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See a sample rate comparisonCPT 20553 Fee Schedule
Medicare rates as of October 2026
CPT 20553 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Muscle Relaxant Injection, One Or More Injections Into A Knotted Or Clenched Muscle To Treat Irritation Or Pain; Three Or More Muscles.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11Office 22On Campus Outpatient Hospital |
| Common Modifiers | 59Distinct Procedural Service AGPrimary physician |
| 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 | 03610450Sign up to view all 13 |
| Medicare Fee Schedule | $59.79 national non-facility rate (2026)View Medicare rates for 20553 |
| Medicaid Fee Schedule | $48.04 median of the 8 states in the free previewView Medicaid rates for 20553 |
National average reimbursement for CPT 20553 by major payers:
$74.40
BCBS / Anthem
$83.38
UnitedHealthcare
$87.97
Aetna
$72.63
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20553.
CPT 20553
5 of 25 sample ratesHigher to lower in this preview
Park Nicollet Methodist Hospital, Park Nicollet Same Day Surgery Center
Park Nicollet Health Services
$1,534.00Published rateChelmsford Surgery Center LLC
$550.00Published rateColumbus Endoscopy Center, Inc
Columbus Endoscopy Center Inc
$115.00Published rateGeorgia Retina Surgery Center, LLC
Georgia Retina Surgery Center LLC
$79.00Published rateNorthway Spc LLC
Northway Spc, LLC D/B/A Northway Surgery And Pain Center
$32.27Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 20553 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20553. 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 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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Frequently Asked Questions
How can I find out the cost of a medical procedure?
To find out the cost of a specific medical procedure, you can use online tools that provide fee schedule lookups. For a detailed estimate based on CPT code and specific location, Payerprice offers a tool designed for this purpose. It's also advisable to contact your insurance provider and the healthcare facility directly for the most accurate information regarding your specific situation and coverage.
What is a CPT code?
CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used to describe medical, surgical, and diagnostic services performed by physicians and other healthcare providers. They are essential for billing, processing insurance claims, and for understanding the specific procedures that will be performed.
Why do medical costs vary so much?
Medical costs can vary significantly due to several factors, including the healthcare provider's fees, geographic location, negotiated rates with different insurance companies, the complexity of the procedure, and whether the facility is in-network or out-of-network. Different facilities also have varying overheads and pricing strategies, contributing to the wide range of costs.
Is there a way to compare prices before a procedure?
Yes, comparing prices before a procedure is highly recommended. Tools like Payerprice allow you to look up fee schedules using CPT codes and specific locations, helping you get an estimate of potential costs. You should also contact your insurance company for your out-of-pocket costs and the healthcare provider's billing department for their specific charges, as these can vary widely.
What is Payerprice?
Payerprice is a service that provides a fee schedule lookup tool. It allows users to search for medical procedure costs using CPT codes and specific locations, helping individuals understand potential healthcare expenses and compare prices before receiving services.
What APC is CPT 20553 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20553 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 20553 in an ambulatory surgery center?
CMS lists CPT 20553 with ASC payment indicator P3: Office-based; paid from physician fee schedule practice expense.
Which add-on codes are billed with CPT 20553?
CMS add-on code edits list CPT 20553 as a primary code for these add-on codes: 77002.
Which revenue codes are billed with CPT 20553?
Hospital price transparency files list CPT 20553 under these revenue codes: including 0361, 0450, 0761, 0360 and 0510. A revenue code names the hospital department or charge category for the line; it does not change what the service is.