Medicare Reimbursement for CPT Code 17003

This page covers CPT code 17003, a procedure code used in Medicare billing (the official descriptor is not reproduced here due to AMA licensing). It shows the Medicare Physician Fee Schedule (PFS) allowed amount nationally and can be adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$6.35	$1.67
ALASKA* (AK)	$7.34	$2.36
ALABAMA (AL)	$5.72	$1.63
ARKANSAS (AR)	$5.64	$1.62
ARIZONA (AZ)	$6.19	$1.66
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$8.53	$1.93
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$8.71	$1.96
OXNARD-THOUSAND OAKS-VENTURA (CA)	$7.30	$1.77
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$7.32	$1.79
NAPA (CA)	$8.02	$1.86
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$8.53	$1.93
VALLEJO (CA)	$8.02	$1.86
BAKERSFIELD (CA)	$6.85	$1.73
CHICO (CA)	$6.85	$1.72
FRESNO (CA)	$6.85	$1.72
HANFORD-CORCORAN (CA)	$6.85	$1.72
MADERA (CA)	$6.85	$1.72
MERCED (CA)	$6.85	$1.72
MODESTO (CA)	$6.85	$1.72
REDDING (CA)	$6.85	$1.72
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$6.85	$1.73
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$7.21	$1.77
SALINAS (CA)	$7.18	$1.76
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$8.71	$1.96
SANTA CRUZ-WATSONVILLE (CA)	$7.45	$1.77
SANTA ROSA-PETALUMA (CA)	$7.53	$1.79
STOCKTON (CA)	$6.85	$1.72
VISALIA (CA)	$6.85	$1.72
YUBA CITY (CA)	$6.85	$1.72
EL CENTRO (CA)	$6.85	$1.72
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$7.37	$1.78
SAN LUIS OBISPO-PASO ROBLES (CA)	$7.07	$1.74
SANTA MARIA-SANTA BARBARA (CA)	$7.22	$1.76
REST OF CALIFORNIA (CA)	$6.85	$1.72
COLORADO (CO)	$6.68	$1.71
CONNECTICUT (CT)	$6.76	$1.72
DC + MD/VA SUBURBS (DC)	$7.31	$1.80
DELAWARE (DE)	$6.29	$1.67
FORT LAUDERDALE (FL)	$6.41	$1.67
MIAMI (FL)	$6.55	$1.68
REST OF FLORIDA (FL)	$6.13	$1.66
ATLANTA (GA)	$6.43	$1.68
REST OF GEORGIA (GA)	$5.81	$1.63
HAWAII, GUAM (HI)	$7.03	$1.72
IOWA (IA)	$5.92	$1.64
IDAHO (ID)	$5.95	$1.64
EAST ST. LOUIS (IL)	$5.95	$1.64
SUBURBAN CHICAGO (IL)	$6.49	$1.69
CHICAGO (IL)	$6.38	$1.68
REST OF ILLINOIS (IL)	$5.91	$1.64
INDIANA (IN)	$5.98	$1.65
KANSAS (KS)	$5.87	$1.64
KENTUCKY (KY)	$5.79	$1.63
NEW ORLEANS (LA)	$6.05	$1.65
REST OF LOUISIANA (LA)	$5.77	$1.63
METROPOLITAN BOSTON (MA)	$7.37	$1.79
REST OF MASSACHUSETTS (MA)	$6.63	$1.71
BALTIMORE/SURR. CNTYS (MD)	$6.73	$1.72
REST OF MARYLAND (MD)	$6.42	$1.69
SOUTHERN MAINE (ME)	$6.30	$1.67
REST OF MAINE (ME)	$5.95	$1.64
DETROIT (MI)	$6.17	$1.66
REST OF MICHIGAN (MI)	$5.91	$1.64
MINNESOTA (MN)	$6.49	$1.68
METROPOLITAN ST. LOUIS (MO)	$6.11	$1.65
METROPOLITAN KANSAS CITY (MO)	$6.04	$1.65
REST OF MISSOURI (MO)	$5.65	$1.62
MISSISSIPPI (MS)	$5.65	$1.62
MONTANA** (MT)	$6.35	$1.67
NORTH CAROLINA (NC)	$6.01	$1.65
NORTH DAKOTA** (ND)	$6.35	$1.67
NEBRASKA (NE)	$5.96	$1.64
NEW HAMPSHIRE (NH)	$6.55	$1.68
NORTHERN NJ (NJ)	$7.23	$1.81
REST OF NEW JERSEY (NJ)	$6.86	$1.75
NEW MEXICO (NM)	$5.93	$1.64
NEVADA** (NV)	$6.35	$1.67
MANHATTAN (NY)	$7.24	$1.81
NYC SUBURBS/LONG ISLAND (NY)	$7.38	$1.82
POUGHKPSIE/N NYC SUBURBS (NY)	$6.88	$1.76
QUEENS (NY)	$7.34	$1.82
REST OF NEW YORK (NY)	$6.10	$1.65
OHIO (OH)	$5.91	$1.64
OKLAHOMA (OK)	$5.81	$1.63
PORTLAND (OR)	$6.92	$1.73
REST OF OREGON (OR)	$6.33	$1.67
METROPOLITAN PHILADELPHIA (PA)	$6.58	$1.71
REST OF PENNSYLVANIA (PA)	$5.94	$1.64
PUERTO RICO (PR)	$6.40	$1.67
RHODE ISLAND (RI)	$6.54	$1.71
SOUTH CAROLINA (SC)	$5.97	$1.64
SOUTH DAKOTA** (SD)	$6.35	$1.67
TENNESSEE (TN)	$5.89	$1.64
BRAZORIA (TX)	$6.31	$1.68
DALLAS (TX)	$6.34	$1.68
GALVESTON (TX)	$6.32	$1.68
HOUSTON (TX)	$6.32	$1.68
BEAUMONT (TX)	$5.90	$1.64
FORT WORTH (TX)	$6.29	$1.68
AUSTIN (TX)	$6.64	$1.69
REST OF TEXAS (TX)	$6.09	$1.65
UTAH (UT)	$6.05	$1.65
VIRGINIA (VA)	$6.26	$1.66
VIRGIN ISLANDS (VI)	$6.40	$1.67
VERMONT (VT)	$6.30	$1.67
SEATTLE (KING CNTY) (WA)	$7.55	$1.81
REST OF WASHINGTON (WA)	$6.63	$1.71
WISCONSIN (WI)	$6.14	$1.66
WEST VIRGINIA (WV)	$5.69	$1.63
WYOMING** (WY)	$6.35	$1.67

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 13 units 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 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, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor (a dollar-per-RVU rate set each year) to produce the allowed amount. Non-facility and facility amounts differ primarily in the practice-expense RVU, since facility settings (like hospitals) typically have lower practice-expense costs attributed to the billing physician because the facility itself bears some overhead.

RVUs — work 0.04, practice expense 0.15 (non-facility) / 0.01 (facility), malpractice 0 — × 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.
Actual payment can vary by locality, applicable modifiers, claim-specific circumstances, and annual budget-neutrality adjustments.
Sequestration or other federal payment adjustments may reduce the actual amount disbursed.
Always verify current, locality-specific rates with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount for this code?

The facility rate generally reflects a lower practice-expense RVU because overhead costs (equipment, supplies, staff time) are attributed to the facility rather than the billing provider, while the non-facility rate assumes the provider bears those costs directly.

Why might my locality's fee differ from the national figure shown here?

Local wage, rent, and malpractice cost data (captured through GPCIs) adjust each RVU component for your specific geographic area, so the final allowed amount can be higher or lower than the national average.

Does this page tell me the CPT code's official description?

No. CPT descriptors are copyrighted by the American Medical Association and are not reproduced here; this page only addresses Medicare pricing mechanics for the code.

Will I be paid exactly this amount if I bill Medicare?

Not necessarily. The displayed figure is a PFS estimate; actual reimbursement depends on your contractor's final adjudication, applicable modifiers, patient deductible status, and any national payment adjustments in effect at the time of service.

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.