Medicare Reimbursement for CPT 14040

CPT 14040 is a physician procedure code; this page does not display the AMA descriptor text, but it explains how Medicare prices the service. It shows the Medicare Physician Fee Schedule (PFS) allowed amount nationally and by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$767.22	$546.10
ALASKA* (AK)	$920.62	$685.13
ALABAMA (AL)	$695.30	$501.83
ARKANSAS (AR)	$686.26	$496.32
ARIZONA (AZ)	$748.08	$533.82
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$958.30	$646.53
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$975.94	$657.10
OXNARD-THOUSAND OAKS-VENTURA (CA)	$843.72	$582.36
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$849.28	$587.70
NAPA (CA)	$910.79	$619.36
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$959.52	$647.75
VALLEJO (CA)	$909.03	$617.61
BAKERSFIELD (CA)	$801.89	$559.55
CHICO (CA)	$798.72	$556.38
FRESNO (CA)	$798.72	$556.38
HANFORD-CORCORAN (CA)	$798.72	$556.38
MADERA (CA)	$798.72	$556.38
MERCED (CA)	$798.72	$556.38
MODESTO (CA)	$798.72	$556.38
REDDING (CA)	$798.72	$556.38
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$810.33	$567.99
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$834.28	$577.12
SALINAS (CA)	$831.07	$574.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$980.91	$662.07
SANTA CRUZ-WATSONVILLE (CA)	$853.54	$584.89
SANTA ROSA-PETALUMA (CA)	$861.93	$590.40
STOCKTON (CA)	$798.72	$556.38
VISALIA (CA)	$798.72	$556.38
YUBA CITY (CA)	$798.72	$556.38
EL CENTRO (CA)	$798.90	$556.56
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$847.70	$583.25
SAN LUIS OBISPO-PASO ROBLES (CA)	$818.12	$566.27
SANTA MARIA-SANTA BARBARA (CA)	$833.39	$575.57
REST OF CALIFORNIA (CA)	$798.72	$556.38
COLORADO (CO)	$791.63	$556.37
CONNECTICUT (CT)	$815.07	$576.93
DC + MD/VA SUBURBS (DC)	$866.71	$606.24
DELAWARE (DE)	$759.60	$541.13
FORT LAUDERDALE (FL)	$801.96	$577.97
MIAMI (FL)	$840.36	$610.19
REST OF FLORIDA (FL)	$765.34	$553.96
ATLANTA (GA)	$782.46	$557.81
REST OF GEORGIA (GA)	$725.35	$528.11
HAWAII, GUAM (HI)	$813.99	$562.59
IOWA (IA)	$707.31	$504.99
IDAHO (ID)	$712.28	$508.86
EAST ST. LOUIS (IL)	$767.36	$563.93
SUBURBAN CHICAGO (IL)	$808.95	$581.87
CHICAGO (IL)	$817.72	$595.50
REST OF ILLINOIS (IL)	$748.08	$546.20
INDIANA (IN)	$715.91	$510.94
KANSAS (KS)	$706.17	$506.29
KENTUCKY (KY)	$714.09	$517.52
NEW ORLEANS (LA)	$745.46	$537.39
REST OF LOUISIANA (LA)	$713.82	$518.14
METROPOLITAN BOSTON (MA)	$862.32	$598.31
REST OF MASSACHUSETTS (MA)	$788.36	$555.53
BALTIMORE/SURR. CNTYS (MD)	$813.11	$575.86
REST OF MARYLAND (MD)	$772.51	$548.74
SOUTHERN MAINE (ME)	$749.97	$530.85
REST OF MAINE (ME)	$717.61	$514.18
DETROIT (MI)	$775.94	$562.57
REST OF MICHIGAN (MI)	$732.57	$530.69
MINNESOTA (MN)	$755.14	$527.62
METROPOLITAN ST. LOUIS (MO)	$745.63	$535.13
METROPOLITAN KANSAS CITY (MO)	$738.87	$531.24
REST OF MISSOURI (MO)	$704.02	$513.42
MISSISSIPPI (MS)	$695.17	$504.79
MONTANA** (MT)	$767.15	$546.03
NORTH CAROLINA (NC)	$724.08	$517.78
NORTH DAKOTA** (ND)	$745.99	$524.88
NEBRASKA (NE)	$710.24	$506.15
NEW HAMPSHIRE (NH)	$781.25	$551.07
NORTHERN NJ (NJ)	$859.50	$603.01
REST OF NEW JERSEY (NJ)	$823.41	$581.95
NEW MEXICO (NM)	$736.95	$534.19
NEVADA** (NV)	$761.70	$540.37
MANHATTAN (NY)	$879.20	$622.26
NYC SUBURBS/LONG ISLAND (NY)	$901.07	$638.16
POUGHKPSIE/N NYC SUBURBS (NY)	$830.20	$588.08
QUEENS (NY)	$883.08	$621.72
REST OF NEW YORK (NY)	$734.04	$523.98
OHIO (OH)	$728.25	$526.37
OKLAHOMA (OK)	$710.97	$513.51
PORTLAND (OR)	$812.64	$566.98
REST OF OREGON (OR)	$754.80	$534.57
METROPOLITAN PHILADELPHIA (PA)	$797.66	$567.48
REST OF PENNSYLVANIA (PA)	$728.25	$525.27
PUERTO RICO (PR)	$771.65	$548.10
RHODE ISLAND (RI)	$783.57	$555.16
SOUTH CAROLINA (SC)	$727.56	$523.25
SOUTH DAKOTA** (SD)	$743.49	$522.37
TENNESSEE (TN)	$709.61	$508.62
BRAZORIA (TX)	$757.54	$538.41
DALLAS (TX)	$762.86	$542.63
GALVESTON (TX)	$760.15	$540.59
HOUSTON (TX)	$779.74	$560.17
BEAUMONT (TX)	$724.07	$522.86
FORT WORTH (TX)	$758.81	$540.79
AUSTIN (TX)	$789.88	$555.94
REST OF TEXAS (TX)	$740.74	$530.90
UTAH (UT)	$736.50	$528.65
VIRGINIA (VA)	$749.04	$531.69
VIRGIN ISLANDS (VI)	$771.65	$548.10
VERMONT (VT)	$745.05	$526.15
SEATTLE (KING CNTY) (WA)	$877.12	$605.82
REST OF WASHINGTON (WA)	$786.24	$553.40
WISCONSIN (WI)	$723.53	$511.71
WEST VIRGINIA (WV)	$723.51	$531.36
WYOMING** (WY)	$757.93	$536.81

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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 pricing for this procedure code is based on three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two allowed amounts differ — facility settings typically have lower practice-expense RVUs since overhead costs are borne by the facility.

RVUs — work 8.39, practice expense 13.51 (non-facility) / 6.89 (facility), malpractice 1.07 — × 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 insurance is responsible for the remainder.
Actual payment can vary by locality, modifiers applied, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and applicable rules with your Medicare Administrative Contractor (MAC).

Frequently asked

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

In facility settings, the facility itself incurs many of the overhead and equipment costs, so the practice-expense RVUs assigned to the physician's service are lower, reducing the total allowed amount compared to non-facility settings.

Does this amount reflect what Medicare actually pays?

No — the amount shown is the Medicare-allowed amount before the standard 80/20 split. Medicare generally reimburses 80% of the allowed amount after the patient meets their deductible, with the remaining 20% owed by the patient or secondary payer.

Why might my MAC's rate differ from the amount shown here?

Locality-specific GPCI adjustments, modifier usage, claim-level edits, sequestration, and periodic budget-neutrality adjustments can all cause variation from the baseline PFS calculation shown on this page.

Can I see the CPT code's official description here?

No. CPT descriptors are copyrighted by the American Medical Association and are not reproduced on this page; please consult your CPT codebook or licensed coding software for the official language.

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.