Inj dupuytren cord w/enzyme

CPT code 20527 covers the injection of an enzyme (collagenase) into the cord of tissue causing Dupuytren's contracture, a hand condition where fingers bend toward the palm and cannot straighten. This non-surgical treatment dissolves the contracted cord without surgery.

Showing rates for

National Average

Base Medicare rate

$86.04

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

PE RVU (NF)

1.48

MP RVU

0.18

Total RVU

2.66

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Bill in non-facility setting when possible to maximize reimbursement
Impact: Increases payment by $21.67 ($86.04 vs $64.37), a 33.7% increase over facility rate
Document the specific cord location (which joint and finger) and contracture angle in degrees before injection
Impact: Reduces denial risk by 40-60%; specific anatomical documentation supports medical necessity
Bill only for the injection procedure; the subsequent manipulation/finger extension procedure performed 24-72 hours later should be reported separately with CPT 26341
Impact: Unbundling these services properly can add $150-250 in additional legitimate reimbursement
Separately report the collagenase drug supply using HCPCS code J0775 in addition to the injection procedure
Impact: Drug reimbursement averages $3,400-4,200 per vial; failure to bill separately results in significant loss
Verify prior authorization requirements as many payers require pre-approval for collagenase due to high drug cost
Impact: Prevents denials averaging $3,500-4,300 per case; retroactive authorization rarely approved
Use diagnosis code M72.0 (Palmar fascial fibromatosis [Dupuytren's contracture]) as primary diagnosis with joint-specific contracture codes as secondary
Impact: Proper diagnosis coding increases first-pass claim acceptance rate by approximately 25%

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 20527 in 2025?

Medicare pays $86.04 for CPT 20527 in non-facility settings and $64.37 in facility settings based on the 2025 Physician Fee Schedule. The non-facility rate is 33.7% higher due to practice expense differences.

How many RVUs is CPT code 20527 worth?

CPT 20527 has a total of 2.66 RVUs, consisting of 1.0 work RVU, 1.48 non-facility practice expense RVU (0.81 facility PE RVU), and 0.18 malpractice RVU.

Can you bill CPT 20527 more than once per patient?

Yes, 20527 can be billed for each separate cord injected. If treating multiple cords in different fingers, you may bill separately with appropriate modifiers (F1-F9 finger modifiers or modifier 59). Some payers limit frequency to one injection per cord per treatment episode.

What is the difference between CPT 20527 and 26341?

CPT 20527 is the enzyme injection into the Dupuytren's cord, while CPT 26341 is the manipulation and cord disruption procedure performed 24-72 hours after injection. These are separate procedures typically performed on different days and both should be billed when performed.

Does CPT 20527 include the cost of the collagenase drug?

No, CPT 20527 covers only the injection procedure. The collagenase drug (Xiaflex) must be billed separately using HCPCS code J0775, which represents the expensive medication component (~$3,400-4,200 per dose).

What diagnosis code should be used with CPT 20527?

The primary diagnosis code is M72.0 (Palmar fascial fibromatosis/Dupuytren's contracture). Secondary codes may include joint-specific contracture codes such as M24.54- for contractures of the hand joints, with appropriate sixth digit for laterality and specific joint.

Do I need prior authorization to bill CPT 20527?

Most commercial payers and Medicare Advantage plans require prior authorization for CPT 20527 due to the high cost of collagenase. Traditional Medicare typically does not require prior auth, but medical necessity documentation must be thorough. Always verify payer-specific requirements before scheduling.