How does CPT 20526 compare to other surgical procedure codes?

The CPT 20526 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements. It involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CPT stands for Current Procedural Terminology. CPT codes are a standardized set of medical codes used by healthcare professionals to report medical, surgical, and diagnostic services and procedures. These codes are essential for documentation, billing, and processing claims by health insurance companies.

How can I find the cost of a specific medical procedure?

To find the cost of a specific medical procedure, you will generally need the CPT (Current Procedural Terminology) code for that procedure and your geographic location (e.g., zip code). You can use online tools like Payerprice, which offers a fee schedule lookup tool where you can search with a CPT code and specific location to get an estimated cost. Additionally, contacting your insurance provider directly is recommended to understand your specific out-of-pocket costs based on your plan, deductible, and co-insurance.

What information do I need to look up a medical procedure cost?

The most crucial piece of information you'll need is the CPT (Current Procedural Terminology) code for the specific medical procedure. Knowing your specific geographic location (such as a zip code) is also important, as healthcare costs can vary significantly by region. Having your insurance policy details, including your plan name and member ID, will further help in understanding your potential out-of-pocket expenses.

What is the difference between the billed amount and the amount I actually pay?

The billed amount is the total charge for a medical service or procedure as determined by the healthcare provider. The amount you actually pay, or your out-of-pocket cost, is often different and typically lower than the billed amount. This difference is usually due to negotiations between your insurance company and the healthcare provider, leading to contracted rates for in-network services. Your out-of-pocket cost includes your co-pays, deductibles, and any co-insurance amounts, as dictated by your specific insurance plan after the insurance company has paid its portion.

Where can I find reliable information about healthcare prices and fee schedules?

For reliable information about healthcare prices and fee schedules, especially if you have a CPT code and location, tools like Payerprice are highly recommended. Payerprice offers a fee schedule lookup tool that allows users to search for costs based on specific CPT codes and locations. You can also consult your insurance provider, who can give you estimates based on your specific plan benefits, and healthcare providers can often furnish a 'Good Faith Estimate' for services.

CPT 20526 Fee Schedule

Q: What factors affect CPT 20526 fee schedules?

Several factors influence fee schedules, including: Medicare & Medicaid Rates (Government-set reimbursement amounts), Private Insurance Rates (Negotiated rates between providers and insurance companies), Geographic Location (Costs may be higher in urban areas), and Provider Type (Hospital providers may have different rates than private practice).

Last Verified: October 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Carpal Tunnel Injection, Injection Of Corticosteroid Or Anesthetic Into The Wrist To Relieve Pain Associated With Carpal Tunnel Syndrome.

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Musculoskeletal System
Common Place of Service	11 - Office 22 - On Campus Outpatient Hospital
Common Modifiers	None RT - Right side of body 50 - Bilateral Procedure
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 20526
Medicaid Fee Schedule	View Medicaid rates for 20526

National average reimbursement for CPT 20526 by major payers:

$97.96

$103.59

$111.84

$95.57

Compare published rates across providers.

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CPT 20526

5 of 25 sample ratesHigher to lower in this preview

Jan Mrani
Aurora Medical Group Inc
NJInternal Medicine PhysicianNPI 1679607212Tax ID 39-1678306
$280.01Published rate
Cesar Avalos
Atlantic Health System Inc
NJInternal Medicine PhysicianNPI 1922459353Tax ID 20-2088165
$146.11Published rate
Brian Copeland
Virtua Medical Group PA
NJInternal Medicine PhysicianNPI 1659573525Tax ID 27-1348772
$97.80Published rate
Emily Felzenberg
NJInternal Medicine PhysicianNPI 1063684702Tax ID 42-0868216
$88.81Published rate
Michael Makowsky
Premise Health Of New York Medical PC
NJInternal Medicine PhysicianNPI 1083735104Tax ID 14-1725139
$47.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 20526 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 20526 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 20526 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
20526-CPT	Low	Carpal Tunnel Injection, Injection Of Corticosteroid Or Anesthetic Into The Wrist To Relieve Pain Associated With Carpal Tunnel Syndrome.
20550-CPT	Low	Inject(S); Sngle Tndon Sheath Or Ligamnt Aponeurosis, Injection(S); Single Tendon Sheath Or Ligament Aponeurosis (Eg Plan
20610-CPT	Low	Arthrocentesis Aspiration An, Arthrocentesis Aspiration Andor Injection Major Joint Orbursa (Eg Shoulder Hip Knee Joint Subacromial Bursa) Arthrocentesis Aspiration Andor Injection Major Joint Or
20611-CPT	Low	Drain Inj Joint Bursa W Us, Arthrocentesis Aspiration And Or Injection Major Joint Or Bursa Eg Shoulder Hip Knee Subacromial Bursa With Ultrasound Guidance With Permanent Recording And Reporting

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20526. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 20526 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 20526 Fee Schedule

Compare published rates across providers.

Jan Mrani

Cesar Avalos

Brian Copeland

Emily Felzenberg

Michael Makowsky