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See a sample rate comparisonCPT 20560 Fee Schedule
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.
Ambulance Service Basic Life, Ambulance Service Basic Life Support Emergency Transport (Bls- Emergency
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 49 - Independent Clinic |
| Common Modifiers | None GP - Services delivered under an outpatient physical therapy plan of care 97 - Rehabilitative services |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 20560 |
| Medicaid Fee Schedule | View Medicaid rates for 20560 |
National average reimbursement for CPT 20560 by major payers:
$30.37
$35.37
$33.87
$50.77
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CPT 20560
5 of 25 sample ratesHigher to lower in this preview
Ochsner Medical Center, Ochsner Outpatient Surgery Suite
Ochsner Clinic Foundation
$1,860.00Published rateSt. Joseph'S Outpatient Surgery Center, LLC
St Josephs Outpatient Surgery Center LLC
$566.00Published rateArizona Surgical Arts, Inc.
Arizona Surgical Arts Inc
$250.00Published rateUlna Surgery Center LLC
$117.00Published rateBaltimore Ambulatory Center For Endoscopy
Baltimore Ambulatory Center Fo
$44.00Published rate
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See a sample payer proposalCPT 20560 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20560 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 20560 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 |
|---|---|---|
| 20552-CPT | Low | Muscle Relaxant Injection, One Or More Injections Into A Knotted Or Clenched Muscle To Treat Irritation Or Pain; One Or Two Muscles. |
| 20553-CPT | Low | Muscle Relaxant Injection, One Or More Injections Into A Knotted Or Clenched Muscle To Treat Irritation Or Pain; Three Or More Muscles. |
| 20560-CPT | Low | Ambulance Service Basic Life, Ambulance Service Basic Life Support Emergency Transport (Bls- Emergency |
| 20561-CPT | Low | Needle Insertion(S) Without In, Needle Insertion(S) Without Injection(S) 3 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 20560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20560 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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