CPT code 20560: Dry needling, 1-2 muscles2026 Medicare rate & RVUs in California
Reports dry needling without injected medication when a clinician treats one or two muscles for muscular pain or movement limitation.
Medicare pays $26.08–$31.90 for 20560 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 20560 covers
Code 20560 represents dry needling: a clinician inserts one or more fine needles into one or two muscles, without injecting medication or another substance. Physical therapists commonly perform it in outpatient rehabilitation for myofascial pain or muscle-related movement limitation; other qualified practitioners may perform it within their scope. The target is muscle tissue, rather than a tendon sheath, ligament, or tendon origin.
Choose 20560 by the number of muscles treated, not by needle passes, needles, or trigger points. When three or more muscles are treated, assess the related 20561 level. The record should identify each muscle treated, describe needle insertion without injection, and connect the procedure to the patient's condition and treatment plan. CMS assigns work, practice-expense, and malpractice relative value units to this service; its practice-expense inputs differ between office and facility settings.
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 20560 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
$26.08 to $31.90
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $26.13 | $12.58 |
| Chico, CA | $26.08 | $12.54 |
| El Centro, CA | $26.09 | $12.54 |
| Fresno, CA | $26.08 | $12.54 |
| Hanford, CA | $26.08 | $12.54 |
| Los Angeles, CA | $27.60 | $12.98 |
| Madera, CA | $26.08 | $12.54 |
| Marin County, CA | $31.27 | $13.85 |
| Merced, CA | $26.08 | $12.54 |
| Modesto, CA | $26.08 | $12.54 |
| Napa, CA | $29.67 | $13.38 |
| Oxnard, CA | $27.43 | $12.83 |
| Redding, CA | $26.08 | $12.54 |
| Rest of California | $26.08 | $12.54 |
| Riverside, CA | $26.20 | $12.66 |
| Sacramento, CA | $27.22 | $12.85 |
| Salinas, CA | $27.11 | $12.79 |
| San Benito County, CA | $31.90 | $14.08 |
| San Diego, CA | $27.62 | $12.84 |
| San Francisco, CA | $31.26 | $13.83 |
| San Luis Obispo, CA | $26.69 | $12.61 |
| Santa Clara County, CA | $31.85 | $14.03 |
| Santa Cruz, CA | $27.80 | $12.78 |
| Santa Maria, CA | $27.18 | $12.77 |
| Santa Rosa, CA | $28.07 | $12.89 |
| Stockton, CA | $26.08 | $12.54 |
| Vallejo, CA | $29.65 | $13.36 |
| Visalia, CA | $26.08 | $12.54 |
| Yuba City, CA | $26.08 | $12.54 |
How the 20560 rate is calculated
Each of 20560’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 · 20560
RVUs × geographic indexes × conversion factor
Work0.31
0.31 RVUs× 1.000 GPCI
Practice expense0.42
0.42 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.7400
Conversion factor
$33.4009
Medicare rate
$24.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20560
20560 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 20560
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$24.72
- Non-facility (office)
- $24.72
- Facility
- $12.36
Higher because the practice carries its own overhead.
20560 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20561Dry needlingThree or more muscles
- Both describe dry needling without injection; choose 20560 for one or two muscles and 20561 for three or more.
- 20552Trigger point injectionOne or two muscles
- 20560 is dry needling without injection. 20552 describes trigger-point injection for up to two trigger points.
- 20553Trigger point injectionThree or more muscles
- 20560 represents dry needling without injection. 20553 describes injection of three or more trigger points.
20560 billing questions
When should I use 20560 instead of 20561?
Use 20560 for treatment of one or two muscles. For three or more muscles, assess 20561.
Is 20560 selected by needle count or muscle count?
Select the code by the number of muscles treated, not the number of needles or insertion passes. Document the muscles addressed.
Can 20560 be used when medication is injected?
No. 20560 describes needle insertion without an injection; a trigger-point injection is represented by a different code family, including 20552 and 20553.
What documentation supports 20560?
Record the treated muscle or muscles, the dry-needling procedure without injection, and the clinical condition or limitation being addressed.
How does 20560 differ from trigger-point injection codes?
20560 represents needle insertion without injectate. Codes 20552 and 20553 describe trigger-point injection services, with selection based on the number of points injected.
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
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