CPT 20553 Fee Schedule
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.
| 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 • 59 - Distinct Procedural Service • AG - Primary physician |
| Complexity Level | Low |
National average reimbursement for CPT 20553 by major payers:
$74.40
$83.38
$87.97
$101.10
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 20553 | ||||||
United | 20553 | $78.00 | 1942553300 - COLUMBIA SURGICAL INSTITUTE, LLC | 454449408 - (MD) COLUMBIA SURGICAL INSTITUTE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $230.00 | 1154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE | 871712552 - (AZ) BSC 3 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $741.00 | 1942231493 - TAYLOR STATION SURGICAL CENTER LTD | 311459910 - (OH) TAYLOR STATION SURGICAL CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $150.00 | 1508054818 - CUMMINS WOMENS HEALTHCARE LLC, ELIZABETH CUMMINS MD | 522110421 - (OH) CUMMINS WOMENS HEALTHCARE, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $500.00 | 1952737207 - CPMSC CANTON, LLC | 463595981 - (GA) CPMSC CANTON LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $51.49 | 1962260794 - ASHLEY THOMAS | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 20553 | $530.00 | 1295988731 - BAPTIST EASTPOINT SURGERY CENTER, LLC | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $150.00 | 1457378333 - BEAUMONT SURGICAL AFFILIATES, LTD, BAPTIST BEAUMONT SURGICAL AFFILIATES | 821773443 - (TX) BEAUMONT SURGICAL AFFILIATES | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $566.00 | 1881905792 - SURGCENTER PINELLAS, LLC | 271372259 - (FL) SURGCENTER PINELLAS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $244.00 | 1942335971 - PALOS SURGICENTER, LLC | 364404305 - (IL) PALOS SURGICENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $500.00 | 1265931653 - HEALTHCARE ENTERPRISES LLC, THE SURGERY CENTER | 471428524 - (MA) HEALTHCARE ENTERPRISES LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $1831.00 | 1184922353 - PEARLAND SURGERY CENTER, LLC | 270289493 - (TX) PEARLAND SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $103.00 | 1770151722 - SPECIALTY SURGERY PARTNERS CENTER OF FLORIDA, LLC, ALLIANCE SPECIALTY SURGICAL CENTER | 863661396 - (FL) SPECIALTY SURGERY PARTNERS CENTER OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $681.00 | 1104006006 - PACIFIC ENDOSCOPY AND SURGERY CENTER, LLC | 205755383 - (CA) PACIFIC ENDOSCOPY AND SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20553 | $459.00 | 1891049441 - ISLAND DIGESTIVE HEALTH CENTER, LLC | 452411095 - (NY) ISLAND DIGESTIVE HEALTH CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 20553 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20553 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 20553 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 |
|---|---|---|
| 20527-CPT | Low | Injection, Enzyme (Eg, Collagenase),Palmar Fascial Cord (Ie, Dupuytren's Contracture) |
| 20550-CPT | Low | Inj Tendon Sheath Lig Trigger Pnt Gangli |
| 20551-CPT | Low | Injection; Tendon Origin/Insertion |
| 20553-CPT | Low | Injection(S); Tendon Sheath, Ligament; Single Or Multiple Trigger Point(S), 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 20553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20553 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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