Billing code 20561: Dry needlingMedicare rate & RVUs in Utah
Report this service for needle insertion without medication into three or more muscles during dry needling for musculoskeletal pain or dysfunction.
Medicare pays $36.69 for 20561 in the office in Utah (Utah). Which amount applies depends on the service address.
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 9 sections
What 20561 covers
Dry needling uses a solid needle inserted into muscle tissue without injecting medication, often to address myofascial pain, muscle sensitivity, or movement restrictions. Physical therapists commonly perform it in outpatient rehabilitation; other clinicians may perform it in musculoskeletal or pain-care settings when authorized and trained to do so. The service may target muscles with palpable taut bands or trigger points, but the code’s threshold is the number of muscles treated, not the number of trigger points or needle passes.
Choose 20561 when the session involves three or more distinct muscles; use the lower-level sibling when only one or two muscles are treated. Document the muscles treated and the dry-needling service, including that no substance was injected. Under the Medicare Physician Fee Schedule, the code has work, practice-expense, and malpractice values; practice expense is represented separately for office and facility settings.
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.
20561 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $36.69 | $19.42 |
How the 20561 rate is calculated
Each of 20561’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 · 20561
RVUs × geographic indexes × conversion factor
Work0.47
0.47 RVUs× 1.000 GPCI
Practice expense0.64
0.64 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.1400
Conversion factor
$33.4009
Medicare rate
$38.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20561
20561 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 20561
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$38.08
- Non-facility (office)
- $38.08
- Facility
- $19.71
Higher because the practice carries its own overhead.
20561 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20560Dry needling
- Both describe dry needling without injection. Use 20560 for one or two muscles and 20561 for three or more.
- 20553Trigger point injection
- 20553 is for injection of three or more trigger points; 20561 is for dry needling of three or more muscles without injection.
- 97810Acupuncture
- 97810 describes acupuncture, not the dry-needling service represented by 20561. The treatment method determines which code fits.
20561 billing questions
How is 20561 distinguished from 20560?
Select by the number of distinct muscles treated: 20561 is for three or more, while 20560 is for one or two. Needle passes or trigger points do not determine the level.
Does this code include an injection?
No medication or other substance is injected for the dry-needling service. When a substance is injected into trigger points, consider the trigger-point injection code that matches the number of points treated instead.
Is the code based on the number of needles inserted?
No. The distinction between 20560 and 20561 is the number of muscles treated, not the number of needles, insertions, or passes.
What should the note identify?
Document that dry needling was performed without injection and identify the muscles treated. The record should support treatment of at least three distinct muscles for 20561.
How does 20561 differ from trigger-point injection code 20553?
20561 describes dry needling without injection and is selected by muscles treated. 20553 describes injection treatment of three or more trigger points.
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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