Medicare Reimbursement for CPT 11047

CPT 11047 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, at the national level and adjustable by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$128.59	$85.17
ALASKA* (AK)	$156.51	$110.27
ALABAMA (AL)	$116.26	$78.26
ARKANSAS (AR)	$114.73	$77.43
ARIZONA (AZ)	$125.11	$83.03
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$151.28	$90.06
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$153.70	$91.09
OXNARD-THOUSAND OAKS-VENTURA (CA)	$136.41	$85.09
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$137.71	$86.34
NAPA (CA)	$145.03	$87.80
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$151.68	$90.46
VALLEJO (CA)	$144.45	$87.22
BAKERSFIELD (CA)	$130.72	$83.13
CHICO (CA)	$129.75	$82.16
FRESNO (CA)	$129.75	$82.16
HANFORD-CORCORAN (CA)	$129.75	$82.16
MADERA (CA)	$129.75	$82.16
MERCED (CA)	$129.75	$82.16
MODESTO (CA)	$129.75	$82.16
REDDING (CA)	$129.75	$82.16
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$133.51	$85.92
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$134.76	$84.26
SALINAS (CA)	$134.23	$83.91
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$155.32	$92.71
SANTA CRUZ-WATSONVILLE (CA)	$136.90	$84.14
SANTA ROSA-PETALUMA (CA)	$138.18	$84.86
STOCKTON (CA)	$129.75	$82.16
VISALIA (CA)	$129.75	$82.16
YUBA CITY (CA)	$129.75	$82.16
EL CENTRO (CA)	$129.81	$82.22
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$136.39	$84.46
SAN LUIS OBISPO-PASO ROBLES (CA)	$132.25	$82.79
SANTA MARIA-SANTA BARBARA (CA)	$134.46	$83.83
REST OF CALIFORNIA (CA)	$129.75	$82.16
COLORADO (CO)	$130.46	$84.26
CONNECTICUT (CT)	$136.70	$89.93
DC + MD/VA SUBURBS (DC)	$143.43	$92.28
DELAWARE (DE)	$127.01	$84.11
FORT LAUDERDALE (FL)	$138.79	$94.81
MIAMI (FL)	$148.85	$103.65
REST OF FLORIDA (FL)	$131.92	$90.41
ATLANTA (GA)	$132.05	$87.93
REST OF GEORGIA (GA)	$124.56	$85.83
HAWAII, GUAM (HI)	$131.63	$82.26
IOWA (IA)	$116.60	$76.87
IDAHO (ID)	$117.78	$77.84
EAST ST. LOUIS (IL)	$135.80	$95.85
SUBURBAN CHICAGO (IL)	$139.60	$95.01
CHICAGO (IL)	$144.43	$100.80
REST OF ILLINOIS (IL)	$130.12	$90.48
INDIANA (IN)	$118.34	$78.09
KANSAS (KS)	$117.22	$77.96
KENTUCKY (KY)	$121.15	$82.55
NEW ORLEANS (LA)	$126.75	$85.90
REST OF LOUISIANA (LA)	$121.42	$82.99
METROPOLITAN BOSTON (MA)	$140.99	$89.15
REST OF MASSACHUSETTS (MA)	$130.24	$84.52
BALTIMORE/SURR. CNTYS (MD)	$136.55	$89.96
REST OF MARYLAND (MD)	$128.92	$84.98
SOUTHERN MAINE (ME)	$123.76	$80.73
REST OF MAINE (ME)	$119.53	$79.58
DETROIT (MI)	$134.58	$92.68
REST OF MICHIGAN (MI)	$125.05	$85.40
MINNESOTA (MN)	$122.05	$77.37
METROPOLITAN ST. LOUIS (MO)	$125.83	$84.49
METROPOLITAN KANSAS CITY (MO)	$124.78	$84.01
REST OF MISSOURI (MO)	$120.27	$82.84
MISSISSIPPI (MS)	$117.46	$80.08
MONTANA** (MT)	$128.57	$85.15
NORTH CAROLINA (NC)	$120.48	$79.97
NORTH DAKOTA** (ND)	$121.65	$78.23
NEBRASKA (NE)	$116.85	$76.77
NEW HAMPSHIRE (NH)	$129.51	$84.31
NORTHERN NJ (NJ)	$142.39	$92.02
REST OF NEW JERSEY (NJ)	$137.43	$90.01
NEW MEXICO (NM)	$126.12	$86.30
NEVADA** (NV)	$126.70	$83.23
MANHATTAN (NY)	$148.62	$98.17
NYC SUBURBS/LONG ISLAND (NY)	$153.36	$101.73
POUGHKPSIE/N NYC SUBURBS (NY)	$139.21	$91.67
QUEENS (NY)	$148.10	$96.78
REST OF NEW YORK (NY)	$122.22	$80.97
OHIO (OH)	$123.63	$83.99
OKLAHOMA (OK)	$119.77	$80.99
PORTLAND (OR)	$132.99	$84.75
REST OF OREGON (OR)	$124.89	$81.64
METROPOLITAN PHILADELPHIA (PA)	$134.29	$89.09
REST OF PENNSYLVANIA (PA)	$123.18	$83.32
PUERTO RICO (PR)	$129.06	$85.16
RHODE ISLAND (RI)	$130.37	$85.51
SOUTH CAROLINA (SC)	$122.42	$82.30
SOUTH DAKOTA** (SD)	$120.83	$77.41
TENNESSEE (TN)	$117.89	$78.42
BRAZORIA (TX)	$125.97	$82.94
DALLAS (TX)	$127.23	$83.98
GALVESTON (TX)	$126.65	$83.53
HOUSTON (TX)	$133.05	$89.94
BEAUMONT (TX)	$122.53	$83.02
FORT WORTH (TX)	$126.80	$83.99
AUSTIN (TX)	$130.75	$84.81
REST OF TEXAS (TX)	$124.50	$83.29
UTAH (UT)	$123.91	$83.10
VIRGINIA (VA)	$124.17	$81.49
VIRGIN ISLANDS (VI)	$129.06	$85.16
VERMONT (VT)	$122.24	$79.25
SEATTLE (KING CNTY) (WA)	$142.59	$89.31
REST OF WASHINGTON (WA)	$129.64	$83.92
WISCONSIN (WI)	$118.06	$76.47
WEST VIRGINIA (WV)	$126.02	$88.29
WYOMING** (WY)	$125.55	$82.13

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 10 units per patient per day — Date of Service Edit: Clinical. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare's PFS amount is built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice risk. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings differ mainly in the practice-expense RVU, since overhead costs shift when the facility bears part of the cost, which is why two different national amounts are shown.

RVUs — work 1.76, practice expense 1.74 (non-facility) / 0.44 (facility), malpractice 0.35 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the beneficiary or secondary payer is generally responsible for the rest.
Actual payment varies by locality GPCI values, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
Figures reflect the national conversion factor and RVUs for the stated year and may change with future rule updates.
Always verify final payment amounts with your Medicare Administrative Contractor (MAC) or official CMS PFS lookup tool.

Frequently asked

Why does the facility amount differ from the non-facility amount for the same code?

The practice-expense RVU is lower in the facility setting because the facility (e.g., hospital) absorbs part of the overhead cost, whereas in a non-facility setting the billing provider bears the full practice expense.

Does this amount reflect what Medicare will actually pay?

No. It reflects the PFS allowed amount before the 80/20 split, deductible status, sequestration, and any locality-specific adjustments are applied.

Can I use this figure to bill a patient directly?

No. Billing amounts should follow your MAC's published fee schedule for the specific locality and any applicable modifiers or contractual arrangements.

Why isn't the CPT code description shown on this page?

CPT code descriptors are copyrighted by the American Medical Association and cannot be reproduced without a license, so this page references the code generically.

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.