$58.44–$63.58
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 in Illinois
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 in Illinois.
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 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$50.65–$55.09
4 of 4 localities have a supported rate.
Facility setting
$36.01–$38.98
4 of 4 localities have a supported rate.
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 in Illinois
4 payment localities
$50.65 to $55.09
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 rates for Illinois, from the same CMS release.
$59.27–$64.68
20550 is for injection into a tendon sheath or ligament, rather than trigger points within muscle.
$59.05–$64.25
20551 targets a tendon origin or insertion; 20552 targets trigger points in one or two muscles.
$23.68–$25.43
20560 describes needle insertion without injection in one or two muscles, unlike the injection treatment reported with 20552.
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.
4 of 4 payment localities
Chicago →
Office / nonfacility
$55.09
Facility
$38.98
East St. Louis →
Office / nonfacility
$51.90
Facility
$37.15
Rest Of Illinois →
Office / nonfacility
$50.65
Facility
$36.01
Suburban Chicago →
Office / nonfacility
$54.48
Facility
$38.02
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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