Medicare Reimbursement for CPT 12014

This page covers this procedure code, a CPT-defined service billed under Medicare Part B. It displays the Medicare Physician Fee Schedule (PFS) allowed amount at the national level and adjusted for locality, shown separately for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$172.35	$72.15
ALASKA* (AK)	$199.60	$92.88
ALABAMA (AL)	$153.48	$65.80
ARKANSAS (AR)	$151.12	$65.04
ARIZONA (AZ)	$167.23	$70.13
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$215.07	$73.78
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$219.00	$74.50
OXNARD-THOUSAND OAKS-VENTURA (CA)	$189.12	$70.68
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$190.39	$71.85
NAPA (CA)	$204.38	$72.32
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$215.48	$74.19
VALLEJO (CA)	$203.80	$71.73
BAKERSFIELD (CA)	$179.10	$69.28
CHICO (CA)	$178.12	$68.30
FRESNO (CA)	$178.12	$68.30
HANFORD-CORCORAN (CA)	$178.12	$68.30
MADERA (CA)	$178.12	$68.30
MERCED (CA)	$178.12	$68.30
MODESTO (CA)	$178.12	$68.30
REDDING (CA)	$178.12	$68.30
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$181.99	$72.16
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$186.41	$69.88
SALINAS (CA)	$185.72	$69.58
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$220.67	$76.17
SANTA CRUZ-WATSONVILLE (CA)	$191.33	$69.58
SANTA ROSA-PETALUMA (CA)	$193.20	$70.16
STOCKTON (CA)	$178.12	$68.30
VISALIA (CA)	$178.12	$68.30
YUBA CITY (CA)	$178.12	$68.30
EL CENTRO (CA)	$178.18	$68.36
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$189.78	$69.94
SAN LUIS OBISPO-PASO ROBLES (CA)	$182.82	$68.69
SANTA MARIA-SANTA BARBARA (CA)	$186.33	$69.49
REST OF CALIFORNIA (CA)	$178.12	$68.30
COLORADO (CO)	$177.32	$70.70
CONNECTICUT (CT)	$184.31	$76.39
DC + MD/VA SUBURBS (DC)	$195.91	$77.87
DELAWARE (DE)	$170.08	$71.08
FORT LAUDERDALE (FL)	$183.48	$81.98
MIAMI (FL)	$195.21	$90.90
REST OF FLORIDA (FL)	$173.59	$77.80
ATLANTA (GA)	$176.67	$74.86
REST OF GEORGIA (GA)	$162.86	$73.48
HAWAII, GUAM (HI)	$182.25	$68.32
IOWA (IA)	$155.81	$64.13
IDAHO (ID)	$157.27	$65.09
EAST ST. LOUIS (IL)	$175.80	$83.62
SUBURBAN CHICAGO (IL)	$184.94	$82.03
CHICAGO (IL)	$188.82	$88.12
REST OF ILLINOIS (IL)	$169.62	$78.13
INDIANA (IN)	$158.20	$65.31
KANSAS (KS)	$155.90	$65.32
KENTUCKY (KY)	$159.20	$70.12
NEW ORLEANS (LA)	$167.54	$73.25
REST OF LOUISIANA (LA)	$159.28	$70.60
METROPOLITAN BOSTON (MA)	$194.31	$74.67
REST OF MASSACHUSETTS (MA)	$176.51	$71.00
BALTIMORE/SURR. CNTYS (MD)	$183.99	$76.47
REST OF MARYLAND (MD)	$173.18	$71.78
SOUTHERN MAINE (ME)	$166.93	$67.63
REST OF MAINE (ME)	$159.07	$66.88
DETROIT (MI)	$176.77	$80.08
REST OF MICHIGAN (MI)	$164.40	$72.91
MINNESOTA (MN)	$167.05	$63.94
METROPOLITAN ST. LOUIS (MO)	$167.13	$71.74
METROPOLITAN KANSAS CITY (MO)	$165.41	$71.32
REST OF MISSOURI (MO)	$156.96	$70.59
MISSISSIPPI (MS)	$154.03	$67.75
MONTANA** (MT)	$172.32	$72.12
NORTH CAROLINA (NC)	$160.69	$67.20
NORTH DAKOTA** (ND)	$165.21	$65.00
NEBRASKA (NE)	$156.46	$63.97
NEW HAMPSHIRE (NH)	$175.32	$71.01
NORTHERN NJ (NJ)	$193.86	$77.63
REST OF NEW JERSEY (NJ)	$185.61	$76.19
NEW MEXICO (NM)	$165.70	$73.81
NEVADA** (NV)	$170.45	$70.15
MANHATTAN (NY)	$200.36	$83.92
NYC SUBURBS/LONG ISLAND (NY)	$206.57	$87.43
POUGHKPSIE/N NYC SUBURBS (NY)	$187.55	$77.83
QUEENS (NY)	$200.81	$82.37
REST OF NEW YORK (NY)	$163.32	$68.12
OHIO (OH)	$162.94	$71.46
OKLAHOMA (OK)	$157.98	$68.50
PORTLAND (OR)	$182.21	$70.89
REST OF OREGON (OR)	$168.34	$68.54
METROPOLITAN PHILADELPHIA (PA)	$180.07	$75.76
REST OF PENNSYLVANIA (PA)	$162.73	$70.75
PUERTO RICO (PR)	$173.37	$72.06
RHODE ISLAND (RI)	$175.63	$72.12
SOUTH CAROLINA (SC)	$162.24	$69.66
SOUTH DAKOTA** (SD)	$164.36	$64.16
TENNESSEE (TN)	$156.84	$65.76
BRAZORIA (TX)	$169.13	$69.83
DALLAS (TX)	$170.66	$70.86
GALVESTON (TX)	$169.92	$70.42
HOUSTON (TX)	$176.51	$77.01
BEAUMONT (TX)	$161.67	$70.48
FORT WORTH (TX)	$169.73	$70.93
AUSTIN (TX)	$177.41	$71.40
REST OF TEXAS (TX)	$165.61	$70.52
UTAH (UT)	$164.57	$70.38
VIRGINIA (VA)	$166.96	$68.46
VIRGIN ISLANDS (VI)	$173.37	$72.06
VERMONT (VT)	$165.32	$66.12
SEATTLE (KING CNTY) (WA)	$197.50	$74.55
REST OF WASHINGTON (WA)	$175.93	$70.41
WISCONSIN (WI)	$159.44	$63.45
WEST VIRGINIA (WV)	$163.22	$76.15
WYOMING** (WY)	$169.22	$69.02

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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: Policy. 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 payment is built from three Relative Value Units (RVUs) — work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital outpatient) settings use different practice-expense RVUs, which typically makes the non-facility rate higher since it accounts for overhead the physician bears directly.

RVUs — work 1.53, practice expense 3.27 (non-facility) / 0.27 (facility), malpractice 0.36 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

All figures are estimates only and are 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.
Always confirm current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

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

Facility rates use a lower practice-expense RVU because the facility, not the billing physician, incurs most of the overhead costs (equipment, supplies, staff) when the service is performed in a hospital or other facility setting.

Does this amount apply to every state or region?

No. The national amount is a baseline; actual Medicare payment is adjusted by locality-specific GPCIs, so the final allowed amount can differ depending on where the service is rendered.

Will modifiers change this amount?

Yes. Modifiers (e.g., for bilateral procedures, reduced services, or multiple procedures) can increase or decrease the calculated payment, and are not reflected in the base estimate shown here.

Is this the amount I should expect to collect from Medicare?

This is only the Medicare allowed amount estimate. After the deductible, Medicare generally pays 80%, with the remaining 20% owed by the patient or a secondary payer, subject to further 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.