Medicare Reimbursement for CPT 11762

CPT 11762 is a procedure code defined by the American Medical Association (AMA); the specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for local geographic factors, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$294.26	$175.02
ALASKA* (AK)	$349.25	$222.26
ALABAMA (AL)	$265.95	$161.62
ARKANSAS (AR)	$262.38	$159.95
ARIZONA (AZ)	$286.83	$171.28
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$373.53	$205.40
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$380.63	$208.69
OXNARD-THOUSAND OAKS-VENTURA (CA)	$326.71	$185.76
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$328.61	$187.54
NAPA (CA)	$354.19	$197.03
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$373.91	$205.78
VALLEJO (CA)	$353.64	$196.48
BAKERSFIELD (CA)	$309.60	$178.91
CHICO (CA)	$308.58	$177.89
FRESNO (CA)	$308.58	$177.89
HANFORD-CORCORAN (CA)	$308.58	$177.89
MADERA (CA)	$308.58	$177.89
MERCED (CA)	$308.58	$177.89
MODESTO (CA)	$308.58	$177.89
REDDING (CA)	$308.58	$177.89
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$312.27	$181.59
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$322.93	$184.25
SALINAS (CA)	$321.70	$183.50
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$382.21	$210.27
SANTA CRUZ-WATSONVILLE (CA)	$331.22	$186.34
SANTA ROSA-PETALUMA (CA)	$334.51	$188.09
STOCKTON (CA)	$308.58	$177.89
VISALIA (CA)	$308.58	$177.89
YUBA CITY (CA)	$308.58	$177.89
EL CENTRO (CA)	$308.64	$177.95
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$328.60	$185.98
SAN LUIS OBISPO-PASO ROBLES (CA)	$316.62	$180.81
SANTA MARIA-SANTA BARBARA (CA)	$322.73	$183.69
REST OF CALIFORNIA (CA)	$308.58	$177.89
COLORADO (CO)	$304.90	$178.02
CONNECTICUT (CT)	$312.97	$184.54
DC + MD/VA SUBURBS (DC)	$334.02	$193.55
DELAWARE (DE)	$291.35	$173.54
FORT LAUDERDALE (FL)	$305.87	$185.08
MIAMI (FL)	$319.29	$195.16
REST OF FLORIDA (FL)	$291.74	$177.75
ATLANTA (GA)	$299.82	$178.68
REST OF GEORGIA (GA)	$276.24	$169.88
HAWAII, GUAM (HI)	$315.11	$179.53
IOWA (IA)	$271.52	$162.41
IDAHO (ID)	$273.31	$163.61
EAST ST. LOUIS (IL)	$290.81	$181.11
SUBURBAN CHICAGO (IL)	$308.75	$186.29
CHICAGO (IL)	$310.57	$190.74
REST OF ILLINOIS (IL)	$284.38	$175.52
INDIANA (IN)	$274.77	$164.23
KANSAS (KS)	$270.67	$162.88
KENTUCKY (KY)	$272.53	$166.53
NEW ORLEANS (LA)	$284.77	$172.56
REST OF LOUISIANA (LA)	$272.27	$166.75
METROPOLITAN BOSTON (MA)	$333.23	$190.86
REST OF MASSACHUSETTS (MA)	$303.40	$177.84
BALTIMORE/SURR. CNTYS (MD)	$312.14	$184.20
REST OF MARYLAND (MD)	$296.53	$175.86
SOUTHERN MAINE (ME)	$288.39	$170.22
REST OF MAINE (ME)	$275.01	$165.30
DETROIT (MI)	$295.51	$180.44
REST OF MICHIGAN (MI)	$279.45	$170.59
MINNESOTA (MN)	$291.69	$168.99
METROPOLITAN ST. LOUIS (MO)	$285.31	$171.79
METROPOLITAN KANSAS CITY (MO)	$282.59	$170.62
REST OF MISSOURI (MO)	$268.15	$165.37
MISSISSIPPI (MS)	$265.30	$162.63
MONTANA** (MT)	$294.24	$175.00
NORTH CAROLINA (NC)	$277.63	$166.38
NORTH DAKOTA** (ND)	$287.52	$168.28
NEBRASKA (NE)	$272.80	$162.74
NEW HAMPSHIRE (NH)	$300.51	$176.38
NORTHERN NJ (NJ)	$331.00	$192.68
REST OF NEW JERSEY (NJ)	$316.41	$186.19
NEW MEXICO (NM)	$281.02	$171.68
NEVADA** (NV)	$292.55	$173.19
MANHATTAN (NY)	$337.35	$198.79
NYC SUBURBS/LONG ISLAND (NY)	$345.48	$203.70
POUGHKPSIE/N NYC SUBURBS (NY)	$318.73	$188.16
QUEENS (NY)	$339.46	$198.52
REST OF NEW YORK (NY)	$281.54	$168.26
OHIO (OH)	$278.08	$169.21
OKLAHOMA (OK)	$271.72	$165.23
PORTLAND (OR)	$313.65	$181.17
REST OF OREGON (OR)	$290.14	$171.38
METROPOLITAN PHILADELPHIA (PA)	$305.85	$181.72
REST OF PENNSYLVANIA (PA)	$278.30	$168.84
PUERTO RICO (PR)	$296.15	$175.60
RHODE ISLAND (RI)	$301.03	$177.85
SOUTH CAROLINA (SC)	$278.34	$168.16
SOUTH DAKOTA** (SD)	$286.72	$167.48
TENNESSEE (TN)	$271.98	$163.59
BRAZORIA (TX)	$290.85	$172.68
DALLAS (TX)	$292.76	$174.00
GALVESTON (TX)	$291.77	$173.36
HOUSTON (TX)	$297.99	$179.58
BEAUMONT (TX)	$276.62	$168.11
FORT WORTH (TX)	$291.04	$173.47
AUSTIN (TX)	$304.01	$177.85
REST OF TEXAS (TX)	$283.62	$170.46
UTAH (UT)	$281.88	$169.79
VIRGINIA (VA)	$287.74	$170.53
VIRGIN ISLANDS (VI)	$296.15	$175.60
VERMONT (VT)	$286.78	$168.73
SEATTLE (KING CNTY) (WA)	$339.44	$193.13
REST OF WASHINGTON (WA)	$302.71	$177.15
WISCONSIN (WI)	$278.55	$164.31
WEST VIRGINIA (WV)	$274.65	$171.03
WYOMING** (WY)	$291.31	$172.07

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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 fee for each code is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar allowed amount. Non-facility and facility rates differ mainly because practice-expense RVUs are lower in facility settings, where the facility (not the physician's office) bears more of the overhead cost.

RVUs — work 2.87, practice expense 5.6 (non-facility) / 2.03 (facility), malpractice 0.34 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only — actual Medicare payment can differ based on your specific locality, contractor, and claim details.
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.
Modifiers (e.g., bilateral, multiple procedure, assistant surgeon) can increase or reduce the paid amount.
Amounts may be reduced by sequestration or other federal payment adjustments.
The conversion factor and RVUs are updated annually and may shift due to budget-neutrality adjustments.
Always verify current rates with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why is the facility rate different from the non-facility rate for this code?

Facility rates use lower practice-expense RVUs because the facility (e.g., hospital) absorbs overhead costs like staff and supplies, whereas non-facility (e.g., physician office) rates include those costs in the physician's payment.

Does this amount reflect what Medicare actually pays?

No — this is the Medicare-allowed amount before the standard 80/20 split. Medicare generally pays 80% of the allowed amount after the deductible is met, with the remaining 20% typically billed to the patient or a secondary payer.

Why might my local Medicare payment differ from the national amount shown here?

Local payments are adjusted using Geographic Practice Cost Indices (GPCIs), which account for regional differences in wages, rent, and malpractice costs. Your specific locality's GPCIs may raise or lower the amount compared to the national average.

Can I use this figure to predict my exact reimbursement?

Not precisely. This figure is a planning estimate. Final payment depends on modifiers, place of service, secondary payer coordination, and any applicable federal payment adjustments in effect at the time of service.

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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.