Billing code 20520: Foreign body removalMedicare rate & RVUs
Removal of a foreign object from muscle or a tendon sheath when the extraction is simple, rather than deep or complicated.
Medicare pays $229.80 for 20520 nationally in the office and $141.95 in a hospital or facility. Local office rates run $203.01–$302.68.
Medicare rate · 20520
Foreign body removal
Swap in your local Medicare rate.
- Work RVUs
- 1.85
- Total RVUs
- 6.88
- Global days
- 010
National rate · 2026
$229.80
Office setting, before claim adjustments.
See every locality for 20520 → · Billed by an NP, PA or therapist? →
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 10 sections
What 20520 covers
This service covers straightforward extraction of a foreign object located in muscle or a tendon sheath. A physician or other qualified practitioner may perform it in an office, emergency department, or outpatient procedure setting. Examples include removing a retained splinter or fragment when the object is in the specified tissue and can be removed without a deep or complicated procedure. The tissue location and degree of difficulty distinguish this service from removal of an object confined to subcutaneous tissue.
Report the service when the operative or procedure note supports both the muscle or tendon-sheath location and a simple removal. Document the object’s location and the work needed to extract it; use the deep or complicated family level when those circumstances are supported instead. The service has a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in the same 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 code, and 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.
Where 20520 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$203.01 to $302.68
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $206.01 | $129.15 |
| Alaska* | $266.98 | $173.42 |
| Arizona | $223.57 | $138.45 |
| Arkansas | $203.01 | $127.55 |
| Atlanta | $234.34 | $145.09 |
| Austin | $238.12 | $145.18 |
| Bakersfield | $242.71 | $146.43 |
| Baltimore/Surr. Cntys | $244.53 | $150.27 |
| Beaumont | $214.85 | $134.91 |
| Brazoria | $226.88 | $139.82 |
| Chicago | $242.70 | $154.42 |
| Chico | $241.93 | $145.65 |
| Colorado | $238.74 | $145.27 |
| Connecticut | $245.17 | $150.56 |
| Dallas | $228.44 | $140.94 |
| Dc + Md/Va Suburbs | $262.45 | $158.97 |
| Delaware | $227.29 | $140.50 |
| Detroit | $230.42 | $145.65 |
| East St. Louis | $226.22 | $145.41 |
| El Centro | $241.97 | $145.69 |
| Fort Lauderdale | $239.15 | $150.17 |
| Fort Worth | $226.97 | $140.35 |
| Fresno | $241.93 | $145.65 |
| Galveston | $227.63 | $140.40 |
| Hanford-Corcoran | $241.93 | $145.65 |
| Hawaii, Guam | $247.78 | $147.90 |
| Houston | $232.57 | $145.34 |
| Idaho | $212.33 | $131.51 |
| Indiana | $213.56 | $132.12 |
| Iowa | $210.85 | $130.47 |
| Kansas | $210.06 | $130.65 |
| Kentucky | $211.38 | $133.29 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $258.40 | $154.48 |
| Madera | $241.93 | $145.65 |
| Manhattan | $264.79 | $162.72 |
| Merced | $241.93 | $145.65 |
| Metropolitan Boston | $262.18 | $157.30 |
| Metropolitan Kansas City | $219.89 | $137.41 |
| Metropolitan Philadelphia | $239.17 | $147.72 |
| Metropolitan St. Louis | $222.18 | $138.56 |
| Miami | $250.11 | $158.66 |
| Minnesota | $228.06 | $137.67 |
| Mississippi | $205.35 | $129.71 |
| Modesto | $241.93 | $145.65 |
| Montana** | $229.78 | $141.94 |
| Napa | $279.81 | $164.03 |
| Nebraska | $211.95 | $130.87 |
| Nevada** | $228.45 | $140.52 |
| New Hampshire | $235.19 | $143.74 |
| New Mexico | $218.41 | $137.86 |
| New Orleans | $221.64 | $138.98 |
| North Carolina | $215.89 | $133.93 |
| North Dakota** | $224.44 | $136.60 |
| Northern Nj | $259.74 | $157.84 |
| Nyc Suburbs/Long Island | $271.53 | $167.08 |
| Ohio | $216.04 | $135.84 |
| Oklahoma | $210.78 | $132.33 |
| Oxnard-Thousand Oaks-Ventura | $257.06 | $153.23 |
| Portland | $246.13 | $148.53 |
| Poughkpsie/N Nyc Suburbs | $249.58 | $153.39 |
| Puerto Rico | $231.41 | $142.60 |
| Queens | $266.67 | $162.84 |
| Redding | $241.93 | $145.65 |
| Rest Of California | $241.93 | $145.65 |
| Rest Of Florida | $227.34 | $143.36 |
| Rest Of Georgia | $214.36 | $136.00 |
| Rest Of Illinois | $221.04 | $140.84 |
| Rest Of Louisiana | $211.14 | $133.39 |
| Rest Of Maine | $213.67 | $132.85 |
| Rest Of Maryland | $231.58 | $142.69 |
| Rest Of Massachusetts | $237.38 | $144.88 |
| Rest Of Michigan | $217.13 | $136.93 |
| Rest Of Missouri | $207.62 | $131.90 |
| Rest Of New Jersey | $247.77 | $151.85 |
| Rest Of New York | $219.17 | $135.72 |
| Rest Of Oregon | $226.48 | $138.99 |
| Rest Of Pennsylvania | $216.27 | $135.62 |
| Rest Of Texas | $220.82 | $137.45 |
| Rest Of Washington | $236.87 | $144.37 |
| Rhode Island | $235.24 | $144.50 |
| Riverside-San Bernardino-Ontario | $244.85 | $148.57 |
| Sacramento-Roseville-Folsom | $253.75 | $151.59 |
| Salinas | $252.81 | $151.00 |
| San Diego-Chula Vista-Carlsbad | $258.68 | $153.62 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $295.97 | $172.11 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $295.67 | $171.81 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $302.68 | $176.01 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $301.43 | $174.76 |
| San Luis Obispo-Paso Robles | $248.76 | $148.71 |
| Santa Cruz-Watsonville | $261.09 | $154.36 |
| Santa Maria-Santa Barbara | $253.74 | $151.31 |
| Santa Rosa-Petaluma | $263.72 | $155.84 |
| Seattle (King Cnty) | $267.33 | $159.54 |
| South Carolina | $216.36 | $135.19 |
| South Dakota** | $223.81 | $135.97 |
| Southern Maine | $225.04 | $137.99 |
| Stockton | $241.93 | $145.65 |
| Suburban Chicago | $241.49 | $151.27 |
| Tennessee | $211.15 | $131.30 |
| Utah | $219.34 | $136.77 |
| Vallejo | $279.37 | $163.59 |
| Vermont | $223.75 | $136.79 |
| Virgin Islands | $231.41 | $142.60 |
| Virginia | $224.44 | $138.09 |
| Visalia | $241.93 | $145.65 |
| West Virginia | $212.86 | $136.52 |
| Wisconsin | $216.88 | $132.73 |
| Wyoming** | $227.45 | $139.61 |
| Yuba City | $241.93 | $145.65 |
20520 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.
$203.01
$272.31
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 | $266.98 | 1 |
| AL | $206.01 | 1 |
| AR | $203.01 | 1 |
| AZ | $223.57 | 1 |
| CA | $241.93–$302.68 | 29 |
| CO | $238.74 | 1 |
| CT | $245.17 | 1 |
| DC | $262.45 | 1 |
| DE | $227.29 | 1 |
| FL | $227.34–$250.11 | 3 |
| GA | $214.36–$234.34 | 2 |
| GU | $247.78 | 1 |
| HI | $247.78 | 1 |
| IA | $210.85 | 1 |
| ID | $212.33 | 1 |
| IL | $221.04–$242.70 | 4 |
| IN | $213.56 | 1 |
| KS | $210.06 | 1 |
| KY | $211.38 | 1 |
| LA | $211.14–$221.64 | 2 |
| MA | $237.38–$262.18 | 2 |
| MD | $231.58–$262.45 | 3 |
| ME | $213.67–$225.04 | 2 |
| MI | $217.13–$230.42 | 2 |
| MN | $228.06 | 1 |
| MO | $207.62–$222.18 | 3 |
| MS | $205.35 | 1 |
| MT | $229.78 | 1 |
| NC | $215.89 | 1 |
| ND | $224.44 | 1 |
| NE | $211.95 | 1 |
| NH | $235.19 | 1 |
| NJ | $247.77–$259.74 | 2 |
| NM | $218.41 | 1 |
| NV | $228.45 | 1 |
| NY | $219.17–$271.53 | 5 |
| OH | $216.04 | 1 |
| OK | $210.78 | 1 |
| OR | $226.48–$246.13 | 2 |
| PA | $216.27–$239.17 | 2 |
| PR | $231.41 | 1 |
| RI | $235.24 | 1 |
| SC | $216.36 | 1 |
| SD | $223.81 | 1 |
| TN | $211.15 | 1 |
| TX | $214.85–$238.12 | 8 |
| UT | $219.34 | 1 |
| VA | $224.44–$262.45 | 2 |
| VI | $231.41 | 1 |
| VT | $223.75 | 1 |
| WA | $236.87–$267.33 | 2 |
| WI | $216.88 | 1 |
| WV | $212.86 | 1 |
| WY | $227.45 | 1 |
How the 20520 rate is calculated
Each of 20520’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 · 20520
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.85Practice expense 4.76Malpractice 0.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 20520
20520 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20520
Foreign body removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 20520
Foreign body removal
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20520 without 51 · national office
$229.80
Foreign body removal
20520-51 · Second procedure: 50%
$114.90
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%).
20520 compared with similar codes
Compare codes
20520 vs 20525 vs 10120 vs 10121: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 20525Foreign body removal
- Both concern foreign bodies in muscle or a tendon sheath. Choose 20525 when the removal is deep or complicated rather than simple.
- 10120Foreign body removal
- This code is for a simple removal from muscle or a tendon sheath; 10120 is for a simple removal from subcutaneous tissue.
- 10121Foreign body removal
- Use this code for simple removal from muscle or a tendon sheath. Code 10121 describes complicated removal from subcutaneous tissue.
20520 billing questions
How do I distinguish this code from 20525?
Use this code for a simple removal from muscle or a tendon sheath. Use 20525 when the removal is deep or complicated.
What if the foreign object is only in subcutaneous tissue?
Consider 10120 for a simple removal from subcutaneous tissue or 10121 for a complicated removal. The tissue location, not just the object type, guides code selection.
Can the access incision be billed separately?
Do not separately report an incision that is simply the access needed to remove the foreign object. The service is the removal, with the operative note supporting its location and complexity.
Should modifier 50 be appended for removal on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
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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