$134.83–$167.03
20501 is the diagnostic injection used to outline a sinus tract. 20500 describes therapeutic injection into the tract.
On this page
CMS RVU26D · Effective 2026-10-01
20501 Sinus tract injection Medicare reimbursement rates in California
Injection of contrast into a draining sinus tract to define its course for diagnosis, commonly as part of a fistulogram or sinogram. Compare 20501 office and facility rates across CMS payment localities in California.
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 20501 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$145.36–$185.22
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $39.86 per service.
Facility setting
$30.78–$34.47
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $3.69 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 20501 pays more and less in California
29 payment localities
$145.36 to $185.22
Diagnostic procedure
About 20501: Diagnostic sinus tract injection
Injection of contrast into a draining sinus tract to define its course for diagnosis, commonly as part of a fistulogram or sinogram.
The clinician introduces contrast into an existing sinus tract to outline its path and show where it leads. This is used in evaluating a draining tract, such as one that persists after surgery or infection. A surgeon or other clinician familiar with the tract may perform the injection in an office, procedure room, or facility; radiology staff may provide the associated imaging service. The injection helps distinguish the tract’s course and connections from what can be established by examination alone.
Report 20501 for the diagnostic injection, not for therapeutic instillation into the tract. Documentation should identify the tract, the diagnostic purpose, and the injection performed; report the radiologic examination separately when it is performed and documented. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 20501
- 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 RVU0.74 · 18%
- Practice expense (office) RVU3.25 · 80%
- Malpractice RVU0.07 · 2%
867
Medicare services in 2024 · #3070 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.
20501 compared with similar codes
Office rates for California, from the same CMS release.
$62.10–$77.38
76080 represents the radiologic examination of the sinus tract; 20501 represents the injection that helps produce the study.
$184.17–$236.28
49424 concerns contrast evaluation through an existing percutaneous drainage catheter. Use 20501 for diagnostic injection into a sinus tract.
Compare 20501 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $145.58 | Facility $31.00 |
| Chico | Office $145.36 | Facility $30.78 |
| El Centro | Office $145.38 | Facility $30.79 |
| Fresno | Office $145.36 | Facility $30.78 |
| Hanford-Corcoran | Office $145.36 | Facility $30.78 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $155.70 | Facility $32.02 |
| Madera | Office $145.36 | Facility $30.78 |
| Merced | Office $145.36 | Facility $30.78 |
| Modesto | Office $145.36 | Facility $30.78 |
| Napa | Office $170.53 | Facility $32.74 |
| Oxnard-Thousand Oaks-Ventura | Office $155.17 | Facility $31.60 |
| Redding | Office $145.36 | Facility $30.78 |
| Rest Of California | Office $145.36 | Facility $30.78 |
| Riverside-San Bernardino-Ontario | Office $146.13 | Facility $31.55 |
| Sacramento-Roseville-Folsom | Office $153.11 | Facility $31.52 |
| Salinas | Office $152.55 | Facility $31.38 |
| San Diego-Chula Vista-Carlsbad | Office $156.55 | Facility $31.52 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $181.20 | Facility $33.79 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $181.12 | Facility $33.71 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $185.22 | Facility $34.47 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $184.90 | Facility $34.14 |
| San Luis Obispo-Paso Robles | Office $150.03 | Facility $30.96 |
| Santa Cruz-Watsonville | Office $158.38 | Facility $31.36 |
| Santa Maria-Santa Barbara | Office $153.23 | Facility $31.34 |
| Santa Rosa-Petaluma | Office $160.01 | Facility $31.63 |
| Stockton | Office $145.36 | Facility $30.78 |
| Vallejo | Office $170.42 | Facility $32.63 |
| Visalia | Office $145.36 | Facility $30.78 |
| Yuba City | Office $145.36 | Facility $30.78 |
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20501 billing questions
When should 20501 be chosen instead of 20500?
Use 20501 when contrast is injected to map a sinus tract for diagnosis. Use 20500 when material is injected therapeutically into the tract.
Can the imaging service be reported separately?
Yes. When a radiologic examination of the tract is performed and documented, the imaging service may be reported separately, such as with 76080.
Does 20501 have a global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Should modifier 50 be appended for two tracts?
No. CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50 to represent bilateral anatomy.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and the other procedures are subject to the standard multiple procedure reduction, with payment at 50%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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 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.
1,7502040F,,Bk pn xm on init visit date,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7512044F,,Doc mntl tst b/4 bk trxmnt,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,75220500,,Njx sinus tract therapeutic,A,,1.25,2.45,,1.10,,0.15,3.85,2.50,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,75320501,,Njx sinus tract diagnostic,A,,0.74,3.25,,0.12,,0.07,4.06,0.93,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7542050F,,Wound char size etc docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,75520520,,Rmvl fb musc/tdn simple,A,,1.85,4.76,,2.13,,0.27,6.88,4.25,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,75620525,,Rmvl fb musc/tdn deep/comp,A,,3.45,10.77,,2.87,,0.66,14.88,6.98,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00