CPT code 20561: Dry needling, three or more muscles2026 Medicare rate & RVUs in Nevada
Report this service for needle insertion without medication into three or more muscles during dry needling for musculoskeletal pain or dysfunction.
In Nevada, Medicare pays $37.93 for 20561 in the office and $19.54 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 20561 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Nevada compares for 20561
Across 109 of 109 payment localities, the office rate for 20561 runs from $34.58 in Arkansas to $48.79 in San Benito County, CA. Nevada pays $37.93. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Nevada · this page$37.93
- Los Angeles, CA · California$42.30+$4.37
- Washington, DC area · District of Columbia$42.84+$4.91
- Miami, FL · Florida$40.49+$2.56
- Chicago, IL · Illinois$39.59+$1.66
- Manhattan, NY · New York$43.13+$5.20
- Alaska · Alaska$46.87+$8.94
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $34.97 | $18.90 |
| ArkansasArkansas | $34.58 | $18.80 |
| ArizonaArizona | $37.27 | $19.47 |
| Bakersfield, CACalifornia | $40.04 | $19.90 |
| Chico, CACalifornia | $39.93 | $19.80 |
| El Centro, CACalifornia | $39.94 | $19.80 |
| Fresno, CACalifornia | $39.93 | $19.80 |
| Hanford, CACalifornia | $39.93 | $19.80 |
| Madera, CACalifornia | $39.93 | $19.80 |
| Merced, CACalifornia | $39.93 | $19.80 |
| Modesto, CACalifornia | $39.93 | $19.80 |
| Napa, CACalifornia | $45.37 | $21.16 |
| Oxnard, CACalifornia | $42.03 | $20.32 |
| Redding, CACalifornia | $39.93 | $19.80 |
| Rest of CaliforniaCalifornia | $39.93 | $19.80 |
| Riverside, CACalifornia | $40.26 | $20.13 |
| Sacramento, CACalifornia | $41.66 | $20.30 |
| Salinas, CACalifornia | $41.50 | $20.21 |
| San Diego, CACalifornia | $42.28 | $20.31 |
| Marin County, CACalifornia | $47.79 | $21.89 |
| San Francisco, CACalifornia | $47.76 | $21.85 |
| San Benito County, CACalifornia | $48.79 | $22.30 |
| Santa Clara County, CACalifornia | $48.65 | $22.16 |
| San Luis Obispo, CACalifornia | $40.85 | $19.93 |
| Santa Cruz, CACalifornia | $42.54 | $20.22 |
| Santa Maria, CACalifornia | $41.60 | $20.18 |
| Santa Rosa, CACalifornia | $42.96 | $20.40 |
| Stockton, CACalifornia | $39.93 | $19.80 |
| Vallejo, CACalifornia | $45.32 | $21.11 |
| Visalia, CACalifornia | $39.93 | $19.80 |
| Yuba City, CACalifornia | $39.93 | $19.80 |
| ColoradoColorado | $39.41 | $19.87 |
| ConnecticutConnecticut | $40.25 | $20.46 |
| DelawareDelaware | $37.80 | $19.65 |
| Fort Lauderdale, FLFlorida | $39.16 | $20.56 |
| Rest of FloridaFlorida | $37.64 | $20.08 |
| Atlanta, GAGeorgia | $38.67 | $20.00 |
| Rest of GeorgiaGeorgia | $35.96 | $19.57 |
| Hawaii, Guam, HIHawaii | $40.58 | $19.70 |
| IowaIowa | $35.66 | $18.85 |
| IdahoIdaho | $35.84 | $18.94 |
| East St. Louis, ILIllinois | $37.38 | $20.48 |
| Rest of IllinoisIllinois | $36.78 | $20.01 |
| Suburban Chicago, ILIllinois | $39.54 | $20.67 |
| IndianaIndiana | $36.00 | $18.97 |
| KansasKansas | $35.53 | $18.92 |
| KentuckyKentucky | $35.62 | $19.29 |
| New Orleans, LALouisiana | $36.95 | $19.67 |
| Rest of LouisianaLouisiana | $35.58 | $19.32 |
| Metropolitan Boston, MAMassachusetts | $42.76 | $20.82 |
| Rest of MassachusettsMassachusetts | $39.26 | $19.91 |
| Baltimore area, MDMaryland | $40.13 | $20.41 |
| Rest of MarylandMaryland | $38.41 | $19.82 |
| Rest of MaineMaine | $35.99 | $19.09 |
| Southern Maine, MEMaine | $37.51 | $19.31 |
| Detroit, MIMichigan | $38.02 | $20.29 |
| Rest of MichiganMichigan | $36.35 | $19.57 |
| MinnesotaMinnesota | $37.99 | $19.09 |
| Metropolitan Kansas City, MOMissouri | $36.75 | $19.50 |
| Metropolitan St. Louis, MOMissouri | $37.05 | $19.56 |
| Rest of MissouriMissouri | $35.10 | $19.27 |
| MississippiMississippi | $34.84 | $19.03 |
| MontanaMontana | $38.08 | $19.70 |
| North CarolinaNorth Carolina | $36.28 | $19.14 |
| North DakotaNorth Dakota | $37.48 | $19.11 |
| NebraskaNebraska | $35.81 | $18.85 |
| New HampshireNew Hampshire | $38.83 | $19.70 |
| Northern New JerseyNew Jersey | $42.55 | $21.24 |
| Rest of New JerseyNew Jersey | $40.77 | $20.71 |
| New MexicoNew Mexico | $36.50 | $19.66 |
| NYC suburbs and Long Island, NYNew York | $43.98 | $22.14 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $41.02 | $20.91 |
| Queens, NYNew York | $43.42 | $21.70 |
| Rest of New YorkNew York | $36.71 | $19.26 |
| OhioOhio | $36.23 | $19.45 |
| OklahomaOklahoma | $35.57 | $19.16 |
| Portland, OROregon | $40.44 | $20.03 |
| Rest of OregonOregon | $37.69 | $19.40 |
| Metropolitan Philadelphia, PAPennsylvania | $39.43 | $20.31 |
| Rest of PennsylvaniaPennsylvania | $36.27 | $19.40 |
| Puerto RicoPuerto Rico | $38.30 | $19.72 |
| Rhode IslandRhode Island | $38.97 | $20.00 |
| South CarolinaSouth Carolina | $36.30 | $19.33 |
| South DakotaSouth Dakota | $37.41 | $19.04 |
| TennesseeTennessee | $35.67 | $18.97 |
| Austin, TXTexas | $39.23 | $19.80 |
| Beaumont, TXTexas | $36.08 | $19.36 |
| Brazoria, TXTexas | $37.79 | $19.58 |
| Dallas, TXTexas | $37.99 | $19.69 |
| Fort Worth, TXTexas | $37.79 | $19.68 |
| Galveston, TXTexas | $37.88 | $19.64 |
| Houston, TXTexas | $38.43 | $20.19 |
| Rest of TexasTexas | $36.89 | $19.46 |
| UtahUtah | $36.69 | $19.42 |
| VirginiaVirginia | $37.42 | $19.36 |
| Virgin Islands, VIUnited States Virgin Islands | $38.30 | $19.72 |
| VermontVermont | $37.37 | $19.18 |
| Rest of WashingtonWashington | $39.17 | $19.83 |
| King County, WAWashington | $43.53 | $20.99 |
| WisconsinWisconsin | $36.49 | $18.89 |
| West VirginiaWest Virginia | $35.71 | $19.74 |
| WyomingWyoming | $37.82 | $19.45 |
20561 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.
$34.58
$46.87
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $46.87 | 1 |
| AL | $34.97 | 1 |
| AR | $34.58 | 1 |
| AZ | $37.27 | 1 |
| CA | $39.93–$48.79 | 29 |
| CO | $39.41 | 1 |
| CT | $40.25 | 1 |
| DC | $42.84 | 1 |
| DE | $37.80 | 1 |
| FL | $37.64–$40.49 | 3 |
| GA | $35.96–$38.67 | 2 |
| GU | $40.58 | 1 |
| HI | $40.58 | 1 |
| IA | $35.66 | 1 |
| ID | $35.84 | 1 |
| IL | $36.78–$39.59 | 4 |
| IN | $36.00 | 1 |
| KS | $35.53 | 1 |
| KY | $35.62 | 1 |
| LA | $35.58–$36.95 | 2 |
| MA | $39.26–$42.76 | 2 |
| MD | $38.41–$42.84 | 3 |
| ME | $35.99–$37.51 | 2 |
| MI | $36.35–$38.02 | 2 |
| MN | $37.99 | 1 |
| MO | $35.10–$37.05 | 3 |
| MS | $34.84 | 1 |
| MT | $38.08 | 1 |
| NC | $36.28 | 1 |
| ND | $37.48 | 1 |
| NE | $35.81 | 1 |
| NH | $38.83 | 1 |
| NJ | $40.77–$42.55 | 2 |
| NM | $36.50 | 1 |
| NV | $37.93 | 1 |
| NY | $36.71–$43.98 | 5 |
| OH | $36.23 | 1 |
| OK | $35.57 | 1 |
| OR | $37.69–$40.44 | 2 |
| PA | $36.27–$39.43 | 2 |
| PR | $38.30 | 1 |
| RI | $38.97 | 1 |
| SC | $36.30 | 1 |
| SD | $37.41 | 1 |
| TN | $35.67 | 1 |
| TX | $36.08–$39.23 | 8 |
| UT | $36.69 | 1 |
| VA | $37.42–$42.84 | 2 |
| VI | $38.30 | 1 |
| VT | $37.37 | 1 |
| WA | $39.17–$43.53 | 2 |
| WI | $36.49 | 1 |
| WV | $35.71 | 1 |
| WY | $37.82 | 1 |
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.
How the rate is built · 20561
RVUs × geographic indexes × conversion factor
Work0.47
0.47 RVUs× 1.000 GPCI
Practice expense0.64
0.64 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.1400
Conversion factor
$33.4009
Medicare rate
$38.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Nevada inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,765
- Code
- 20561
- Physician work
- 0.47
- Practice expense
- 0.64
- Malpractice
- 0.03
GPCI2026.csv
73
- Locality
- Nevada
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.47 | × 1.000 | 0.4700 |
| Practice expense | 0.64 | × 1.001 | 0.6406 |
| Malpractice | 0.03 | × 0.833 | 0.0250 |
| Total RVUs | 1.1356 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Nevada$37.93
Office: (0.47 × 1 + 0.64 × 1.001 + 0.03 × 0.833) × $33.4009 = $37.93
Facility: (0.47 × 1 + 0.09 × 1.001 + 0.03 × 0.833) × $33.4009 = $19.54
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.
Place of service · 20561
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$38.08
- Non-facility (office)
- $38.08
- Facility
- $19.71
Higher because the practice carries its own overhead.
How 20561 has changed in Nevada
20561 · Office / nonfacility
$37.93
Effective 2026-10-01
The base rate is $2.18 higher than on 2025-10-01, moving from $35.75 to $37.93 (6.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$35.75changed to$37.93
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.48 changed to 0.47
- Practice expense RVU 0.60 changed to 0.64
- Practice expense GPCI 1.000 changed to 1.001
- Malpractice GPCI 0.844 changed to 0.833
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$36.85changed to$35.75
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.61 changed to 0.60
- Malpractice RVU 0.02 changed to 0.03
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$36.24changed to$36.85
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$38.02changed to$36.24
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.62 changed to 0.61
- Malpractice GPCI 1.098 changed to 0.844
January 1, 2023
RVU23A
$38.74changed to$38.02
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.61 changed to 0.62
- Work GPCI 1.005 changed to 1.000
- Malpractice GPCI 1.351 changed to 1.098
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$39.30changed to$38.74
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.59 changed to 0.61
- Malpractice RVU 0.04 changed to 0.02
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$40.00changed to$39.30
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.57 changed to 0.59
- Malpractice RVU 0.05 changed to 0.04
- Work GPCI 1.004 changed to 1.005
- Malpractice GPCI 1.130 changed to 1.351
Held through RVU21B, RVU21C, RVU21D.
April 1, 2020
RVU20B
No ratechanged to$40.00
Held through RVU20C, RVU20D.
January 1, 2020
RVU20A
No ratechanged toNo rate
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $37.93 | $19.54 | RVU26D |
| 2026-07-01 | $37.93 | $19.54 | RVU26C |
| 2026-04-01 | $37.93 | $19.54 | RVU26B |
| 2026-01-01 | $37.93 | $19.54 | RVU26A |
| 2025-10-01 | $35.75 | $21.84 | RVU25D |
| 2025-07-01 | $35.75 | $21.84 | RVU25C |
| 2025-04-01 | $35.75 | $21.84 | RVU25B |
| 2025-01-01 | $35.75 | $21.84 | RVU25A |
| 2024-10-01 | $36.85 | $21.87 | RVU24D |
| 2024-07-01 | $36.85 | $21.87 | RVU24C |
| 2024-04-01 | $36.85 | $21.87 | RVU24B |
| 2024-03-09 | $36.85 | $21.87 | RVU24AR |
| 2024-01-01 | $36.24 | $21.51 | RVU24A |
| 2023-10-01 | $38.02 | $22.43 | RVU23D |
| 2023-07-01 | $38.02 | $22.43 | RVU23C |
| 2023-04-01 | $38.02 | $22.43 | RVU23B |
| 2023-01-01 | $38.02 | $22.43 | RVU23A |
| 2022-10-01 | $38.74 | $22.82 | RVU22D |
| 2022-07-01 | $38.74 | $22.82 | RVU22C |
| 2022-04-01 | $38.74 | $22.82 | RVU22B |
| 2022-01-01 | $38.74 | $22.82 | RVU22A |
| 2021-10-01 | $39.30 | $25.35 | RVU21D |
| 2021-07-01 | $39.30 | $25.35 | RVU21C |
| 2021-04-01 | $39.30 | $25.35 | RVU21B |
| 2021-01-01 | $39.30 | $25.35 | RVU21A |
| 2020-10-01 | $40.00 | $25.93 | RVU20D |
| 2020-07-01 | $40.00 | $25.93 | RVU20C |
| 2020-04-01 | $40.00 | $25.93 | RVU20B |
| 2020-01-01 | Separate payment rules apply | Separate payment rules apply | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Nevada rate applies
Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.
- Alamo
- Amargosa Valley
- Austin
- Baker
- Battle Mountain
- Beatty
- Beaverdam
- Bennett Springs
20561 billing questions
How is 20561 distinguished from 20560?
Select by the number of distinct muscles treated: 20561 is for three or more, while 20560 is for one or two. Needle passes or trigger points do not determine the level.
Does this code include an injection?
No medication or other substance is injected for the dry-needling service. When a substance is injected into trigger points, consider the trigger-point injection code that matches the number of points treated instead.
Is the code based on the number of needles inserted?
No. The distinction between 20560 and 20561 is the number of muscles treated, not the number of needles, insertions, or passes.
What should the note identify?
Document that dry needling was performed without injection and identify the muscles treated. The record should support treatment of at least three distinct muscles for 20561.
How does 20561 differ from trigger-point injection code 20553?
20561 describes dry needling without injection and is selected by muscles treated. 20553 describes injection treatment of three or more trigger points.
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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