How much does Medicare pay for CPT 20526?

Medicare allowed an average of $88.67 per service and paid $66.13 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $324.25, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 20526?

Injection of carpal tunnel. It was billed 46,957 times to 38,182 Medicare beneficiaries by 1,472 providers in 2024.

Does 20526 pay differently in an office than a hospital?

Yes. The allowed amount averaged $90.28 in an office setting and $59.38 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 20526 most?

Hand Surgery, with 19,069 services from 561 clinicians. Next are Orthopedic Surgery, Physician Assistant, Plastic and Reconstructive Surgery.

CPT 20526

Injection of carpal tunnel

$88.67Medicare-allowed amount per service, averaged across 46,957 services

Providers submitted

$324.25

Asking price, not received

Medicare allowed

$88.67

The fee schedule figure

Medicare paid

$66.13

Balance is patient coinsurance

Providers submitted an average of $324.25 for this code and Medicare allowed $88.67 — 3.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $66.13 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $90.28
Hospital / facility: $59.38

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 44,516 services were billed in an office setting and 2,441 in a facility.

Services: 46,957
Beneficiaries: 38,182
Providers billing it: 1,472
Total allowed: $4,163,677

What Medicare pays for CPT 20526

Across 46,957 services billed by 1,472 providers to 38,182 beneficiaries, Medicare allowed an average of $88.67 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 20526

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hand Surgery	19,069	16,037	$90.20	561
Orthopedic Surgery	16,390	13,632	$90.01	539
Physician Assistant	3,581	3,039	$74.30	146
Plastic and Reconstructive Surgery	1,790	1,327	$93.05	42
Neurology	1,687	910	$96.10	29
Nurse Practitioner	1,248	957	$75.57	40
Physical Medicine and Rehabilitation	851	583	$92.15	29
Rheumatology	750	506	$89.74	27
General Surgery	619	488	$87.15	14
Family Practice	261	191	$88.74	14
Sports Medicine	182	144	$81.24	10
Internal Medicine	160	113	$87.41	6
Anesthesiology	136	81	$93.70	5
Pain Management	92	46	$86.42	2
Ambulatory Surgical Center	80	80	$20.49	5

20526 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	4,517	$90.42	$65.32	116
California	4,261	$91.81	$64.53	119
New York	3,328	$104.53	$70.07	87
Texas	2,896	$86.92	$66.47	97
New Jersey	2,195	$97.05	$67.23	70
Michigan	1,940	$94.64	$72.10	49
Pennsylvania	1,918	$88.13	$66.46	61
Illinois	1,916	$94.42	$65.19	60
Virginia	1,886	$85.64	$64.87	57
North Carolina	1,881	$82.12	$64.20	77
Kentucky	1,856	$91.47	$73.00	28
Massachusetts	1,741	$90.31	$63.95	56
South Carolina	1,363	$84.77	$67.01	38
Ohio	1,321	$79.00	$60.51	47
Tennessee	1,256	$80.81	$65.21	37
Georgia	1,211	$85.52	$65.69	42
Louisiana	1,167	$79.55	$64.98	33
Mississippi	903	$80.69	$65.41	24
Arizona	886	$83.54	$64.40	35
Indiana	818	$82.94	$65.91	26
Maryland	816	$94.39	$64.89	29
Oklahoma	549	$77.00	$62.14	16
Connecticut	541	$94.87	$65.84	23
Iowa	517	$78.53	$63.18	18
Nevada	508	$81.28	$62.62	16
Missouri	436	$83.88	$64.22	18
Alabama	387	$83.70	$70.08	13
Colorado	386	$90.14	$66.64	21
Arkansas	361	$80.10	$65.07	16
Kansas	320	$80.57	$66.39	12
Minnesota	289	$85.70	$64.39	13
Washington	255	$86.57	$61.62	13
New Hampshire	223	$77.92	$54.68	10
Oregon	202	$83.41	$63.51	9
Nebraska	189	$77.16	$60.57	7
North Dakota	186	$61.16	$48.13	9
South Dakota	180	$76.44	$60.96	7
Hawaii	158	$82.20	$58.18	6
West Virginia	144	$81.12	$60.64	5
Wisconsin	139	$76.87	$60.31	9
Rhode Island	126	$81.52	$58.72	5
New Mexico	115	$86.53	$63.77	6
Montana	115	$79.11	$57.68	5
Delaware	95	$87.67	$68.74	4
Utah	91	$89.98	$69.67	5
Vermont	80	$61.65	$48.35	4
District of Columbia	62	$74.55	$49.48	2
Puerto Rico	61	$107.59	$85.09	3
Wyoming	54	$82.48	$54.20	3
Idaho	48	$84.21	$68.42	2
Maine	35	$65.60	$47.04	2
Guam	29	$92.66	$65.48	2

Related codes

20550Injection into tendon or ligament$50.46
20553Injection of trigger points$52.41
20552Injection of trigger points$44.76
20551Injection into tendon at attachment to bone or muscle$41.92
20527Injection of medication into palm$76.06

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.