$114.85
This code describes manipulation of a palmar fascial cord after injection, not the collagenase injection itself. It is commonly performed at a later visit.
On this page
CMS RVU26D · Effective 2026-10-01
20527 Palmar cord injection Medicare reimbursement rates in Indiana
Report this service for injecting collagenase into a palmar fascial cord to treat Dupuytren contracture, typically as part of a staged treatment plan. Compare 20527 office and facility rates across CMS payment localities in Indiana.
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 20527 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$86.91
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$53.78
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
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.
Hand procedure
About 20527: Collagenase injection for Dupuytren cord
Report this service for injecting collagenase into a palmar fascial cord to treat Dupuytren contracture, typically as part of a staged treatment plan.
A clinician injects collagenase into a palpable cord of thickened palmar fascia causing Dupuytren contracture. Hand surgeons and other clinicians who treat hand disorders commonly perform the injection in an office or outpatient setting. The enzyme weakens the targeted cord; a separate manipulation may be performed at a later visit to help extend the affected finger. Document the cord and hand treated, the contracture findings, and the injection performed.
Report 20527 for the injection service, not for the later manipulation. When collagenase is supplied and separately reportable, the drug is reported with its applicable drug code and units. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgery and team-surgery payment are not permitted.
CMS billing rules for 20527
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU0.98 · 35%
- Practice expense (office) RVU1.65 · 59%
- Malpractice RVU0.19 · 7%
8.8K
Medicare services in 2024 · #1546 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.
20527 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
Use 26040 for percutaneous division of palmar fascia; use 20527 when collagenase is injected into the cord.
No office rate
Use 26121 for surgical removal of palmar fascia. Code 20527 describes enzyme injection and does not represent excision.
Compare 20527 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.
1 of 1 payment localities
Indiana →
Office / nonfacility
$86.91
Facility
$53.78
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 20527 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
1,758
- Code
- 20527
- Physician work
- 0.98
- Practice expense
- 1.65
- Malpractice
- 0.19
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.000 | 0.9800 |
| Practice expense | 1.65 | × 0.927 | 1.5295 |
| Malpractice | 0.19 | × 0.486 | 0.0923 |
| Total RVUs | 2.6019 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$86.91
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 1.65 | 0.927 |
| Malpractice | 0.19 | 0.486 |
(0.98 × 1 + 1.65 × 0.927 + 0.19 × 0.486) × $33.4009 = $86.91
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 0.58 | 0.927 |
| Malpractice | 0.19 | 0.486 |
(0.98 × 1 + 0.58 × 0.927 + 0.19 × 0.486) × $33.4009 = $53.78
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
20527 billing questions
When should 20527 be chosen instead of a palmar fasciectomy code?
Use 20527 for enzyme injection into a palmar fascial cord. A fasciectomy code describes surgical removal of diseased fascia, not injection treatment.
Is the post-injection finger manipulation included in 20527?
No. The manipulation is a separate service, commonly reported with 26341 when performed after collagenase injection; it is typically done at a later visit.
Can the collagenase drug be reported separately?
When the drug is separately reportable, report it with the applicable drug code, such as J0775, using units based on the amount administered. The 20527 service represents the injection procedure.
What documentation supports reporting 20527?
Document the Dupuytren contracture, the targeted palmar fascial cord and hand, and the collagenase injection performed. Record the drug and amount administered when needed to support separate drug reporting.
How is 20527 reported when both hands are treated?
CMS lists bilateral reporting with modifier 50, paid at 150%. Document the injection on each side.
Does 20527 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
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.
1,75520520,,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
1,75720526,,Ther injection carp tunnel,A,,0.92,1.55,,0.39,,0.17,2.64,1.48,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,75820527,,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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915