How much does Medicare pay for CPT 20552?

Medicare allowed an average of $44.76 per service and paid $33.65 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $262.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 20552?

Injection of trigger points, 1-2 muscles. It was billed 162,142 times to 112,259 Medicare beneficiaries by 3,729 providers in 2024.

Does 20552 pay differently in an office than a hospital?

Yes. The allowed amount averaged $46.58 in an office setting and $28.38 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 20552 most?

Physical Medicine and Rehabilitation, with 32,152 services from 710 clinicians. Next are Nurse Practitioner, Orthopedic Surgery, Pain Management.

CPT 20552

Injection of trigger points, 1-2 muscles

$44.76Medicare-allowed amount per service, averaged across 162,142 services

Providers submitted

$262.22

Asking price, not received

Medicare allowed

$44.76

The fee schedule figure

Medicare paid

$33.65

Balance is patient coinsurance

Providers submitted an average of $262.22 for this code and Medicare allowed $44.76 — 5.9× 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 $33.65 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $46.58
Hospital / facility: $28.38

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. 145,934 services were billed in an office setting and 16,208 in a facility.

Services: 162,142
Beneficiaries: 112,259
Providers billing it: 3,729
Total allowed: $7,257,476

What Medicare pays for CPT 20552

Across 162,142 services billed by 3,729 providers to 112,259 beneficiaries, Medicare allowed an average of $44.76 per service. That is 1.4 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 20552

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Medicine and Rehabilitation	32,152	22,651	$47.75	710
Nurse Practitioner	20,321	11,822	$39.82	400
Orthopedic Surgery	19,888	14,579	$47.16	405
Pain Management	18,264	13,417	$46.56	426
Physician Assistant	16,464	12,007	$40.62	416
Anesthesiology	12,110	8,747	$42.04	329
Interventional Pain Management	10,614	7,591	$47.33	248
Rheumatology	7,554	5,128	$43.42	159
Family Practice	7,091	4,526	$47.45	187
Internal Medicine	4,309	2,868	$50.49	106
Sports Medicine	3,171	2,423	$46.88	91
Neurology	2,502	1,523	$43.63	69
Ambulatory Surgical Center	2,226	1,588	$21.17	52
Osteopathic Manipulative Medicine	1,063	536	$48.08	17
General Practice	957	401	$53.10	11

20552 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	20,703	$46.78	$34.57	423
California	16,393	$46.40	$32.09	308
New York	13,248	$53.55	$35.94	248
Pennsylvania	9,098	$43.48	$32.48	199
Georgia	8,904	$43.18	$33.08	196
North Carolina	7,510	$42.16	$32.79	178
Texas	7,418	$43.45	$33.58	199
New Jersey	6,393	$52.30	$36.61	146
Illinois	6,215	$44.23	$32.66	115
Virginia	5,603	$43.77	$33.70	130
Ohio	4,641	$40.03	$30.67	111
Alabama	4,518	$41.55	$34.41	100
Arkansas	3,908	$41.36	$34.90	64
Tennessee	3,866	$41.77	$33.81	114
Arizona	3,322	$39.82	$30.53	90
Maryland	3,256	$47.51	$34.28	75
Massachusetts	3,168	$40.62	$28.89	76
South Carolina	2,581	$43.53	$34.32	73
Michigan	2,301	$45.27	$34.52	66
Missouri	2,141	$40.63	$31.97	60
Indiana	1,876	$41.59	$33.14	60
Louisiana	1,822	$43.80	$35.42	53
Colorado	1,805	$41.33	$31.61	43
Mississippi	1,746	$37.50	$31.19	44
Connecticut	1,717	$51.33	$36.46	33
Wisconsin	1,709	$38.09	$30.21	54
Kansas	1,693	$38.15	$30.76	42
Nevada	1,648	$44.54	$33.75	31
Kentucky	1,613	$42.23	$34.17	53
Iowa	1,253	$34.61	$28.08	34
Oklahoma	1,220	$42.59	$34.52	37
Washington	1,019	$44.04	$32.52	30
South Dakota	990	$39.74	$29.24	20
Minnesota	911	$44.38	$33.82	37
Utah	666	$41.06	$30.44	20
West Virginia	634	$40.02	$29.81	18
Rhode Island	564	$36.55	$26.97	17
Delaware	558	$48.13	$36.32	11
New Hampshire	530	$46.66	$34.25	18
Nebraska	512	$39.91	$32.36	19
Maine	437	$43.70	$29.80	10
Idaho	433	$40.37	$31.21	14
Oregon	408	$44.97	$34.87	12
Montana	370	$31.20	$23.92	14
Alaska	157	$57.30	$33.43	6
New Mexico	147	$47.01	$34.98	5
Wyoming	97	$46.80	$34.94	4
District of Columbia	93	$51.56	$35.56	6
Puerto Rico	84	$49.12	$32.91	3
Guam	81	$54.25	$35.91	1
North Dakota	76	$37.23	$27.26	4
Hawaii	36	$38.14	$27.88	2
U.S. Virgin Islands	35	$49.83	$35.41	2
Vermont	15	$48.96	$35.68	1

Related codes

20550Injection into tendon or ligament$50.46
20553Injection of trigger points$52.41
20551Injection into tendon at attachment to bone or muscle$41.92
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.