$52.98–$58.78
Both codes describe medication injection into muscle trigger points. Choose 20552 for one or two muscles and 20553 for three or more.
On this page
CMS RVU26D · Effective 2026-10-01
20553 Trigger point injection Medicare reimbursement rates in Washington
Reports medication injection into trigger points in three or more muscles to treat myofascial pain during a single session. Compare 20553 office and facility rates across CMS payment localities in Washington.
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 20553 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$61.20–$67.95
2 of 2 localities have a supported rate.
Facility setting
$41.15–$44.59
2 of 2 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.
Injection procedures
About 20553: Trigger point injections, three or more muscles
Reports medication injection into trigger points in three or more muscles to treat myofascial pain during a single session.
This service treats myofascial pain by placing a needle into trigger points in three or more muscles and injecting medication at the identified sites. A trigger point is a tender, taut area within muscle associated with the patient’s symptoms; the target is muscle rather than a tendon sheath or tendon attachment. Physicians and other qualified practitioners commonly perform these injections in office-based pain, rehabilitation, primary care, or orthopedic settings.
Select the code by the number of muscles treated, not the number of trigger points or needle passes: 20553 covers three or more muscles, while 20552 covers one or two. Document the muscles and sites treated, relevant examination findings, and the procedure performed. 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 others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 20553
- 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 RVU0.73 · 41%
- Practice expense (office) RVU0.98 · 55%
- Malpractice RVU0.08 · 4%
286.4K
Medicare services in 2024 · #321 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.
20553 compared with similar codes
Office rates for Washington, from the same CMS release.
$61.81–$68.63
Use 20550 when the injection target is a tendon sheath or ligament; 20553 targets trigger points in muscle.
$61.90–$68.77
Use 20551 for injection at a tendon origin or insertion. Use 20553 when the treated targets are muscle trigger points.
$39.17–$43.53
20561 describes needle insertion without injection in three or more muscles. 20553 includes injection into trigger points in three or more muscles.
Compare 20553 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.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
$61.20
Facility
$41.15
Seattle (King Cnty) →
Office / nonfacility
$67.95
Facility
$44.59
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20553 billing questions
How is 20553 distinguished from 20552?
Count the muscles injected: use 20553 for three or more muscles and 20552 for one or two. The number of trigger points or needle passes does not determine the level.
What should the procedure note identify?
Document the muscles and injection sites, the clinical findings supporting trigger point treatment, and the procedure performed. The record should support treatment of at least three distinct muscles.
Can the medication be reported separately?
The code represents the injection procedure. A separately supplied medication may be reported when it is separately payable and the claim documentation supports it.
Can modifier 50 be used for bilateral trigger point injections?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the service based on the muscles treated rather than using modifier 50.
How are other procedures in the same session paid?
Under the CMS multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.
Is same-day preoperative or postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
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.
1,75920550,,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
1,76520561,,Ndl insj w/o njx 3+ musc,A,,0.47,0.64,,0.09,,0.03,1.14,0.59,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00