Medicare Reimbursement for CPT 11444
CPT 11444 is a procedure code billed under Medicare Part B; the specific clinical descriptor is not shown here due to AMA licensing restrictions on CPT text. This page presents the Medicare Physician Fee Schedule (PFS) allowed amount for 2026, shown nationally and adjustable by locality, with separate figures for non-facility and facility settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $288.25 | $200.07 |
| ALASKA* (AK) | $344.79 | $250.88 |
| ALABAMA (AL) | $260.77 | $183.61 |
| ARKANSAS (AR) | $257.31 | $181.57 |
| ARIZONA (AZ) | $280.91 | $195.47 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $359.56 | $235.23 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $366.16 | $239.01 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $316.69 | $212.46 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $318.79 | $214.48 |
| NAPA (CA) | $341.79 | $225.57 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $360.05 | $235.72 |
| VALLEJO (CA) | $341.09 | $224.87 |
| BAKERSFIELD (CA) | $300.93 | $204.29 |
| CHICO (CA) | $299.67 | $203.03 |
| FRESNO (CA) | $299.67 | $203.03 |
| HANFORD-CORCORAN (CA) | $299.67 | $203.03 |
| MADERA (CA) | $299.67 | $203.03 |
| MERCED (CA) | $299.67 | $203.03 |
| MODESTO (CA) | $299.67 | $203.03 |
| REDDING (CA) | $299.67 | $203.03 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $304.33 | $207.69 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $313.04 | $210.49 |
| SALINAS (CA) | $311.84 | $209.64 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $368.16 | $241.00 |
| SANTA CRUZ-WATSONVILLE (CA) | $320.32 | $213.18 |
| SANTA ROSA-PETALUMA (CA) | $323.46 | $215.18 |
| STOCKTON (CA) | $299.67 | $203.03 |
| VISALIA (CA) | $299.67 | $203.03 |
| YUBA CITY (CA) | $299.67 | $203.03 |
| EL CENTRO (CA) | $299.74 | $203.10 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $318.11 | $212.65 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $306.98 | $206.55 |
| SANTA MARIA-SANTA BARBARA (CA) | $312.72 | $209.90 |
| REST OF CALIFORNIA (CA) | $299.67 | $203.03 |
| COLORADO (CO) | $297.23 | $203.41 |
| CONNECTICUT (CT) | $306.43 | $211.47 |
| DC + MD/VA SUBURBS (DC) | $325.74 | $221.87 |
| DELAWARE (DE) | $285.28 | $198.16 |
| FORT LAUDERDALE (FL) | $302.06 | $212.74 |
| MIAMI (FL) | $317.18 | $225.39 |
| REST OF FLORIDA (FL) | $287.99 | $203.70 |
| ATLANTA (GA) | $294.17 | $204.58 |
| REST OF GEORGIA (GA) | $272.65 | $193.99 |
| HAWAII, GUAM (HI) | $305.49 | $205.24 |
| IOWA (IA) | $265.14 | $184.46 |
| IDAHO (ID) | $267.08 | $185.96 |
| EAST ST. LOUIS (IL) | $289.21 | $208.09 |
| SUBURBAN CHICAGO (IL) | $304.65 | $214.10 |
| CHICAGO (IL) | $308.43 | $219.81 |
| REST OF ILLINOIS (IL) | $281.54 | $201.04 |
| INDIANA (IN) | $268.46 | $186.72 |
| KANSAS (KS) | $264.81 | $185.09 |
| KENTUCKY (KY) | $268.16 | $189.77 |
| NEW ORLEANS (LA) | $280.17 | $197.20 |
| REST OF LOUISIANA (LA) | $268.10 | $190.06 |
| METROPOLITAN BOSTON (MA) | $323.91 | $218.63 |
| REST OF MASSACHUSETTS (MA) | $296.01 | $203.15 |
| BALTIMORE/SURR. CNTYS (MD) | $305.73 | $211.11 |
| REST OF MARYLAND (MD) | $290.15 | $200.91 |
| SOUTHERN MAINE (ME) | $281.42 | $194.04 |
| REST OF MAINE (ME) | $269.22 | $188.10 |
| DETROIT (MI) | $292.15 | $207.06 |
| REST OF MICHIGAN (MI) | $275.31 | $194.80 |
| MINNESOTA (MN) | $283.07 | $192.33 |
| METROPOLITAN ST. LOUIS (MO) | $280.12 | $196.17 |
| METROPOLITAN KANSAS CITY (MO) | $277.55 | $194.75 |
| REST OF MISSOURI (MO) | $264.41 | $188.41 |
| MISSISSIPPI (MS) | $260.87 | $184.95 |
| MONTANA** (MT) | $288.22 | $200.04 |
| NORTH CAROLINA (NC) | $271.67 | $189.40 |
| NORTH DAKOTA** (ND) | $279.72 | $191.54 |
| NEBRASKA (NE) | $266.23 | $184.84 |
| NEW HAMPSHIRE (NH) | $293.42 | $201.63 |
| NORTHERN NJ (NJ) | $322.97 | $220.69 |
| REST OF NEW JERSEY (NJ) | $309.44 | $213.15 |
| NEW MEXICO (NM) | $277.03 | $196.17 |
| NEVADA** (NV) | $286.02 | $197.75 |
| MANHATTAN (NY) | $330.86 | $228.39 |
| NYC SUBURBS/LONG ISLAND (NY) | $339.34 | $234.49 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $312.09 | $215.54 |
| QUEENS (NY) | $332.19 | $227.96 |
| REST OF NEW YORK (NY) | $275.48 | $191.71 |
| OHIO (OH) | $273.57 | $193.07 |
| OKLAHOMA (OK) | $266.86 | $188.11 |
| PORTLAND (OR) | $305.11 | $207.14 |
| REST OF OREGON (OR) | $283.30 | $195.48 |
| METROPOLITAN PHILADELPHIA (PA) | $299.86 | $208.07 |
| REST OF PENNSYLVANIA (PA) | $273.52 | $192.57 |
| PUERTO RICO (PR) | $289.90 | $200.76 |
| RHODE ISLAND (RI) | $294.28 | $203.19 |
| SOUTH CAROLINA (SC) | $273.17 | $191.70 |
| SOUTH DAKOTA** (SD) | $278.71 | $190.53 |
| TENNESSEE (TN) | $266.13 | $185.97 |
| BRAZORIA (TX) | $284.39 | $197.01 |
| DALLAS (TX) | $286.47 | $198.64 |
| GALVESTON (TX) | $285.42 | $197.86 |
| HOUSTON (TX) | $293.29 | $205.73 |
| BEAUMONT (TX) | $271.93 | $191.69 |
| FORT WORTH (TX) | $284.95 | $198.01 |
| AUSTIN (TX) | $296.68 | $203.39 |
| REST OF TEXAS (TX) | $278.19 | $194.50 |
| UTAH (UT) | $276.58 | $193.70 |
| VIRGINIA (VA) | $281.14 | $194.46 |
| VIRGIN ISLANDS (VI) | $289.90 | $200.76 |
| VERMONT (VT) | $279.45 | $192.16 |
| SEATTLE (KING CNTY) (WA) | $329.41 | $221.21 |
| REST OF WASHINGTON (WA) | $295.18 | $202.33 |
| WISCONSIN (WI) | $271.17 | $186.70 |
| WEST VIRGINIA (WV) | $272.17 | $195.54 |
| WYOMING** (WY) | $284.52 | $196.34 |
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Maximum units per day (MUE)
Medicare’s Medically Unlikely Edit caps this code at 2 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): physician work, practice expense (PE), and malpractice (MP). Each RVU component is adjusted by locality-specific Geographic Practice Cost Indices (GPCIs) to reflect regional cost differences, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different PE RVUs because practice expense burden differs depending on where the service is performed. The national figures shown here use national averages; actual locality-based payments will vary.
RVUs — work 3.11, practice expense 5.09 (non-facility) / 2.45 (facility), malpractice 0.43 — × 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 insurer covers the remainder.
- Actual payment can vary by locality GPCIs, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
- Always verify current amounts with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.
Frequently asked
Why does the facility amount differ from the non-facility amount for CPT 11444?
Facility and non-facility rates differ mainly because of practice expense RVUs. When a procedure is performed in a facility (like a hospital), the facility bears more of the overhead cost, so the physician's PE RVU—and thus the payment—is lower than when the same code is billed for a non-facility (office) setting.
Does the conversion factor change every year?
Yes. CMS updates the conversion factor annually, and budget-neutrality adjustments, legislative changes, and RVU updates can all affect the final PFS amount from one year to the next.
Why can't you show the CPT code description?
CPT codes and their descriptors are copyrighted by the American Medical Association (AMA) and require a license to display. This page shows only the code and its associated payment data.
Will my locality's payment match the national amount shown here?
Not necessarily. The national amount is a reference calculated using national GPCI values; actual reimbursement in your locality will differ based on that area's specific GPCI adjustments for work, practice expense, and malpractice.
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.
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