CPT code 20561: Dry needling, three or more muscles2026 Medicare rate & RVUs

Medicare pays $38.08 for 20561 nationally in the office and $19.71 in a hospital or facility. Local office rates run $34.58–$48.79.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 20561 covers

Dry needling uses a solid needle inserted into muscle tissue without injecting medication, often to address myofascial pain, muscle sensitivity, or movement restrictions. Physical therapists commonly perform it in outpatient rehabilitation; other clinicians may perform it in musculoskeletal or pain-care settings when authorized and trained to do so. The service may target muscles with palpable taut bands or trigger points, but the code’s threshold is the number of muscles treated, not the number of trigger points or needle passes.

Choose 20561 when the session involves three or more distinct muscles; use the lower-level sibling when only one or two muscles are treated. Document the muscles treated and the dry-needling service, including that no substance was injected. Under the Medicare Physician Fee Schedule, the code has work, practice-expense, and malpractice values; practice expense is represented separately for 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 20561 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

20561 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 20561 rate is calculated

Each of 20561’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.

Payment rules and modifiers for 20561

20561 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.

20561 compared with similar codes

How to choose

20560Dry needling1-2 muscles

Both describe dry needling without injection. Use 20560 for one or two muscles and 20561 for three or more.

20553Trigger point injectionThree or more muscles

20553 is for injection of three or more trigger points; 20561 is for dry needling of three or more muscles without injection.

97810AcupunctureWithout electrical stimulation, initial 15 minutes

97810 describes acupuncture, not the dry-needling service represented by 20561. The treatment method determines which code fits.

Codes related to 20561

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates