Medicare Reimbursement for CPT 12044

CPT 12044 is a procedure code defined by the American Medical Association; its official descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, nationally and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$388.12	$190.72
ALASKA* (AK)	$450.98	$240.75
ALABAMA (AL)	$348.05	$175.32
ARKANSAS (AR)	$342.98	$173.42
ARIZONA (AZ)	$377.65	$186.37
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$500.05	$221.72
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$509.82	$225.17
OXNARD-THOUSAND OAKS-VENTURA (CA)	$434.54	$201.22
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$436.77	$203.24
NAPA (CA)	$473.15	$212.98
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$500.55	$222.22
VALLEJO (CA)	$472.43	$212.26
BAKERSFIELD (CA)	$410.22	$193.87
CHICO (CA)	$408.94	$192.59
FRESNO (CA)	$408.94	$192.59
HANFORD-CORCORAN (CA)	$408.94	$192.59
MADERA (CA)	$408.94	$192.59
MERCED (CA)	$408.94	$192.59
MODESTO (CA)	$408.94	$192.59
REDDING (CA)	$408.94	$192.59
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$413.70	$197.35
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$428.97	$199.40
SALINAS (CA)	$427.38	$198.59
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$511.86	$227.21
SANTA CRUZ-WATSONVILLE (CA)	$441.43	$201.59
SANTA ROSA-PETALUMA (CA)	$445.87	$203.47
STOCKTON (CA)	$408.94	$192.59
VISALIA (CA)	$408.94	$192.59
YUBA CITY (CA)	$408.94	$192.59
EL CENTRO (CA)	$409.02	$192.67
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$437.33	$201.25
SAN LUIS OBISPO-PASO ROBLES (CA)	$420.53	$195.69
SANTA MARIA-SANTA BARBARA (CA)	$428.95	$198.78
REST OF CALIFORNIA (CA)	$408.94	$192.59
COLORADO (CO)	$403.40	$193.36
CONNECTICUT (CT)	$414.04	$201.44
DC + MD/VA SUBURBS (DC)	$443.37	$210.83
DELAWARE (DE)	$383.92	$188.89
FORT LAUDERDALE (FL)	$403.50	$203.53
MIAMI (FL)	$421.64	$216.15
REST OF FLORIDA (FL)	$383.65	$194.94
ATLANTA (GA)	$395.70	$195.14
REST OF GEORGIA (GA)	$361.83	$185.75
HAWAII, GUAM (HI)	$418.86	$194.42
IOWA (IA)	$356.35	$175.72
IDAHO (ID)	$358.81	$177.20
EAST ST. LOUIS (IL)	$381.46	$199.85
SUBURBAN CHICAGO (IL)	$407.47	$204.74
CHICAGO (IL)	$409.23	$210.84
REST OF ILLINOIS (IL)	$372.94	$192.72
INDIANA (IN)	$360.89	$177.90
KANSAS (KS)	$354.95	$176.50
KENTUCKY (KY)	$356.95	$181.46
NEW ORLEANS (LA)	$374.21	$188.46
REST OF LOUISIANA (LA)	$356.50	$181.81
METROPOLITAN BOSTON (MA)	$443.05	$207.36
REST OF MASSACHUSETTS (MA)	$401.08	$193.22
BALTIMORE/SURR. CNTYS (MD)	$412.94	$201.13
REST OF MARYLAND (MD)	$391.19	$191.42
SOUTHERN MAINE (ME)	$380.27	$184.65
REST OF MAINE (ME)	$361.00	$179.39
DETROIT (MI)	$388.77	$198.28
REST OF MICHIGAN (MI)	$366.56	$186.34
MINNESOTA (MN)	$385.59	$182.47
METROPOLITAN ST. LOUIS (MO)	$375.21	$187.29
METROPOLITAN KANSAS CITY (MO)	$371.34	$185.98
REST OF MISSOURI (MO)	$350.54	$180.38
MISSISSIPPI (MS)	$346.82	$176.86
MONTANA** (MT)	$388.09	$190.69
NORTH CAROLINA (NC)	$364.75	$180.58
NORTH DAKOTA** (ND)	$379.39	$181.99
NEBRASKA (NE)	$358.22	$176.02
NEW HAMPSHIRE (NH)	$397.33	$191.84
NORTHERN NJ (NJ)	$438.79	$209.81
REST OF NEW JERSEY (NJ)	$418.50	$202.94
NEW MEXICO (NM)	$368.70	$187.69
NEVADA** (NV)	$385.93	$188.34
MANHATTAN (NY)	$447.04	$217.67
NYC SUBURBS/LONG ISLAND (NY)	$458.31	$223.60
POUGHKPSIE/N NYC SUBURBS (NY)	$421.49	$205.33
QUEENS (NY)	$450.32	$216.99
REST OF NEW YORK (NY)	$370.28	$182.75
OHIO (OH)	$364.79	$184.56
OKLAHOMA (OK)	$356.00	$179.72
PORTLAND (OR)	$415.94	$196.63
REST OF OREGON (OR)	$382.68	$186.07
METROPOLITAN PHILADELPHIA (PA)	$403.88	$198.38
REST OF PENNSYLVANIA (PA)	$365.21	$183.99
PUERTO RICO (PR)	$390.86	$191.29
RHODE ISLAND (RI)	$397.40	$193.49
SOUTH CAROLINA (SC)	$365.43	$183.03
SOUTH DAKOTA** (SD)	$378.36	$180.96
TENNESSEE (TN)	$356.79	$177.35
BRAZORIA (TX)	$383.29	$187.67
DALLAS (TX)	$385.89	$189.28
GALVESTON (TX)	$384.53	$188.52
HOUSTON (TX)	$392.59	$196.57
BEAUMONT (TX)	$362.82	$183.18
FORT WORTH (TX)	$383.38	$188.75
AUSTIN (TX)	$402.28	$193.44
REST OF TEXAS (TX)	$372.95	$185.61
UTAH (UT)	$370.45	$184.89
VIRGINIA (VA)	$379.22	$185.17
VIRGIN ISLANDS (VI)	$390.86	$191.29
VERMONT (VT)	$378.16	$182.74
SEATTLE (KING CNTY) (WA)	$451.81	$209.60
REST OF WASHINGTON (WA)	$400.24	$192.38
WISCONSIN (WI)	$366.63	$177.52
WEST VIRGINIA (WV)	$359.14	$187.60
WYOMING** (WY)	$384.30	$186.90

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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 PFS amounts are built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by 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 conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because the resource costs differ depending on where the service is performed. This is why the same code can show two different national and locality-specific allowed amounts.

RVUs — work 3.11, practice expense 8.07 (non-facility) / 2.16 (facility), malpractice 0.44 — × 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.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Actual payment varies by Medicare Administrative Contractor (MAC) and locality; always verify current rates with your MAC before billing.

Frequently asked

Why are the non-facility and facility amounts different for CPT 12044?

The practice-expense RVU differs by setting because the resources (staff, equipment, supplies) a physician practice bears are higher in a non-facility setting like an office compared to a hospital or facility setting, where the facility itself absorbs some of those costs.

Does this amount reflect what my specific locality will pay?

The national amount is a baseline; actual payment depends on the GPCI values for the specific locality where the service was performed, which can raise or lower the amount shown here.

Will CPT 12044 always be paid at this rate?

No. The conversion factor and RVUs are updated annually, and claim-specific factors such as modifiers, place of service, and sequestration can change the actual reimbursement.

Where can I find the official CPT descriptor for this code?

The official CPT code descriptor is copyrighted by the American Medical Association and must be obtained through AMA-licensed sources, such as the CPT codebook or a licensed EHR/billing system.

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.