Medicare Reimbursement for CPT Code 11760

This page covers a specific CPT procedure code (descriptor not shown due to AMA licensing restrictions). It displays the estimated Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both at the national level and adjusted by locality, and shown separately for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$186.71	$103.88
ALASKA* (AK)	$218.69	$130.47
ALABAMA (AL)	$168.05	$95.57
ARKANSAS (AR)	$165.69	$94.54
ARIZONA (AZ)	$181.85	$101.59
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$240.28	$123.49
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$244.97	$125.53
OXNARD-THOUSAND OAKS-VENTURA (CA)	$208.97	$111.06
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$210.04	$112.05
NAPA (CA)	$227.40	$118.23
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$240.50	$123.70
VALLEJO (CA)	$227.09	$117.92
BAKERSFIELD (CA)	$197.46	$106.67
CHICO (CA)	$196.89	$106.10
FRESNO (CA)	$196.89	$106.10
HANFORD-CORCORAN (CA)	$196.89	$106.10
MADERA (CA)	$196.89	$106.10
MERCED (CA)	$196.89	$106.10
MODESTO (CA)	$196.89	$106.10
REDDING (CA)	$196.89	$106.10
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$198.95	$108.16
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$206.42	$110.09
SALINAS (CA)	$205.65	$109.64
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$245.86	$126.41
SANTA CRUZ-WATSONVILLE (CA)	$212.24	$111.60
SANTA ROSA-PETALUMA (CA)	$214.37	$112.65
STOCKTON (CA)	$196.89	$106.10
VISALIA (CA)	$196.89	$106.10
YUBA CITY (CA)	$196.89	$106.10
EL CENTRO (CA)	$196.92	$106.13
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$210.34	$111.27
SAN LUIS OBISPO-PASO ROBLES (CA)	$202.36	$108.01
SANTA MARIA-SANTA BARBARA (CA)	$206.38	$109.79
REST OF CALIFORNIA (CA)	$196.89	$106.10
COLORADO (CO)	$194.10	$105.97
CONNECTICUT (CT)	$198.90	$109.69
DC + MD/VA SUBURBS (DC)	$212.95	$115.37
DELAWARE (DE)	$184.81	$102.97
FORT LAUDERDALE (FL)	$193.49	$109.58
MIAMI (FL)	$201.63	$115.40
REST OF FLORIDA (FL)	$184.30	$105.11
ATLANTA (GA)	$190.18	$106.02
REST OF GEORGIA (GA)	$174.19	$100.30
HAWAII, GUAM (HI)	$201.47	$107.29
IOWA (IA)	$172.07	$96.27
IDAHO (ID)	$173.19	$96.98
EAST ST. LOUIS (IL)	$182.97	$106.76
SUBURBAN CHICAGO (IL)	$195.42	$110.35
CHICAGO (IL)	$195.94	$112.69
REST OF ILLINOIS (IL)	$179.21	$103.58
INDIANA (IN)	$174.16	$97.37
KANSAS (KS)	$171.35	$96.46
KENTUCKY (KY)	$172.05	$98.41
NEW ORLEANS (LA)	$180.07	$102.12
REST OF LOUISIANA (LA)	$171.81	$98.50
METROPOLITAN BOSTON (MA)	$212.88	$113.97
REST OF MASSACHUSETTS (MA)	$193.02	$105.79
BALTIMORE/SURR. CNTYS (MD)	$198.35	$109.47
REST OF MARYLAND (MD)	$188.25	$104.42
SOUTHERN MAINE (ME)	$183.22	$101.14
REST OF MAINE (ME)	$174.13	$97.92
DETROIT (MI)	$186.61	$106.68
REST OF MICHIGAN (MI)	$176.46	$100.83
MINNESOTA (MN)	$185.93	$100.70
METROPOLITAN ST. LOUIS (MO)	$180.62	$101.76
METROPOLITAN KANSAS CITY (MO)	$178.80	$101.02
REST OF MISSOURI (MO)	$168.98	$97.58
MISSISSIPPI (MS)	$167.37	$96.05
MONTANA** (MT)	$186.70	$103.86
NORTH CAROLINA (NC)	$175.89	$98.61
NORTH DAKOTA** (ND)	$182.94	$100.11
NEBRASKA (NE)	$172.96	$96.51
NEW HAMPSHIRE (NH)	$191.14	$104.90
NORTHERN NJ (NJ)	$210.85	$114.76
REST OF NEW JERSEY (NJ)	$201.16	$110.70
NEW MEXICO (NM)	$177.42	$101.47
NEVADA** (NV)	$185.78	$102.86
MANHATTAN (NY)	$214.44	$118.19
NYC SUBURBS/LONG ISLAND (NY)	$219.60	$121.11
POUGHKPSIE/N NYC SUBURBS (NY)	$202.52	$111.82
QUEENS (NY)	$216.08	$118.17
REST OF NEW YORK (NY)	$178.46	$99.77
OHIO (OH)	$175.69	$100.06
OKLAHOMA (OK)	$171.68	$97.71
PORTLAND (OR)	$200.06	$108.03
REST OF OREGON (OR)	$184.32	$101.81
METROPOLITAN PHILADELPHIA (PA)	$194.11	$107.88
REST OF PENNSYLVANIA (PA)	$175.93	$99.89
PUERTO RICO (PR)	$188.02	$104.27
RHODE ISLAND (RI)	$191.23	$105.67
SOUTH CAROLINA (SC)	$176.09	$99.55
SOUTH DAKOTA** (SD)	$182.50	$99.66
TENNESSEE (TN)	$172.19	$96.90
BRAZORIA (TX)	$184.59	$102.51
DALLAS (TX)	$185.78	$103.28
GALVESTON (TX)	$185.15	$102.90
HOUSTON (TX)	$188.63	$106.38
BEAUMONT (TX)	$174.81	$99.43
FORT WORTH (TX)	$184.59	$102.91
AUSTIN (TX)	$193.47	$105.84
REST OF TEXAS (TX)	$179.61	$101.00
UTAH (UT)	$178.43	$100.56
VIRGINIA (VA)	$182.68	$101.26
VIRGIN ISLANDS (VI)	$188.02	$104.27
VERMONT (VT)	$182.30	$100.30
SEATTLE (KING CNTY) (WA)	$217.09	$115.45
REST OF WASHINGTON (WA)	$192.63	$105.40
WISCONSIN (WI)	$176.97	$97.62
WEST VIRGINIA (WV)	$172.78	$100.79
WYOMING** (WY)	$185.06	$102.23

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 4 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, and malpractice — assigned to the code. Each RVU component is adjusted using the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is furnished, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Non-facility and facility rates differ mainly because the practice-expense RVU is higher when the physician's own overhead (supplies, staff, equipment) is used, versus lower when the service is furnished in a facility that bills its own overhead separately.

RVUs — work 1.59, practice expense 3.81 (non-facility) / 1.33 (facility), malpractice 0.19 — × 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 patient or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, place of service, sequestration reductions, and annual budget-neutrality adjustments to RVUs or the conversion factor.
Always confirm the current allowed amount and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why is the facility amount lower than the non-facility amount for this code?

The facility rate uses a lower practice-expense RVU because the facility (e.g., hospital) bears the overhead cost of supplies and staff, whereas the non-facility rate assumes the physician's practice covers those costs.

Does this amount reflect what I will actually be paid?

No. It's a national or locality-adjusted estimate based on standard RVUs and the conversion factor. Your actual payment depends on your specific locality, contract, modifiers, and any sequestration or policy adjustments in effect.

Why do amounts change year to year?

CMS updates RVUs, GPCIs, and the conversion factor annually, and applies budget-neutrality adjustments, which can raise or lower the calculated allowed amount even if the code itself hasn't changed.

Can I use this figure to appeal a denial?

This estimate can help you gauge whether a paid or denied amount looks reasonable, but for an actual appeal you should reference the Medicare Administrative Contractor's fee schedule and remittance advice for the specific claim.

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.