Medicare Reimbursement for CPT 17111
CPT 17111 is a procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount for this code, both nationally and adjusted for locality, with separate figures for non-facility and facility settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $129.93 | $73.82 |
| ALASKA* (AK) | $150.80 | $91.04 |
| ALABAMA (AL) | $116.83 | $67.73 |
| ARKANSAS (AR) | $115.16 | $66.96 |
| ARIZONA (AZ) | $126.58 | $72.21 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $170.57 | $91.45 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $174.03 | $93.12 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $147.20 | $80.87 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $147.81 | $81.43 |
| NAPA (CA) | $160.99 | $87.03 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $170.66 | $91.54 |
| VALLEJO (CA) | $160.86 | $86.90 |
| BAKERSFIELD (CA) | $138.66 | $77.16 |
| CHICO (CA) | $138.40 | $76.90 |
| FRESNO (CA) | $138.40 | $76.90 |
| HANFORD-CORCORAN (CA) | $138.40 | $76.90 |
| MADERA (CA) | $138.40 | $76.90 |
| MERCED (CA) | $138.40 | $76.90 |
| MODESTO (CA) | $138.40 | $76.90 |
| REDDING (CA) | $138.40 | $76.90 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $139.28 | $77.78 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $145.40 | $80.14 |
| SALINAS (CA) | $144.86 | $79.83 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $174.40 | $93.49 |
| SANTA CRUZ-WATSONVILLE (CA) | $149.89 | $81.72 |
| SANTA ROSA-PETALUMA (CA) | $151.42 | $82.51 |
| STOCKTON (CA) | $138.40 | $76.90 |
| VISALIA (CA) | $138.40 | $76.90 |
| YUBA CITY (CA) | $138.40 | $76.90 |
| EL CENTRO (CA) | $138.41 | $76.91 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $148.38 | $81.27 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $142.51 | $78.59 |
| SANTA MARIA-SANTA BARBARA (CA) | $145.44 | $80.01 |
| REST OF CALIFORNIA (CA) | $138.40 | $76.90 |
| COLORADO (CO) | $135.84 | $76.13 |
| CONNECTICUT (CT) | $138.48 | $78.05 |
| DC + MD/VA SUBURBS (DC) | $148.95 | $82.85 |
| DELAWARE (DE) | $128.67 | $73.23 |
| FORT LAUDERDALE (FL) | $133.33 | $76.49 |
| MIAMI (FL) | $137.93 | $79.52 |
| REST OF FLORIDA (FL) | $127.07 | $73.43 |
| ATLANTA (GA) | $132.09 | $75.08 |
| REST OF GEORGIA (GA) | $120.13 | $70.07 |
| HAWAII, GUAM (HI) | $141.89 | $78.09 |
| IOWA (IA) | $120.20 | $68.85 |
| IDAHO (ID) | $120.88 | $69.25 |
| EAST ST. LOUIS (IL) | $125.00 | $73.37 |
| SUBURBAN CHICAGO (IL) | $134.79 | $77.17 |
| CHICAGO (IL) | $134.09 | $77.70 |
| REST OF ILLINOIS (IL) | $123.12 | $71.89 |
| INDIANA (IN) | $121.58 | $69.57 |
| KANSAS (KS) | $119.43 | $68.71 |
| KENTUCKY (KY) | $119.10 | $69.21 |
| NEW ORLEANS (LA) | $124.66 | $71.85 |
| REST OF LOUISIANA (LA) | $118.83 | $69.17 |
| METROPOLITAN BOSTON (MA) | $149.47 | $82.47 |
| REST OF MASSACHUSETTS (MA) | $134.96 | $75.87 |
| BALTIMORE/SURR. CNTYS (MD) | $138.04 | $77.83 |
| REST OF MARYLAND (MD) | $131.17 | $74.39 |
| SOUTHERN MAINE (ME) | $128.08 | $72.48 |
| REST OF MAINE (ME) | $121.28 | $69.65 |
| DETROIT (MI) | $128.42 | $74.27 |
| REST OF MICHIGAN (MI) | $121.96 | $70.73 |
| MINNESOTA (MN) | $130.82 | $73.08 |
| METROPOLITAN ST. LOUIS (MO) | $125.35 | $71.93 |
| METROPOLITAN KANSAS CITY (MO) | $124.04 | $71.35 |
| REST OF MISSOURI (MO) | $116.68 | $68.31 |
| MISSISSIPPI (MS) | $115.95 | $67.64 |
| MONTANA** (MT) | $129.92 | $73.81 |
| NORTH CAROLINA (NC) | $122.56 | $70.21 |
| NORTH DAKOTA** (ND) | $128.34 | $72.23 |
| NEBRASKA (NE) | $120.91 | $69.12 |
| NEW HAMPSHIRE (NH) | $133.51 | $75.10 |
| NORTHERN NJ (NJ) | $147.39 | $82.30 |
| REST OF NEW JERSEY (NJ) | $140.25 | $78.97 |
| NEW MEXICO (NM) | $122.54 | $71.08 |
| NEVADA** (NV) | $129.58 | $73.41 |
| MANHATTAN (NY) | $149.00 | $83.80 |
| NYC SUBURBS/LONG ISLAND (NY) | $152.30 | $85.59 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $140.99 | $79.55 |
| QUEENS (NY) | $150.53 | $84.20 |
| REST OF NEW YORK (NY) | $124.36 | $71.05 |
| OHIO (OH) | $121.64 | $70.41 |
| OKLAHOMA (OK) | $119.11 | $69.00 |
| PORTLAND (OR) | $140.36 | $78.01 |
| REST OF OREGON (OR) | $128.75 | $72.86 |
| METROPOLITAN PHILADELPHIA (PA) | $134.93 | $76.52 |
| REST OF PENNSYLVANIA (PA) | $121.95 | $70.44 |
| PUERTO RICO (PR) | $130.94 | $74.21 |
| RHODE ISLAND (RI) | $133.40 | $75.43 |
| SOUTH CAROLINA (SC) | $122.27 | $70.42 |
| SOUTH DAKOTA** (SD) | $128.16 | $72.04 |
| TENNESSEE (TN) | $120.00 | $68.99 |
| BRAZORIA (TX) | $128.74 | $73.13 |
| DALLAS (TX) | $129.45 | $73.56 |
| GALVESTON (TX) | $129.06 | $73.33 |
| HOUSTON (TX) | $130.52 | $74.80 |
| BEAUMONT (TX) | $121.14 | $70.08 |
| FORT WORTH (TX) | $128.53 | $73.21 |
| AUSTIN (TX) | $135.23 | $75.86 |
| REST OF TEXAS (TX) | $124.80 | $71.55 |
| UTAH (UT) | $123.93 | $71.18 |
| VIRGINIA (VA) | $127.52 | $72.36 |
| VIRGIN ISLANDS (VI) | $130.94 | $74.21 |
| VERMONT (VT) | $127.65 | $72.10 |
| SEATTLE (KING CNTY) (WA) | $152.71 | $83.86 |
| REST OF WASHINGTON (WA) | $134.77 | $75.68 |
| WISCONSIN (WI) | $124.07 | $70.31 |
| WEST VIRGINIA (WV) | $118.57 | $69.80 |
| WYOMING** (WY) | $129.23 | $73.12 |
Look up another code or locality →
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) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific 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) settings use different practice-expense RVUs because overhead costs differ, which is why two separate amounts are shown.
RVUs — work 0.95, practice expense 2.86 (non-facility) / 1.18 (facility), malpractice 0.08 — × 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 patient meets the annual Part B deductible; the patient or secondary payer is generally responsible for the remainder.
- Modifiers, place of service, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
- Locality-specific GPCI values mean the actual rate can differ from the national figure shown here.
- Always confirm current rates and coverage rules with your Medicare Administrative Contractor (MAC).
Frequently asked
Why is the facility amount different from the non-facility amount?
The facility rate uses lower practice-expense RVUs because Medicare assumes the facility (e.g., hospital) absorbs certain overhead costs like staff and supplies, while the non-facility rate reflects the full overhead typically borne by a physician's office.
Does this amount reflect what the patient will owe?
No. The figure shown is the Medicare-allowed amount. After the deductible is met, Medicare generally pays 80%, leaving a 20% coinsurance plus any applicable deductible for the patient or secondary insurer.
Why might my local Medicare payment differ from the national amount?
Local Geographic Practice Cost Indices (GPCIs) adjust the RVUs for regional differences in wages, rent, and malpractice costs, so the same code can pay differently depending on the locality where it was billed.
Does this change year to year?
Yes. RVUs, GPCIs, and the conversion factor are all updated annually (and sometimes mid-year), along with budget-neutrality adjustments, so the allowed amount for this code can change each year.
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.
Bill accurately, get paid faster
Join providers across the country delivering modern virtual care with CareNiva. Free to start, ready in minutes.
100% Satisfaction Guaranteed — try it risk-free