Medicare Reimbursement for 0509T

Medicare Physician Fee Schedule allowed amounts for code 0509T, shown nationally and by locality, non-facility vs facility, for 2026.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$77.82	$77.82
ALASKA* (AK)	$88.21	$88.21
ALABAMA (AL)	$69.52	$69.52
ARKANSAS (AR)	$68.46	$68.46
ARIZONA (AZ)	$75.74	$75.74
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$104.97	$104.97
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$107.20	$107.20
OXNARD-THOUSAND OAKS-VENTURA (CA)	$89.61	$89.61
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$89.87	$89.87
NAPA (CA)	$98.71	$98.71
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$104.99	$104.99
VALLEJO (CA)	$98.68	$98.68
BAKERSFIELD (CA)	$83.97	$83.97
CHICO (CA)	$83.89	$83.89
FRESNO (CA)	$83.89	$83.89
HANFORD-CORCORAN (CA)	$83.89	$83.89
MADERA (CA)	$83.89	$83.89
MERCED (CA)	$83.89	$83.89
MODESTO (CA)	$83.89	$83.89
REDDING (CA)	$83.89	$83.89
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$84.12	$84.12
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$88.44	$88.44
SALINAS (CA)	$88.11	$88.11
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$107.29	$107.29
SANTA CRUZ-WATSONVILLE (CA)	$91.58	$91.58
SANTA ROSA-PETALUMA (CA)	$92.53	$92.53
STOCKTON (CA)	$83.89	$83.89
VISALIA (CA)	$83.89	$83.89
YUBA CITY (CA)	$83.89	$83.89
EL CENTRO (CA)	$83.90	$83.90
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$90.48	$90.48
SAN LUIS OBISPO-PASO ROBLES (CA)	$86.65	$86.65
SANTA MARIA-SANTA BARBARA (CA)	$88.52	$88.52
REST OF CALIFORNIA (CA)	$83.89	$83.89
COLORADO (CO)	$81.94	$81.94
CONNECTICUT (CT)	$83.16	$83.16
DC + MD/VA SUBURBS (DC)	$90.02	$90.02
DELAWARE (DE)	$77.05	$77.05
FORT LAUDERDALE (FL)	$79.20	$79.20
MIAMI (FL)	$81.47	$81.47
REST OF FLORIDA (FL)	$75.34	$75.34
ATLANTA (GA)	$79.02	$79.02
REST OF GEORGIA (GA)	$71.03	$71.03
HAWAII, GUAM (HI)	$86.33	$86.33
IOWA (IA)	$71.97	$71.97
IDAHO (ID)	$72.34	$72.34
EAST ST. LOUIS (IL)	$73.37	$73.37
SUBURBAN CHICAGO (IL)	$80.16	$80.16
CHICAGO (IL)	$79.10	$79.10
REST OF ILLINOIS (IL)	$72.62	$72.62
INDIANA (IN)	$72.80	$72.80
KANSAS (KS)	$71.34	$71.34
KENTUCKY (KY)	$70.65	$70.65
NEW ORLEANS (LA)	$74.13	$74.13
REST OF LOUISIANA (LA)	$70.42	$70.42
METROPOLITAN BOSTON (MA)	$90.73	$90.73
REST OF MASSACHUSETTS (MA)	$81.30	$81.30
BALTIMORE/SURR. CNTYS (MD)	$82.87	$82.87
REST OF MARYLAND (MD)	$78.67	$78.67
SOUTHERN MAINE (ME)	$77.00	$77.00
REST OF MAINE (ME)	$72.44	$72.44
DETROIT (MI)	$76.04	$76.04
REST OF MICHIGAN (MI)	$72.33	$72.33
MINNESOTA (MN)	$79.21	$79.21
METROPOLITAN ST. LOUIS (MO)	$74.75	$74.75
METROPOLITAN KANSAS CITY (MO)	$73.90	$73.90
REST OF MISSOURI (MO)	$68.96	$68.96
MISSISSIPPI (MS)	$68.74	$68.74
MONTANA** (MT)	$77.82	$77.82
NORTH CAROLINA (NC)	$73.29	$73.29
NORTH DAKOTA** (ND)	$77.43	$77.43
NEBRASKA (NE)	$72.47	$72.47
NEW HAMPSHIRE (NH)	$80.37	$80.37
NORTHERN NJ (NJ)	$88.95	$88.95
REST OF NEW JERSEY (NJ)	$84.31	$84.31
NEW MEXICO (NM)	$72.64	$72.64
NEVADA** (NV)	$77.78	$77.78
MANHATTAN (NY)	$89.44	$89.44
NYC SUBURBS/LONG ISLAND (NY)	$91.35	$91.35
POUGHKPSIE/N NYC SUBURBS (NY)	$84.64	$84.64
QUEENS (NY)	$90.62	$90.62
REST OF NEW YORK (NY)	$74.42	$74.42
OHIO (OH)	$72.25	$72.25
OKLAHOMA (OK)	$70.81	$70.81
PORTLAND (OR)	$84.98	$84.98
REST OF OREGON (OR)	$77.37	$77.37
METROPOLITAN PHILADELPHIA (PA)	$80.82	$80.82
REST OF PENNSYLVANIA (PA)	$72.53	$72.53
PUERTO RICO (PR)	$78.52	$78.52
RHODE ISLAND (RI)	$80.12	$80.12
SOUTH CAROLINA (SC)	$72.85	$72.85
SOUTH DAKOTA** (SD)	$77.38	$77.38
TENNESSEE (TN)	$71.68	$71.68
BRAZORIA (TX)	$77.20	$77.20
DALLAS (TX)	$77.59	$77.59
GALVESTON (TX)	$77.36	$77.36
HOUSTON (TX)	$77.73	$77.73
BEAUMONT (TX)	$72.00	$72.00
FORT WORTH (TX)	$76.96	$76.96
AUSTIN (TX)	$81.49	$81.49
REST OF TEXAS (TX)	$74.49	$74.49
UTAH (UT)	$73.91	$73.91
VIRGINIA (VA)	$76.54	$76.54
VIRGIN ISLANDS (VI)	$78.52	$78.52
VERMONT (VT)	$76.85	$76.85
SEATTLE (KING CNTY) (WA)	$92.91	$92.91
REST OF WASHINGTON (WA)	$81.23	$81.23
WISCONSIN (WI)	$74.67	$74.67
WEST VIRGINIA (WV)	$69.71	$69.71
WYOMING** (WY)	$77.65	$77.65

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How the amount is calculated

The amount is each RVU component (work, practice expense, malpractice) multiplied by the locality's GPCI, then by the annual conversion factor; non-facility and facility differ in the practice-expense RVU.

RVUs — work 0.39, practice expense 1.92 (non-facility) / 1.92 (facility), malpractice 0.02 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

• Estimate only.
• Medicare generally pays 80% after the deductible.
• Modifiers, sequestration, and annual updates change the amount.
• Verify with your MAC.

More free billing tools: all Medicare fees · fee calculator · denial code decoder

Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.