Medicare Reimbursement for CPT 17262

CPT 17262 is a procedure code reported to Medicare and other payers; the specific service it describes is defined by AMA CPT and is not reproduced here. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$173.68	$93.19
ALASKA* (AK)	$205.33	$119.60
ALABAMA (AL)	$156.96	$86.53
ARKANSAS (AR)	$154.84	$85.70
ARIZONA (AZ)	$169.34	$91.34
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$222.90	$109.40
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$227.24	$111.16
OXNARD-THOUSAND OAKS-VENTURA (CA)	$194.13	$98.98
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$195.15	$99.93
NAPA (CA)	$211.05	$104.95
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$223.08	$109.58
VALLEJO (CA)	$210.78	$104.69
BAKERSFIELD (CA)	$183.67	$95.44
CHICO (CA)	$183.17	$94.95
FRESNO (CA)	$183.17	$94.95
HANFORD-CORCORAN (CA)	$183.17	$94.95
MADERA (CA)	$183.17	$94.95
MERCED (CA)	$183.17	$94.95
MODESTO (CA)	$183.17	$94.95
REDDING (CA)	$183.17	$94.95
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$184.92	$96.69
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$191.90	$98.28
SALINAS (CA)	$191.17	$97.88
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$227.98	$111.90
SANTA CRUZ-WATSONVILLE (CA)	$197.10	$99.29
SANTA ROSA-PETALUMA (CA)	$199.07	$100.22
STOCKTON (CA)	$183.17	$94.95
VISALIA (CA)	$183.17	$94.95
YUBA CITY (CA)	$183.17	$94.95
EL CENTRO (CA)	$183.20	$94.97
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$195.42	$99.14
SAN LUIS OBISPO-PASO ROBLES (CA)	$188.13	$96.44
SANTA MARIA-SANTA BARBARA (CA)	$191.82	$97.96
REST OF CALIFORNIA (CA)	$183.17	$94.95
COLORADO (CO)	$180.53	$94.88
CONNECTICUT (CT)	$184.74	$98.05
DC + MD/VA SUBURBS (DC)	$197.67	$102.84
DELAWARE (DE)	$172.03	$92.50
FORT LAUDERDALE (FL)	$179.50	$97.96
MIAMI (FL)	$186.58	$102.78
REST OF FLORIDA (FL)	$171.30	$94.35
ATLANTA (GA)	$176.76	$94.98
REST OF GEORGIA (GA)	$162.27	$90.46
HAWAII, GUAM (HI)	$187.22	$95.70
IOWA (IA)	$160.67	$87.01
IDAHO (ID)	$161.65	$87.59
EAST ST. LOUIS (IL)	$169.88	$95.83
SUBURBAN CHICAGO (IL)	$181.29	$98.62
CHICAGO (IL)	$181.55	$100.65
REST OF ILLINOIS (IL)	$166.67	$93.18
INDIANA (IN)	$162.53	$87.91
KANSAS (KS)	$159.97	$87.20
KENTUCKY (KY)	$160.44	$88.88
NEW ORLEANS (LA)	$167.61	$91.87
REST OF LOUISIANA (LA)	$160.21	$88.97
METROPOLITAN BOSTON (MA)	$197.63	$101.52
REST OF MASSACHUSETTS (MA)	$179.56	$94.79
BALTIMORE/SURR. CNTYS (MD)	$184.21	$97.84
REST OF MARYLAND (MD)	$175.16	$93.70
SOUTHERN MAINE (ME)	$170.68	$90.90
REST OF MAINE (ME)	$162.45	$88.39
DETROIT (MI)	$173.32	$95.64
REST OF MICHIGAN (MI)	$164.35	$90.86
MINNESOTA (MN)	$173.26	$90.43
METROPOLITAN ST. LOUIS (MO)	$168.16	$91.53
METROPOLITAN KANSAS CITY (MO)	$166.53	$90.95
REST OF MISSOURI (MO)	$157.64	$88.26
MISSISSIPPI (MS)	$156.27	$86.97
MONTANA** (MT)	$173.67	$93.18
NORTH CAROLINA (NC)	$164.03	$88.93
NORTH DAKOTA** (ND)	$170.51	$90.01
NEBRASKA (NE)	$161.49	$87.19
NEW HAMPSHIRE (NH)	$177.74	$93.94
NORTHERN NJ (NJ)	$195.83	$102.46
REST OF NEW JERSEY (NJ)	$186.93	$99.03
NEW MEXICO (NM)	$165.19	$91.38
NEVADA** (NV)	$172.91	$92.33
MANHATTAN (NY)	$198.88	$105.35
NYC SUBURBS/LONG ISLAND (NY)	$203.44	$107.73
POUGHKPSIE/N NYC SUBURBS (NY)	$188.14	$100.00
QUEENS (NY)	$200.42	$105.27
REST OF NEW YORK (NY)	$166.34	$89.86
OHIO (OH)	$163.70	$90.21
OKLAHOMA (OK)	$160.16	$88.28
PORTLAND (OR)	$185.96	$96.53
REST OF OREGON (OR)	$171.64	$91.46
METROPOLITAN PHILADELPHIA (PA)	$180.40	$96.60
REST OF PENNSYLVANIA (PA)	$163.94	$90.05
PUERTO RICO (PR)	$174.87	$93.49
RHODE ISLAND (RI)	$177.92	$94.77
SOUTH CAROLINA (SC)	$164.13	$89.75
SOUTH DAKOTA** (SD)	$170.14	$89.64
TENNESSEE (TN)	$160.72	$87.55
BRAZORIA (TX)	$171.90	$92.13
DALLAS (TX)	$172.94	$92.77
GALVESTON (TX)	$172.38	$92.45
HOUSTON (TX)	$175.31	$95.38
BEAUMONT (TX)	$162.93	$89.68
FORT WORTH (TX)	$171.86	$92.49
AUSTIN (TX)	$179.87	$94.70
REST OF TEXAS (TX)	$167.29	$90.90
UTAH (UT)	$166.23	$90.56
VIRGINIA (VA)	$170.15	$91.03
VIRGIN ISLANDS (VI)	$174.87	$93.49
VERMONT (VT)	$169.89	$90.20
SEATTLE (KING CNTY) (WA)	$201.52	$102.75
REST OF WASHINGTON (WA)	$179.21	$94.44
WISCONSIN (WI)	$165.15	$88.03
WEST VIRGINIA (WV)	$160.89	$90.94
WYOMING** (WY)	$172.30	$91.80

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 6 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 PFS amounts are built from three Relative Value Units (RVUs): physician work, practice expense (PE), and malpractice (MP). Each RVU component is adjusted by locality-specific Geographic Practice Cost Indices (GPCIs) to reflect regional cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. The practice expense RVU differs depending on whether the service is performed in a non-facility setting (e.g., physician office) or a facility setting (e.g., hospital), which is why two different allowed amounts are shown. Work and malpractice RVUs generally stay the same across settings, while PE RVUs are typically higher in non-facility settings because the practice bears more of the overhead cost.

RVUs — work 1.59, practice expense 3.45 (non-facility) / 1.04 (facility), malpractice 0.16 — × 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 varies by locality, applicable modifiers, place of service, sequestration, and annual budget-neutrality adjustments.
Always verify current amounts and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why are there two different amounts for this code?

Medicare publishes separate allowed amounts for non-facility (e.g., office) and facility (e.g., hospital outpatient) settings because the practice expense RVU component differs based on who bears the overhead cost of performing the service.

Why does the fee differ by locality?

Each locality has its own Geographic Practice Cost Indices (GPCIs) for work, practice expense, and malpractice, which adjust the RVUs to reflect regional differences in costs such as wages and rent.

Does this amount change every year?

Yes. CMS updates the conversion factor annually and may revise RVUs, so the allowed amount for the same code can change from year to year, sometimes due to budget-neutrality adjustments.

Is this the amount my practice will actually be paid?

Not necessarily. The figure shown is an estimate based on standard PFS inputs; actual reimbursement can be affected by modifiers, sequestration, secondary payers, and contractor-specific policies.

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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.