Medicare Reimbursement for CPT Code 12032

CPT code 12032 is a procedure code defined by the American Medical Association; the specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both at the national level and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$299.94	$165.00
ALASKA* (AK)	$350.71	$207.00
ALABAMA (AL)	$270.03	$151.96
ARKANSAS (AR)	$266.25	$150.33
ARIZONA (AZ)	$292.21	$161.45
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$388.48	$198.21
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$396.16	$201.58
OXNARD-THOUSAND OAKS-VENTURA (CA)	$337.02	$177.52
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$338.65	$179.02
NAPA (CA)	$367.33	$189.48
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$388.77	$198.51
VALLEJO (CA)	$366.91	$189.06
BAKERSFIELD (CA)	$318.18	$170.28
CHICO (CA)	$317.38	$169.49
FRESNO (CA)	$317.38	$169.49
HANFORD-CORCORAN (CA)	$317.38	$169.49
MADERA (CA)	$317.38	$169.49
MERCED (CA)	$317.38	$169.49
MODESTO (CA)	$317.38	$169.49
REDDING (CA)	$317.38	$169.49
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$320.22	$172.32
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$332.95	$176.02
SALINAS (CA)	$331.70	$175.31
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$397.37	$202.78
SANTA CRUZ-WATSONVILLE (CA)	$342.59	$178.64
SANTA ROSA-PETALUMA (CA)	$346.05	$180.34
STOCKTON (CA)	$317.38	$169.49
VISALIA (CA)	$317.38	$169.49
YUBA CITY (CA)	$317.38	$169.49
EL CENTRO (CA)	$317.42	$169.53
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$339.41	$178.02
SAN LUIS OBISPO-PASO ROBLES (CA)	$326.37	$172.67
SANTA MARIA-SANTA BARBARA (CA)	$332.92	$175.58
REST OF CALIFORNIA (CA)	$317.38	$169.49
COLORADO (CO)	$312.41	$168.83
CONNECTICUT (CT)	$319.51	$174.18
DC + MD/VA SUBURBS (DC)	$342.58	$183.62
DELAWARE (DE)	$296.96	$163.64
FORT LAUDERDALE (FL)	$309.68	$172.98
MIAMI (FL)	$321.79	$181.32
REST OF FLORIDA (FL)	$295.11	$166.11
ATLANTA (GA)	$305.28	$168.18
REST OF GEORGIA (GA)	$279.03	$158.66
HAWAII, GUAM (HI)	$324.93	$171.50
IOWA (IA)	$276.93	$153.46
IDAHO (ID)	$278.64	$154.49
EAST ST. LOUIS (IL)	$292.02	$167.87
SUBURBAN CHICAGO (IL)	$312.86	$174.28
CHICAGO (IL)	$312.81	$177.19
REST OF ILLINOIS (IL)	$286.64	$163.44
INDIANA (IN)	$280.21	$155.12
KANSAS (KS)	$275.56	$153.57
KENTUCKY (KY)	$275.99	$156.03
NEW ORLEANS (LA)	$288.78	$161.81
REST OF LOUISIANA (LA)	$275.53	$156.11
METROPOLITAN BOSTON (MA)	$342.92	$181.80
REST OF MASSACHUSETTS (MA)	$310.57	$168.48
BALTIMORE/SURR. CNTYS (MD)	$318.58	$173.79
REST OF MARYLAND (MD)	$302.56	$166.00
SOUTHERN MAINE (ME)	$294.85	$161.13
REST OF MAINE (ME)	$279.93	$155.79
DETROIT (MI)	$298.58	$168.36
REST OF MICHIGAN (MI)	$282.87	$159.67
MINNESOTA (MN)	$299.89	$161.04
METROPOLITAN ST. LOUIS (MO)	$289.92	$161.46
METROPOLITAN KANSAS CITY (MO)	$286.99	$160.28
REST OF MISSOURI (MO)	$270.86	$154.54
MISSISSIPPI (MS)	$268.61	$152.43
MONTANA** (MT)	$299.92	$164.98
NORTH CAROLINA (NC)	$282.80	$156.90
NORTH DAKOTA** (ND)	$294.78	$159.84
NEBRASKA (NE)	$278.44	$153.89
NEW HAMPSHIRE (NH)	$307.43	$166.96
NORTHERN NJ (NJ)	$339.16	$182.63
REST OF NEW JERSEY (NJ)	$323.31	$175.95
NEW MEXICO (NM)	$284.33	$160.59
NEVADA** (NV)	$298.70	$163.62
MANHATTAN (NY)	$344.16	$187.36
NYC SUBURBS/LONG ISLAND (NY)	$352.16	$191.72
POUGHKPSIE/N NYC SUBURBS (NY)	$325.32	$177.57
QUEENS (NY)	$347.09	$187.59
REST OF NEW YORK (NY)	$286.91	$158.71
OHIO (OH)	$281.82	$158.62
OKLAHOMA (OK)	$275.63	$155.13
PORTLAND (OR)	$322.24	$172.32
REST OF OREGON (OR)	$296.52	$162.12
METROPOLITAN PHILADELPHIA (PA)	$311.67	$171.20
REST OF PENNSYLVANIA (PA)	$282.32	$158.44
PUERTO RICO (PR)	$302.11	$165.69
RHODE ISLAND (RI)	$307.46	$168.07
SOUTH CAROLINA (SC)	$282.75	$158.06
SOUTH DAKOTA** (SD)	$294.17	$159.23
TENNESSEE (TN)	$276.89	$154.23
BRAZORIA (TX)	$296.81	$163.08
DALLAS (TX)	$298.61	$164.21
GALVESTON (TX)	$297.64	$163.65
HOUSTON (TX)	$302.40	$168.40
BEAUMONT (TX)	$280.51	$157.71
FORT WORTH (TX)	$296.63	$163.58
AUSTIN (TX)	$311.24	$168.48
REST OF TEXAS (TX)	$288.43	$160.38
UTAH (UT)	$286.51	$159.67
VIRGINIA (VA)	$293.83	$161.19
VIRGIN ISLANDS (VI)	$302.11	$165.69
VERMONT (VT)	$293.56	$159.97
SEATTLE (KING CNTY) (WA)	$349.92	$184.35
REST OF WASHINGTON (WA)	$310.01	$167.92
WISCONSIN (WI)	$285.15	$155.88
WEST VIRGINIA (WV)	$276.29	$159.03
WYOMING** (WY)	$297.68	$162.74

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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 allowed amount for this procedure code is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted using the Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why two separate national and locality-adjusted amounts are shown. The conversion factor is updated annually and applies uniformly across all codes in a given year.

RVUs — work 2.46, practice expense 6.26 (non-facility) / 2.22 (facility), malpractice 0.26 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

All figures are estimates based on the published PFS formula and are not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets the annual deductible; the patient or secondary insurance is responsible for the remainder.
Actual payment can be affected by modifiers, place of service, sequestration reductions, and annual budget-neutrality adjustments.
Locality-adjusted amounts depend on the GPCI values for the specific Medicare locality and may differ from the national figures shown.
Always verify the final allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why are there two different amounts for this code?

Medicare calculates separate allowed amounts for non-facility (e.g., office) and facility (e.g., hospital outpatient) settings because the practice expense RVU component differs based on where the service is performed.

Why might the amount my practice receives differ from the national figure shown here?

The national amount uses a GPCI of 1.000 for all components, while actual payments are adjusted using locality-specific GPCIs, which can raise or lower the amount depending on regional cost factors.

Does this amount reflect what the patient will owe?

No. The figures shown represent the Medicare-approved amount before cost-sharing. Patients are typically responsible for 20% coinsurance after meeting the deductible, unless other coverage applies.

Can modifiers change this reimbursement amount?

Yes. Modifiers such as those indicating bilateral procedures, multiple procedures, or reduced services can increase or decrease the final payment relative to the base PFS amount.

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.