Medicare Reimbursement for CPT 17260

CPT 17260 is a physician procedure code; the specific clinical descriptor is not shown here due to AMA licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for 2026, nationally and adjustable by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$96.86	$59.12
ALASKA* (AK)	$115.44	$75.25
ALABAMA (AL)	$87.85	$54.83
ARKANSAS (AR)	$86.71	$54.29
ARIZONA (AZ)	$94.53	$57.96
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$124.05	$70.84
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$126.46	$72.03
OXNARD-THOUSAND OAKS-VENTURA (CA)	$108.16	$63.55
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$108.74	$64.09
NAPA (CA)	$117.49	$67.75
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$124.15	$70.93
VALLEJO (CA)	$117.36	$67.62
BAKERSFIELD (CA)	$102.44	$61.08
CHICO (CA)	$102.18	$60.82
FRESNO (CA)	$102.18	$60.82
HANFORD-CORCORAN (CA)	$102.18	$60.82
MADERA (CA)	$102.18	$60.82
MERCED (CA)	$102.18	$60.82
MODESTO (CA)	$102.18	$60.82
REDDING (CA)	$102.18	$60.82
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$103.06	$61.70
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$106.99	$63.09
SALINAS (CA)	$106.58	$62.84
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$126.83	$72.41
SANTA CRUZ-WATSONVILLE (CA)	$109.78	$63.92
SANTA ROSA-PETALUMA (CA)	$110.88	$64.53
STOCKTON (CA)	$102.18	$60.82
VISALIA (CA)	$102.18	$60.82
YUBA CITY (CA)	$102.18	$60.82
EL CENTRO (CA)	$102.20	$60.83
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$108.89	$63.75
SAN LUIS OBISPO-PASO ROBLES (CA)	$104.88	$61.90
SANTA MARIA-SANTA BARBARA (CA)	$106.93	$62.92
REST OF CALIFORNIA (CA)	$102.18	$60.82
COLORADO (CO)	$100.67	$60.51
CONNECTICUT (CT)	$102.89	$62.24
DC + MD/VA SUBURBS (DC)	$110.04	$65.58
DELAWARE (DE)	$96.00	$58.71
FORT LAUDERDALE (FL)	$99.84	$61.60
MIAMI (FL)	$103.52	$64.23
REST OF FLORIDA (FL)	$95.44	$59.36
ATLANTA (GA)	$98.50	$60.15
REST OF GEORGIA (GA)	$90.59	$56.93
HAWAII, GUAM (HI)	$104.34	$61.43
IOWA (IA)	$89.91	$55.38
IDAHO (ID)	$90.43	$55.71
EAST ST. LOUIS (IL)	$94.55	$59.83
SUBURBAN CHICAGO (IL)	$100.84	$62.08
CHICAGO (IL)	$100.86	$62.92
REST OF ILLINOIS (IL)	$92.90	$58.44
INDIANA (IN)	$90.91	$55.92
KANSAS (KS)	$89.51	$55.39
KENTUCKY (KY)	$89.67	$56.11
NEW ORLEANS (LA)	$93.52	$58.01
REST OF LOUISIANA (LA)	$89.53	$56.13
METROPOLITAN BOSTON (MA)	$110.04	$64.97
REST OF MASSACHUSETTS (MA)	$100.15	$60.41
BALTIMORE/SURR. CNTYS (MD)	$102.58	$62.08
REST OF MARYLAND (MD)	$97.71	$59.52
SOUTHERN MAINE (ME)	$95.31	$57.91
REST OF MAINE (ME)	$90.83	$56.11
DETROIT (MI)	$96.50	$60.08
REST OF MICHIGAN (MI)	$91.74	$57.28
MINNESOTA (MN)	$96.80	$57.96
METROPOLITAN ST. LOUIS (MO)	$93.85	$57.92
METROPOLITAN KANSAS CITY (MO)	$92.97	$57.53
REST OF MISSOURI (MO)	$88.13	$55.59
MISSISSIPPI (MS)	$87.44	$54.94
MONTANA** (MT)	$96.86	$59.11
NORTH CAROLINA (NC)	$91.69	$56.48
NORTH DAKOTA** (ND)	$95.28	$57.53
NEBRASKA (NE)	$90.37	$55.53
NEW HAMPSHIRE (NH)	$99.10	$59.81
NORTHERN NJ (NJ)	$109.07	$65.29
REST OF NEW JERSEY (NJ)	$104.15	$62.94
NEW MEXICO (NM)	$92.19	$57.58
NEVADA** (NV)	$96.48	$58.70
MANHATTAN (NY)	$110.61	$66.75
NYC SUBURBS/LONG ISLAND (NY)	$113.03	$68.15
POUGHKPSIE/N NYC SUBURBS (NY)	$104.80	$63.47
QUEENS (NY)	$111.48	$66.87
REST OF NEW YORK (NY)	$92.93	$57.07
OHIO (OH)	$91.42	$56.96
OKLAHOMA (OK)	$89.55	$55.84
PORTLAND (OR)	$103.65	$61.72
REST OF OREGON (OR)	$95.82	$58.23
METROPOLITAN PHILADELPHIA (PA)	$100.52	$61.23
REST OF PENNSYLVANIA (PA)	$91.57	$56.92
PUERTO RICO (PR)	$97.51	$59.36
RHODE ISLAND (RI)	$99.24	$60.25
SOUTH CAROLINA (SC)	$91.69	$56.81
SOUTH DAKOTA** (SD)	$95.09	$57.35
TENNESSEE (TN)	$89.91	$55.60
BRAZORIA (TX)	$95.96	$58.56
DALLAS (TX)	$96.51	$58.92
GALVESTON (TX)	$96.21	$58.74
HOUSTON (TX)	$97.68	$60.20
BEAUMONT (TX)	$91.02	$56.68
FORT WORTH (TX)	$95.92	$58.71
AUSTIN (TX)	$100.26	$60.33
REST OF TEXAS (TX)	$93.40	$57.58
UTAH (UT)	$92.82	$57.34
VIRGINIA (VA)	$95.01	$57.91
VIRGIN ISLANDS (VI)	$97.51	$59.36
VERMONT (VT)	$94.91	$57.55
SEATTLE (KING CNTY) (WA)	$112.20	$65.89
REST OF WASHINGTON (WA)	$99.96	$60.22
WISCONSIN (WI)	$92.38	$56.22
WEST VIRGINIA (WV)	$89.79	$56.99
WYOMING** (WY)	$96.17	$58.42

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 7 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

The Medicare PFS amount is built from three Relative Value Units (RVUs) — work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed. These adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs, since overhead costs differ by site of service, which is why the two allowed amounts differ.

RVUs — work 0.94, practice expense 1.88 (non-facility) / 0.75 (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 annual Part B deductible is met; the patient or secondary payer is responsible for the remainder.
Actual payment can vary by locality GPCIs, applicable modifiers, claim-level adjustments, sequestration, and annual budget-neutrality changes to RVUs or the conversion factor.
Always verify current-year rates and locality-specific amounts 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?

Facility and non-facility payments use different practice-expense RVUs because overhead costs (equipment, supplies, staff time) differ depending on whether the service is performed in a facility like a hospital versus a non-facility setting like a physician's office.

Does this amount reflect what Medicare will actually pay?

No. The figure shown is the Medicare-allowed amount before the standard 80/20 coinsurance split, deductible status, modifiers, and any locality-specific or claim-specific adjustments are applied.

Why can the allowed amount change from year to year?

CMS updates RVUs and the conversion factor annually, and may apply budget-neutrality adjustments, so the same code's allowed amount can shift even without a change in how the service is performed.

Where can I find the exact amount for my locality?

Use the locality-adjusted GPCI figures referenced on this page, or consult your MAC's fee schedule lookup tool for the precise amount applicable to your specific geographic area.

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.