How much does Medicare pay for CPT 20551?

Medicare allowed an average of $41.92 per service and paid $31.67 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $155.04, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 20551?

Injection into tendon at attachment to bone or muscle. It was billed 74,496 times to 31,932 Medicare beneficiaries by 1,180 providers in 2024.

Does 20551 pay differently in an office than a hospital?

Yes. The allowed amount averaged $42.09 in an office setting and $28.49 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 20551 most?

Physical Medicine and Rehabilitation, with 15,257 services from 116 clinicians. Next are Podiatry, Physician Assistant, Orthopedic Surgery.

CPT 20551

Injection into tendon at attachment to bone or muscle

$41.92Medicare-allowed amount per service, averaged across 74,496 services

Providers submitted

$155.04

Asking price, not received

Medicare allowed

$41.92

The fee schedule figure

Medicare paid

$31.67

Balance is patient coinsurance

Providers submitted an average of $155.04 for this code and Medicare allowed $41.92 — 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 $31.67 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $42.09
Hospital / facility: $28.49

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. 73,588 services were billed in an office setting and 908 in a facility.

Services: 74,496
Beneficiaries: 31,932
Providers billing it: 1,180
Total allowed: $3,122,872

What Medicare pays for CPT 20551

Across 74,496 services billed by 1,180 providers to 31,932 beneficiaries, Medicare allowed an average of $41.92 per service. That is 2.3 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 20551

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Medicine and Rehabilitation	15,257	3,953	$37.76	116
Podiatry	12,316	7,428	$50.10	319
Physician Assistant	11,177	1,859	$32.46	71
Orthopedic Surgery	8,566	6,151	$48.81	244
Nurse Practitioner	5,855	828	$31.50	35
Hand Surgery	5,437	3,874	$49.27	129
Family Practice	3,075	1,539	$44.25	60
Rheumatology	2,672	1,507	$44.00	44
Sports Medicine	2,268	1,760	$49.95	61
Interventional Pain Management	1,710	447	$33.77	16
Internal Medicine	1,165	585	$53.25	15
Plastic and Reconstructive Surgery	1,143	495	$41.67	8
Osteopathic Manipulative Medicine	1,139	371	$50.66	11
Anesthesiology	750	364	$34.69	9
Neurology	649	159	$39.71	9

20551 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
California	9,007	$41.32	$27.83	104
Arizona	7,546	$32.59	$23.90	51
Florida	7,004	$47.27	$34.00	150
Maryland	6,591	$37.32	$24.48	38
North Carolina	5,904	$34.52	$23.09	29
New York	4,363	$50.07	$33.82	83
Georgia	4,075	$39.71	$32.94	32
Pennsylvania	3,763	$47.80	$34.25	87
Kentucky	2,863	$40.26	$32.39	17
Texas	2,579	$41.96	$31.07	58
New Jersey	2,573	$54.33	$37.39	72
Illinois	1,883	$44.54	$30.79	41
Virginia	1,695	$46.58	$34.94	40
South Carolina	1,607	$30.96	$26.55	26
Michigan	1,285	$46.16	$32.74	32
Oklahoma	1,187	$40.20	$30.59	18
Massachusetts	1,133	$52.83	$36.39	35
Delaware	1,102	$48.48	$36.09	14
Tennessee	831	$45.97	$35.55	31
Utah	792	$36.05	$29.70	8
Louisiana	723	$44.55	$35.12	19
Arkansas	673	$41.78	$34.02	19
Ohio	568	$48.76	$37.95	17
Alabama	493	$41.60	$35.18	14
Colorado	471	$48.70	$33.84	15
Missouri	411	$49.62	$38.61	11
Nevada	411	$44.73	$33.90	11
Washington	362	$50.71	$35.41	9
Indiana	359	$43.68	$34.89	17
Mississippi	296	$43.43	$35.37	14
Kansas	249	$36.61	$30.84	6
West Virginia	222	$48.69	$39.78	6
New Hampshire	191	$35.49	$26.80	4
Nebraska	170	$43.94	$34.24	8
Montana	143	$40.11	$28.50	4
Oregon	132	$46.17	$33.46	6
Maine	115	$42.25	$31.74	4
Minnesota	102	$45.49	$35.90	2
Hawaii	102	$50.65	$39.30	3
Idaho	99	$43.17	$33.91	5
New Mexico	96	$27.89	$21.94	3
Iowa	80	$50.13	$36.28	4
South Dakota	53	$40.19	$34.57	3
Alaska	53	$63.07	$38.89	2
Connecticut	45	$58.55	$41.27	3
Rhode Island	39	$50.52	$37.38	2
Wisconsin	38	$47.51	$34.95	2
Vermont	17	$32.94	$23.06	1

Related codes

20550Injection into tendon or ligament$50.46
20553Injection of trigger points$52.41
20552Injection of trigger points$44.76
20526Injection of carpal tunnel$88.67
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.