$53.88–$75.70
Both codes describe trigger-point injection treatment. Select 20552 for one or two muscles and 20553 for three or more muscles.
On this page
CMS RVU26D · Effective 2026-10-01
20552 Trigger point injection Medicare reimbursement rates
Report 20552 for injection treatment of one or more myofascial trigger points located in one or two muscles, such as trapezius muscles. Compare 20552 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 20552?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$46.68–$65.44
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $18.76 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 20552 pays more and less
109 payment localities
$46.68 to $65.44
Musculoskeletal procedures
About 20552: Trigger point injection, one or two muscles
Report 20552 for injection treatment of one or more myofascial trigger points located in one or two muscles, such as trapezius muscles.
A clinician injects medication into one or more palpable, symptomatic trigger points in one or two muscles to treat myofascial pain. Common sites include cervical or lumbar paraspinal muscles and the trapezius. The service is often performed in an office or outpatient setting by clinicians treating musculoskeletal or pain conditions. The code describes the number of muscles treated, not the number of trigger points or needle placements; dry needling without injection is a different service.
Choose 20552 when the documented injection treatment involves one or two muscles; use the three-or-more-muscle code when that threshold is met. Record the treated muscles, trigger-point findings, injection sites, and medication administered. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one 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 service, and co-surgeon or team-surgery reporting is not permitted.
CMS billing rules for 20552
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.64 · 41%
- Practice expense (office) RVU0.84 · 54%
- Malpractice RVU0.07 · 5%
237.4K
Medicare services in 2024 · #350 by national volume
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.
20552 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$54.34–$76.36
20550 is for injection into a tendon sheath or ligament, rather than trigger points within muscle.
$54.45–$76.66
20551 targets a tendon origin or insertion; 20552 targets trigger points in one or two muscles.
$22.58–$31.90
20560 describes needle insertion without injection in one or two muscles, unlike the injection treatment reported with 20552.
See how rates vary across the country
20552 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$46.68
$63.23
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $63.23 | 1 |
| AL | $47.25 | 1 |
| AR | $46.68 | 1 |
| AZ | $50.56 | 1 |
| CA | $53.74–$65.44 | 29 |
| CO | $53.31 | 1 |
| CT | $54.85 | 1 |
| DC | $58.18 | 1 |
| DE | $51.31 | 1 |
| FL | $51.71–$56.50 | 3 |
| GA | $49.19–$52.75 | 2 |
| GU | $54.63 | 1 |
| HI | $54.63 | 1 |
| IA | $47.98 | 1 |
| ID | $48.29 | 1 |
| IL | $50.65–$55.09 | 4 |
| IN | $48.52 | 1 |
| KS | $47.92 | 1 |
| KY | $48.46 | 1 |
| LA | $48.45–$50.43 | 2 |
| MA | $53.13–$57.83 | 2 |
| MD | $52.13–$58.18 | 3 |
| ME | $48.64–$50.66 | 2 |
| MI | $49.63–$52.39 | 2 |
| MN | $50.94 | 1 |
| MO | $47.84–$50.43 | 3 |
| MS | $47.26 | 1 |
| MT | $51.77 | 1 |
| NC | $49.05 | 1 |
| ND | $50.38 | 1 |
| NE | $48.16 | 1 |
| NH | $52.63 | 1 |
| NJ | $55.43–$57.77 | 2 |
| NM | $49.91 | 1 |
| NV | $51.41 | 1 |
| NY | $49.67–$60.45 | 5 |
| OH | $49.35 | 1 |
| OK | $48.25 | 1 |
| OR | $50.96–$54.63 | 2 |
| PA | $49.34–$53.76 | 2 |
| PR | $52.04 | 1 |
| RI | $52.85 | 1 |
| SC | $49.29 | 1 |
| SD | $50.22 | 1 |
| TN | $48.14 | 1 |
| TX | $49.08–$53.17 | 8 |
| UT | $49.85 | 1 |
| VA | $50.61–$58.18 | 2 |
| VI | $52.04 | 1 |
| VT | $50.34 | 1 |
| WA | $52.98–$58.78 | 2 |
| WI | $48.98 | 1 |
| WV | $49.10 | 1 |
| WY | $51.16 | 1 |
Compare 20552 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $47.25 | Facility $33.22 |
| Alaska* | Office $63.23 | Facility $46.16 |
| Arizona | Office $50.56 | Facility $35.03 |
| Arkansas | Office $46.68 | Facility $32.91 |
| Atlanta | Office $52.75 | Facility $36.47 |
| Austin | Office $53.17 | Facility $36.21 |
| Bakersfield | Office $53.96 | Facility $36.39 |
| Baltimore/Surr. Cntys | Office $54.72 | Facility $37.51 |
| Beaumont | Office $49.08 | Facility $34.49 |
| Brazoria | Office $51.18 | Facility $35.29 |
| Chicago | Office $55.09 | Facility $38.98 |
| Chico | Office $53.74 | Facility $36.17 |
| Colorado | Office $53.31 | Facility $36.25 |
| Connecticut | Office $54.85 | Facility $37.58 |
| Dallas | Office $51.52 | Facility $35.55 |
| Dc + Md/Va Suburbs | Office $58.18 | Facility $39.30 |
| Delaware | Office $51.31 | Facility $35.47 |
| Detroit | Office $52.39 | Facility $36.92 |
| East St. Louis | Office $51.90 | Facility $37.15 |
| El Centro | Office $53.76 | Facility $36.18 |
| Fort Lauderdale | Office $54.03 | Facility $37.78 |
| Fort Worth | Office $51.27 | Facility $35.46 |
| Fresno | Office $53.74 | Facility $36.17 |
| Galveston | Office $51.34 | Facility $35.42 |
| Hanford-Corcoran | Office $53.74 | Facility $36.17 |
| Hawaii, Guam | Office $54.63 | Facility $36.40 |
| Houston | Office $52.63 | Facility $36.70 |
| Idaho | Office $48.29 | Facility $33.54 |
| Indiana | Office $48.52 | Facility $33.66 |
| Iowa | Office $47.98 | Facility $33.31 |
| Kansas | Office $47.92 | Facility $33.42 |
| Kentucky | Office $48.46 | Facility $34.21 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $57.00 | Facility $38.03 |
| Madera | Office $53.74 | Facility $36.17 |
| Manhattan | Office $59.05 | Facility $40.43 |
| Merced | Office $53.74 | Facility $36.17 |
| Metropolitan Boston | Office $57.83 | Facility $38.69 |
| Metropolitan Kansas City | Office $50.01 | Facility $34.95 |
| Metropolitan Philadelphia | Office $53.76 | Facility $37.07 |
| Metropolitan St. Louis | Office $50.43 | Facility $35.17 |
| Miami | Office $56.50 | Facility $39.81 |
| Minnesota | Office $50.94 | Facility $34.44 |
| Mississippi | Office $47.26 | Facility $33.46 |
| Modesto | Office $53.74 | Facility $36.17 |
| Montana** | Office $51.77 | Facility $35.73 |
| Napa | Office $60.89 | Facility $39.76 |
| Nebraska | Office $48.16 | Facility $33.36 |
| Nevada** | Office $51.41 | Facility $35.36 |
| New Hampshire | Office $52.63 | Facility $35.94 |
| New Mexico | Office $49.91 | Facility $35.21 |
| New Orleans | Office $50.43 | Facility $35.35 |
| North Carolina | Office $49.05 | Facility $34.09 |
| North Dakota** | Office $50.38 | Facility $34.35 |
| Northern Nj | Office $57.77 | Facility $39.17 |
| Nyc Suburbs/Long Island | Office $60.45 | Facility $41.38 |
| Ohio | Office $49.35 | Facility $34.71 |
| Oklahoma | Office $48.25 | Facility $33.93 |
| Oxnard-Thousand Oaks-Ventura | Office $56.59 | Facility $37.64 |
| Portland | Office $54.63 | Facility $36.82 |
| Poughkpsie/N Nyc Suburbs | Office $55.89 | Facility $38.33 |
| Puerto Rico | Office $52.04 | Facility $35.84 |
| Queens | Office $59.28 | Facility $40.33 |
| Redding | Office $53.74 | Facility $36.17 |
| Rest Of California | Office $53.74 | Facility $36.17 |
| Rest Of Florida | Office $51.71 | Facility $36.39 |
| Rest Of Georgia | Office $49.19 | Facility $34.89 |
| Rest Of Illinois | Office $50.65 | Facility $36.01 |
| Rest Of Louisiana | Office $48.45 | Facility $34.26 |
| Rest Of Maine | Office $48.64 | Facility $33.89 |
| Rest Of Maryland | Office $52.13 | Facility $35.91 |
| Rest Of Massachusetts | Office $53.13 | Facility $36.24 |
| Rest Of Michigan | Office $49.63 | Facility $34.99 |
| Rest Of Missouri | Office $47.84 | Facility $34.02 |
| Rest Of New Jersey | Office $55.43 | Facility $37.93 |
| Rest Of New York | Office $49.67 | Facility $34.44 |
| Rest Of Oregon | Office $50.96 | Facility $35.00 |
| Rest Of Pennsylvania | Office $49.34 | Facility $34.62 |
| Rest Of Texas | Office $50.11 | Facility $34.90 |
| Rest Of Washington | Office $52.98 | Facility $36.10 |
| Rhode Island | Office $52.85 | Facility $36.29 |
| Riverside-San Bernardino-Ontario | Office $54.51 | Facility $36.93 |
| Sacramento-Roseville-Folsom | Office $56.03 | Facility $37.38 |
| Salinas | Office $55.81 | Facility $37.23 |
| San Diego-Chula Vista-Carlsbad | Office $56.84 | Facility $37.67 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $64.04 | Facility $41.43 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $63.96 | Facility $41.36 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $65.44 | Facility $42.32 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $65.11 | Facility $42.00 |
| San Luis Obispo-Paso Robles | Office $54.95 | Facility $36.69 |
| Santa Cruz-Watsonville | Office $57.17 | Facility $37.69 |
| Santa Maria-Santa Barbara | Office $55.94 | Facility $37.25 |
| Santa Rosa-Petaluma | Office $57.72 | Facility $38.04 |
| Seattle (King Cnty) | Office $58.78 | Facility $39.11 |
| South Carolina | Office $49.29 | Facility $34.47 |
| South Dakota** | Office $50.22 | Facility $34.19 |
| Southern Maine | Office $50.66 | Facility $34.77 |
| Stockton | Office $53.74 | Facility $36.17 |
| Suburban Chicago | Office $54.48 | Facility $38.02 |
| Tennessee | Office $48.14 | Facility $33.56 |
| Utah | Office $49.85 | Facility $34.78 |
| Vallejo | Office $60.78 | Facility $39.64 |
| Vermont | Office $50.34 | Facility $34.46 |
| Virgin Islands | Office $52.04 | Facility $35.84 |
| Virginia | Office $50.61 | Facility $34.85 |
| Visalia | Office $53.74 | Facility $36.17 |
| West Virginia | Office $49.10 | Facility $35.17 |
| Wisconsin | Office $48.98 | Facility $33.62 |
| Wyoming** | Office $51.16 | Facility $35.13 |
| Yuba City | Office $53.74 | Facility $36.17 |
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20552 billing questions
Does the number of trigger points determine whether to report 20552?
No. The distinction is based on the number of muscles injected: 20552 covers one or two muscles, regardless of the number of trigger points treated.
When should 20553 be reported instead?
Use 20553 when injection treatment involves three or more muscles. Document the muscles treated so the code selection is supported.
Can dry needling be reported as 20552?
No. 20552 describes trigger-point injection treatment; needle insertion without injection is represented by the dry-needling codes.
Should modifier 50 be added for bilateral trigger points?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.
What documentation supports reporting 20552?
Document the symptomatic trigger points, the one or two muscles treated, injection sites, and the medication administered.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,75820527,,Njx nzm palmar fascial cord,A,,0.98,1.65,,0.58,,0.19,2.82,1.75,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,75920550,,Njx 1 tendon sheath/ligament,A,,0.73,0.99,,0.18,,0.09,1.81,1.00,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76020551,,Njx 1 tendon origin/insj,A,,0.73,1.00,,0.18,,0.08,1.81,0.99,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76120552,,Njx 1/mlt trigger point 1/2,A,,0.64,0.84,,0.36,,0.07,1.55,1.07,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76220553,,Njx 1/mlt trigger points 3/>,A,,0.73,0.98,,0.41,,0.08,1.79,1.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76320555,,Place ndl musc/tis for rt,A,,5.85,2.06,NA,2.06,,0.46,8.37,8.37,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,76420560,,Ndl insj w/o njx 1 or 2 musc,A,,0.31,0.42,,0.05,,0.01,0.74,0.37,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00