Medicare Reimbursement for CPT 11750

CPT 11750 is a physician procedure code billed under Medicare Part B. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for 2026, both 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)	$157.65	$94.19
ALASKA* (AK)	$187.87	$120.28
ALABAMA (AL)	$142.93	$87.40
ARKANSAS (AR)	$141.07	$86.55
ARIZONA (AZ)	$153.83	$92.34
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$201.48	$112.00
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$205.37	$113.86
OXNARD-THOUSAND OAKS-VENTURA (CA)	$175.81	$100.80
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$176.77	$101.70
NAPA (CA)	$190.88	$107.24
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$201.64	$112.16
VALLEJO (CA)	$190.65	$107.01
BAKERSFIELD (CA)	$166.55	$96.99
CHICO (CA)	$166.10	$96.55
FRESNO (CA)	$166.10	$96.55
HANFORD-CORCORAN (CA)	$166.10	$96.55
MADERA (CA)	$166.10	$96.55
MERCED (CA)	$166.10	$96.55
MODESTO (CA)	$166.10	$96.55
REDDING (CA)	$166.10	$96.55
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$167.64	$98.08
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$173.89	$100.08
SALINAS (CA)	$173.22	$99.67
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$206.02	$114.51
SANTA CRUZ-WATSONVILLE (CA)	$178.39	$101.29
SANTA ROSA-PETALUMA (CA)	$180.18	$102.25
STOCKTON (CA)	$166.10	$96.55
VISALIA (CA)	$166.10	$96.55
YUBA CITY (CA)	$166.10	$96.55
EL CENTRO (CA)	$166.13	$96.57
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$176.96	$101.06
SAN LUIS OBISPO-PASO ROBLES (CA)	$170.47	$98.19
SANTA MARIA-SANTA BARBARA (CA)	$173.78	$99.78
REST OF CALIFORNIA (CA)	$166.10	$96.55
COLORADO (CO)	$163.74	$96.22
CONNECTICUT (CT)	$167.48	$99.13
DC + MD/VA SUBURBS (DC)	$179.03	$104.27
DELAWARE (DE)	$156.22	$93.52
FORT LAUDERDALE (FL)	$162.75	$98.46
MIAMI (FL)	$168.97	$102.90
REST OF FLORIDA (FL)	$155.54	$94.87
ATLANTA (GA)	$160.37	$95.89
REST OF GEORGIA (GA)	$147.58	$90.98
HAWAII, GUAM (HI)	$169.59	$97.44
IOWA (IA)	$146.20	$88.13
IDAHO (ID)	$147.06	$88.68
EAST ST. LOUIS (IL)	$154.27	$95.89
SUBURBAN CHICAGO (IL)	$164.36	$99.19
CHICAGO (IL)	$164.58	$100.80
REST OF ILLINOIS (IL)	$151.45	$93.51
INDIANA (IN)	$147.84	$89.01
KANSAS (KS)	$145.59	$88.22
KENTUCKY (KY)	$145.98	$89.57
NEW ORLEANS (LA)	$152.30	$92.58
REST OF LOUISIANA (LA)	$145.78	$89.62
METROPOLITAN BOSTON (MA)	$178.95	$103.17
REST OF MASSACHUSETTS (MA)	$162.91	$96.08
BALTIMORE/SURR. CNTYS (MD)	$167.00	$98.90
REST OF MARYLAND (MD)	$159.00	$94.78
SOUTHERN MAINE (ME)	$155.01	$92.12
REST OF MAINE (ME)	$147.76	$89.38
DETROIT (MI)	$157.31	$96.07
REST OF MICHIGAN (MI)	$149.42	$91.48
MINNESOTA (MN)	$157.30	$92.00
METROPOLITAN ST. LOUIS (MO)	$152.79	$92.37
METROPOLITAN KANSAS CITY (MO)	$151.35	$91.76
REST OF MISSOURI (MO)	$143.52	$88.81
MISSISSIPPI (MS)	$142.32	$87.68
MONTANA** (MT)	$157.64	$94.18
NORTH CAROLINA (NC)	$149.16	$89.95
NORTH DAKOTA** (ND)	$154.87	$91.41
NEBRASKA (NE)	$146.93	$88.35
NEW HAMPSHIRE (NH)	$161.23	$95.17
NORTHERN NJ (NJ)	$177.46	$103.84
REST OF NEW JERSEY (NJ)	$169.50	$100.20
NEW MEXICO (NM)	$150.16	$91.97
NEVADA** (NV)	$156.97	$93.45
MANHATTAN (NY)	$180.13	$106.39
NYC SUBURBS/LONG ISLAND (NY)	$184.14	$108.69
POUGHKPSIE/N NYC SUBURBS (NY)	$170.60	$101.10
QUEENS (NY)	$181.49	$106.48
REST OF NEW YORK (NY)	$151.19	$90.90
OHIO (OH)	$148.86	$90.92
OKLAHOMA (OK)	$145.74	$89.07
PORTLAND (OR)	$168.55	$98.04
REST OF OREGON (OR)	$155.86	$92.65
METROPOLITAN PHILADELPHIA (PA)	$163.64	$97.58
REST OF PENNSYLVANIA (PA)	$149.07	$90.81
PUERTO RICO (PR)	$158.70	$94.54
RHODE ISLAND (RI)	$161.48	$95.92
SOUTH CAROLINA (SC)	$149.23	$90.60
SOUTH DAKOTA** (SD)	$154.55	$91.09
TENNESSEE (TN)	$146.25	$88.56
BRAZORIA (TX)	$156.12	$93.23
DALLAS (TX)	$157.05	$93.84
GALVESTON (TX)	$156.55	$93.53
HOUSTON (TX)	$159.11	$96.09
BEAUMONT (TX)	$148.18	$90.43
FORT WORTH (TX)	$156.09	$93.52
AUSTIN (TX)	$163.11	$95.97
REST OF TEXAS (TX)	$152.02	$91.80
UTAH (UT)	$151.08	$91.43
VIRGINIA (VA)	$154.55	$92.17
VIRGIN ISLANDS (VI)	$158.70	$94.54
VERMONT (VT)	$154.33	$91.50
SEATTLE (KING CNTY) (WA)	$182.42	$104.55
REST OF WASHINGTON (WA)	$162.58	$95.76
WISCONSIN (WI)	$150.15	$89.36
WEST VIRGINIA (WV)	$146.37	$91.22
WYOMING** (WY)	$156.44	$92.97

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 6 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 payment for this code is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility amounts (e.g., office settings) generally use higher practice-expense RVUs than facility amounts (e.g., hospital settings), since the physician's overhead cost differs based on where the service takes place. This is why the same code can have two different national and locality-adjusted rates depending on place of service.

RVUs — work 1.54, practice expense 3.04 (non-facility) / 1.14 (facility), malpractice 0.14 — × 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 patient meets the Part B deductible; the patient or secondary payer is responsible for the remainder.
Actual payment varies by locality, applicable modifiers, sequestration, and annual budget-neutrality adjustments made by CMS.
Always verify the current, locality-specific fee with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

Facility rates use lower practice-expense RVUs because the facility (e.g., hospital) bears part of the overhead cost, whereas non-facility rates assume the physician's practice covers those costs directly.

Does this fee apply the same way in every state?

No. The GPCIs adjust the work, practice-expense, and malpractice RVUs based on the cost of practicing in a specific locality, so the final allowed amount can vary by geographic area.

Will this be the exact amount Medicare pays?

Not necessarily. Modifiers, multiple-procedure reductions, sequestration, and yearly budget-neutrality adjustments can all change the final paid amount from the base PFS calculation.

Where can I confirm the exact rate for my locality?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules that reflect the most current GPCIs and conversion factor for your area.

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.