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See a sample rate comparisonCPT 20561 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.
Needle Insertion(S) Without In, Needle Insertion(S) Without Injection(S) 3 Or More Muscles
| 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 20561 |
| Medicaid Fee Schedule | View Medicaid rates for 20561 |
National average reimbursement for CPT 20561 by major payers:
$43.52
$52.49
$48.70
$70.31
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CPT 20561
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Southwest Ohio, LLC, The Surgery Center Of Southwest Ohio
The Surgery Center Of Southwest
$4,097.00Published rateMemorial Surgery Center, LLC
Memorial Surgery Center LLC
$555.00Published rateEndoscopy Of Plano, Lp, Gastrointestinal Endoscopy Center Of Plano
Endoscopy Of Plano Lp
$261.00Published rateSpartan Health Surgicenter LLC
Spartan Health Surgicenter, LLC
$101.00Published rateSummer Swinney
Deaconess Hospital Inc
$31.32Published rate
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See a sample payer proposalCPT 20561 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20561 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 20561 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 20561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20561 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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