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See a sample rate comparisonCPT 20551 Fee Schedule
Medicare rates as of October 2026
CPT 20551 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Injection; Tendon Origin/Insertion
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11Office 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5441 - Level 1 Nerve Injections |
| Surgery Center Payment (ASC) | P3 - Office-based; paid from physician fee schedule practice expense |
| Add-on Codes | 77002 |
| Common Revenue Codes | 07610361Sign up to view all 12 |
| Medicare Fee Schedule | $60.46 national non-facility rate (2026)View Medicare rates for 20551 |
| Medicaid Fee Schedule | $48.585 median of the 8 states in the free previewView Medicaid rates for 20551 |
National average reimbursement for CPT 20551 by major payers:
$72.44
BCBS / Anthem
$76.58
UnitedHealthcare
$81.63
Aetna
$68.73
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20551.
CPT 20551
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Northwest, LLP, Memorial Hermann Surgery Center Greater Heights
Memorial Hermann Surgery Center Northwest LLP
$2,079.00Published rateEndoscopy Center Of St Thomas LLC, St Thomas Medical Group Endoscopy Center
Endoscopy Center Of St Thomas LLC
$107.00Published rateMary-Ann Fares
Neurohospitalist Of Clear Lake PLLC
$63.36Published rateMichael Kindya
Total Orthopaedic Care, PA
$43.93Published rateOlga Luepschen
Olga Garcia Luepschen Dpm PA
$29.53Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 20551 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20551. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 20550-CPT | Inject(S); Sngle Tndon Sheath Or Ligamnt Aponeurosis, Injection(S); Single Tendon Sheath Or Ligament Aponeurosis (Eg Plan |
| 20551-CPT | Injection; Tendon Origin/Insertion |
| 20552-CPT | Muscle Relaxant Injection, One Or More Injections Into A Knotted Or Clenched Muscle To Treat Irritation Or Pain; One Or Two Muscles. |
| 20553-CPT | Muscle Relaxant Injection, One Or More Injections Into A Knotted Or Clenched Muscle To Treat Irritation Or Pain; Three Or More Muscles. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20551. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20551 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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Frequently Asked Questions
What is CPT 20551?
CPT 20551 reports an injection into a single tendon origin or insertion, for example for tendinopathy at the elbow or hip. Injections into a tendon sheath, ligament or aponeurosis use 20550 instead.
What is billed separately with CPT 20551?
The injected drug is billed separately with its HCPCS code, such as a J-code for a corticosteroid, and imaging guidance can be reported with its own code when used. CPT 20551 has a 0-day global period.
Why do payer rates for CPT 20551 vary?
Medicare pays CPT 20551 under the Physician Fee Schedule. The non-facility rate applies when the service is done in an office and covers the practice's staff, supplies and equipment; the lower facility rate applies in a hospital or surgery center, which bills its own facility fee. Both are adjusted for the local cost of practice. Commercial payers negotiate their own rates, often as a percentage of Medicare, so the same code can pay very differently from one contract to the next.
Where can I compare CPT 20551 rates by payer?
This page lists the rates commercial payers have published for CPT 20551 in their Transparency in Coverage files, so you can compare payers and see where a contract falls. For government benchmarks, PayerPrice also has the Medicare fee schedule lookup and Medicaid fee schedules by state.
What APC is CPT 20551 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20551 to APC 5441 (Level 1 Nerve Injections). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20551 in an ambulatory surgery center?
CMS lists CPT 20551 with ASC payment indicator P3: Office-based; paid from physician fee schedule practice expense.
Which add-on codes are billed with CPT 20551?
CMS add-on code edits list CPT 20551 as a primary code for these add-on codes: 77002.
Which revenue codes are billed with CPT 20551?
Hospital price transparency files list CPT 20551 under these revenue codes: including 0761, 0361, 0510, 0360 and 0450. A revenue code names the hospital department or charge category for the line; it does not change what the service is.