Medicare Reimbursement for CPT 11983

CPT 11983 is a procedure code defined by the American Medical Association (AMA); its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for 2026, nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$144.63	$88.85
ALASKA* (AK)	$175.21	$115.81
ALABAMA (AL)	$130.80	$82.00
ARKANSAS (AR)	$129.09	$81.17
ARIZONA (AZ)	$140.79	$86.73
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$173.17	$94.52
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$176.06	$95.62
OXNARD-THOUSAND OAKS-VENTURA (CA)	$155.03	$89.10
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$156.38	$90.39
NAPA (CA)	$165.58	$92.06
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$173.55	$94.90
VALLEJO (CA)	$165.02	$91.50
BAKERSFIELD (CA)	$148.20	$87.06
CHICO (CA)	$147.24	$86.11
FRESNO (CA)	$147.24	$86.11
HANFORD-CORCORAN (CA)	$147.24	$86.11
MADERA (CA)	$147.24	$86.11
MERCED (CA)	$147.24	$86.11
MODESTO (CA)	$147.24	$86.11
REDDING (CA)	$147.24	$86.11
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$150.90	$89.77
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$153.19	$88.32
SALINAS (CA)	$152.59	$87.95
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$177.64	$97.20
SANTA CRUZ-WATSONVILLE (CA)	$155.96	$88.19
SANTA ROSA-PETALUMA (CA)	$157.44	$88.94
STOCKTON (CA)	$147.24	$86.11
VISALIA (CA)	$147.24	$86.11
YUBA CITY (CA)	$147.24	$86.11
EL CENTRO (CA)	$147.30	$86.16
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$155.23	$88.52
SAN LUIS OBISPO-PASO ROBLES (CA)	$150.30	$86.77
SANTA MARIA-SANTA BARBARA (CA)	$152.91	$87.87
REST OF CALIFORNIA (CA)	$147.24	$86.11
COLORADO (CO)	$147.44	$88.09
CONNECTICUT (CT)	$153.73	$93.66
DC + MD/VA SUBURBS (DC)	$161.93	$96.22
DELAWARE (DE)	$142.94	$87.83
FORT LAUDERDALE (FL)	$154.73	$98.22
MIAMI (FL)	$164.91	$106.84
REST OF FLORIDA (FL)	$147.21	$93.88
ATLANTA (GA)	$148.23	$91.56
REST OF GEORGIA (GA)	$139.12	$89.37
HAWAII, GUAM (HI)	$149.59	$86.17
IOWA (IA)	$131.73	$80.69
IDAHO (ID)	$132.95	$81.63
EAST ST. LOUIS (IL)	$150.45	$99.13
SUBURBAN CHICAGO (IL)	$155.75	$98.46
CHICAGO (IL)	$160.12	$104.06
REST OF ILLINOIS (IL)	$144.83	$93.90
INDIANA (IN)	$133.60	$81.89
KANSAS (KS)	$132.16	$81.74
KENTUCKY (KY)	$135.76	$86.18
NEW ORLEANS (LA)	$141.97	$89.48
REST OF LOUISIANA (LA)	$135.97	$86.60
METROPOLITAN BOSTON (MA)	$159.73	$93.13
REST OF MASSACHUSETTS (MA)	$147.09	$88.35
BALTIMORE/SURR. CNTYS (MD)	$153.50	$93.65
REST OF MARYLAND (MD)	$145.17	$88.72
SOUTHERN MAINE (ME)	$139.80	$84.52
REST OF MAINE (ME)	$134.64	$83.32
DETROIT (MI)	$149.93	$96.10
REST OF MICHIGAN (MI)	$139.90	$88.97
MINNESOTA (MN)	$138.69	$81.30
METROPOLITAN ST. LOUIS (MO)	$141.23	$88.13
METROPOLITAN KANSAS CITY (MO)	$140.02	$87.65
REST OF MISSOURI (MO)	$134.51	$86.43
MISSISSIPPI (MS)	$131.77	$83.75
MONTANA** (MT)	$144.60	$88.82
NORTH CAROLINA (NC)	$135.76	$83.72
NORTH DAKOTA** (ND)	$137.88	$82.10
NEBRASKA (NE)	$132.08	$80.60
NEW HAMPSHIRE (NH)	$146.12	$88.06
NORTHERN NJ (NJ)	$160.70	$95.99
REST OF NEW JERSEY (NJ)	$154.76	$93.85
NEW MEXICO (NM)	$141.00	$89.85
NEVADA** (NV)	$142.80	$86.97
MANHATTAN (NY)	$166.78	$101.97
NYC SUBURBS/LONG ISLAND (NY)	$171.78	$105.46
POUGHKPSIE/N NYC SUBURBS (NY)	$156.57	$95.49
QUEENS (NY)	$166.57	$100.64
REST OF NEW YORK (NY)	$137.70	$84.71
OHIO (OH)	$138.53	$87.60
OKLAHOMA (OK)	$134.48	$84.67
PORTLAND (OR)	$150.61	$88.64
REST OF OREGON (OR)	$140.97	$85.41
METROPOLITAN PHILADELPHIA (PA)	$150.85	$92.79
REST OF PENNSYLVANIA (PA)	$138.17	$86.96
PUERTO RICO (PR)	$145.24	$88.85
RHODE ISLAND (RI)	$146.93	$89.31
SOUTH CAROLINA (SC)	$137.52	$85.98
SOUTH DAKOTA** (SD)	$137.09	$81.31
TENNESSEE (TN)	$132.89	$82.19
BRAZORIA (TX)	$141.98	$86.71
DALLAS (TX)	$143.29	$87.73
GALVESTON (TX)	$142.67	$87.28
HOUSTON (TX)	$148.89	$93.51
BEAUMONT (TX)	$137.42	$86.66
FORT WORTH (TX)	$142.72	$87.73
AUSTIN (TX)	$147.58	$88.57
REST OF TEXAS (TX)	$139.90	$86.96
UTAH (UT)	$139.20	$86.77
VIRGINIA (VA)	$140.08	$85.25
VIRGIN ISLANDS (VI)	$145.24	$88.85
VERMONT (VT)	$138.30	$83.08
SEATTLE (KING CNTY) (WA)	$161.80	$93.36
REST OF WASHINGTON (WA)	$146.49	$87.75
WISCONSIN (WI)	$133.78	$80.34
WEST VIRGINIA (WV)	$140.20	$91.73
WYOMING** (WY)	$141.67	$85.89

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit 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. 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 conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs, since overhead costs differ, which is why the two amounts shown differ. The conversion factor is updated annually and applied uniformly before locality adjustments and any budget-neutrality or sequestration changes.

RVUs — work 1.86, practice expense 2.13 (non-facility) / 0.46 (facility), malpractice 0.34 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This figure is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary insurer is generally responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why is the non-facility amount higher than the facility amount?

The non-facility rate includes higher practice-expense RVUs because the billing provider is assumed to be covering overhead costs (e.g., supplies, staff, equipment) that a facility would otherwise absorb.

Does this amount reflect what my practice will actually be paid?

No — it's a national or locality-adjusted estimate based on standard RVUs and the conversion factor. Actual reimbursement depends on your specific MAC, contract terms, modifiers, and any sequestration or policy adjustments in effect.

Why can't you show the CPT code's description?

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

How often does the conversion factor change?

The conversion factor is typically updated annually by CMS, often as part of the Medicare Physician Fee Schedule final rule, and can shift due to legislative or budget-neutrality adjustments.

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.