Worth, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,762

Code
20553
Physician work
0.73
Practice expense
0.98
Malpractice
0.08

GPCI2026.csv

100

Locality
Fort Worth, TX
Physician work
1.009
Practice expense
0.986
Malpractice
0.871
Office calculation for 20553 in Fort Worth, TX
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0090.7366
Practice expense0.98× 0.9860.9663
Malpractice0.08× 0.8710.0697
Total RVUs1.7725
Conversion factor× 33.4009

Office rate, Fort Worth, TX$59.20

Office: (0.73 × 1.009 + 0.98 × 0.986 + 0.08 × 0.871) × $33.4009 = $59.20

Facility: (0.73 × 1.009 + 0.41 × 0.986 + 0.08 × 0.871) × $33.4009 = $40.43

Open 20553 in the RVU calculator

Payment rules and modifiers for 20553

The CMS indicators that decide how 20553 is paid alongside other services.

CMS payment indicators · 20553

Trigger point injection, three or more 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

20553 without 51 · national office

$59.79

Trigger point injection, three or more muscles

20553-51 · Second procedure: 50%

$29.90

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 20553 has changed in Fort Worth, TX

20553 · Office / nonfacility

$59.20

Effective 2026-10-01

The base rate is $0.70 higher than on 2025-10-01, moving from $58.50 to $59.20 (1.2%).

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

    $58.50changed to$59.20

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 0.998 changed to 0.986
    • Malpractice GPCI 0.902 changed to 0.871

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $60.50changed to$58.50

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $59.51changed to$60.50

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $61.27changed to$59.51

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.013 changed to 1.011
    • Practice expense GPCI 0.996 changed to 0.998
    • Malpractice GPCI 0.721 changed to 0.902
  5. January 1, 2023

    RVU23A

    $61.98changed to$61.27

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.016 changed to 1.013
    • Practice expense GPCI 0.995 changed to 0.996
    • Malpractice GPCI 0.539 changed to 0.721

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $62.31changed to$61.98

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.09 changed to 0.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $64.50changed to$62.31

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.011 changed to 1.016
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.643 changed to 0.539

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $64.20changed to$64.50

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.007 changed to 1.011
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.747 changed to 0.643

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $64.13changed to$64.20

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $64.11changed to$64.13

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.006 changed to 1.007
    • Practice expense GPCI 0.991 changed to 0.986
    • Malpractice GPCI 0.760 changed to 0.747

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $64.11changed to$64.11

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.005 changed to 1.006
    • Practice expense GPCI 0.995 changed to 0.991
    • Malpractice GPCI 0.772 changed to 0.760

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $64.42changed to$64.11

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.99 changed to 0.98
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $64.10changed to$64.42

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $63.57changed to$64.10

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.98 changed to 0.99
    • Work GPCI 1.002 changed to 1.005
    • Practice expense GPCI 0.987 changed to 0.995
    • Malpractice GPCI 0.799 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $63.79changed to$63.57

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.09 changed to 0.98
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.979 changed to 0.987
    • Malpractice GPCI 0.826 changed to 0.799

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $63.79

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$59.20$40.43RVU26D
2026-07-01$59.20$40.43RVU26C
2026-04-01$59.20$40.43RVU26B
2026-01-01$59.20$40.43RVU26A
2025-10-01$58.50$40.10RVU25D
2025-07-01$58.50$40.10RVU25C
2025-04-01$58.50$40.10RVU25B
2025-01-01$58.50$40.10RVU25A
2024-10-01$60.50$41.56RVU24D
2024-07-01$60.50$41.56RVU24C
2024-04-01$60.50$41.56RVU24B
2024-03-09$60.50$41.56RVU24AR
2024-01-01$59.51$40.88RVU24A
2023-10-01$61.27$42.03RVU23D
2023-07-01$61.27$42.03RVU23C
2023-04-01$61.27$42.03RVU23B
2023-01-01$61.27$42.03RVU23A
2022-10-01$61.98$42.35RVU22D
2022-07-01$61.98$42.35RVU22C
2022-04-01$61.98$42.35RVU22B
2022-01-01$61.98$42.35RVU22A
2021-10-01$62.31$42.52RVU21D
2021-07-01$62.31$42.52RVU21C
2021-04-01$62.31$42.52RVU21B
2021-01-01$62.31$42.52RVU21A
2020-10-01$64.50$44.12RVU20D
2020-07-01$64.50$44.12RVU20C
2020-04-01$64.50$44.12RVU20B
2020-01-01$64.50$44.12RVU20A
2019-10-01$64.20$43.94RVU19D
2019-07-01$64.20$43.94RVU19C
2019-04-01$64.20$43.94RVU19B
2019-01-01$64.20$43.94RVU19A
2018-10-01$64.13$43.89RVU18D
2018-07-01$64.13$43.89RVU18C
2018-04-01$64.13$43.89RVU18B
2018-01-01$64.13$43.89RVU18AR1
2017-10-01$64.11$43.84RVU17D
2017-07-01$64.11$43.84RVU17C
2017-04-01$64.11$43.84RVU17B
2017-01-01$64.11$43.84RVU17A
2016-10-01$64.11$43.81RVU16D
2016-07-01$64.11$43.81RVU16C
2016-04-01$64.11$43.81RVU16B
2016-01-01$64.11$43.81RVU16A
2015-10-01$64.42$43.69RVU15D
2015-07-01$64.42$43.69RVU15C
2015-04-01$64.10$43.47RVU15B
2015-01-01$64.10$43.47RVU15A
2014-10-01$63.57$43.42RVU14D
2014-07-01$63.57$43.42RVU14C
2014-04-01$63.57$43.42RVU14B
2014-01-01$63.57$43.42RVU14A
2013-10-01$63.79$42.14RVU13D
2013-07-01$63.79$42.14RVU13C
2013-04-01$63.79$42.14RVU13B
2013-01-01$63.79$42.14RVU13AR

Price 20553 for an earlier date of service

Where the Fort Worth, TX rate applies

Fort Worth, TX is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

20553 billing questions

How is 20553 distinguished from 20552?

Count the muscles injected: use 20553 for three or more muscles and 20552 for one or two. The number of trigger points or needle passes does not determine the level.

What should the procedure note identify?

Document the muscles and injection sites, the clinical findings supporting trigger point treatment, and the procedure performed. The record should support treatment of at least three distinct muscles.

Can the medication be reported separately?

The code represents the injection procedure. A separately supplied medication may be reported when it is separately payable and the claim documentation supports it.

Can modifier 50 be used for bilateral trigger point injections?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the service based on the muscles treated rather than using modifier 50.

How are other procedures in the same session paid?

Under the CMS multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.

Is same-day preoperative or postoperative care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

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 20553PPRRVU2026_Oct_nonQPP.csv, line 1,762 (RVU26D)
Geographic factors for Fort Worth, TXGPCI2026.csv, line 100 (RVU26D)

Open CMS sourceHow we calculate rates

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