Medicare Reimbursement for CPT 17266

CPT 17266 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for 2026, nationally and adjustable by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$230.47	$127.59
ALASKA* (AK)	$275.35	$165.79
ALABAMA (AL)	$209.01	$119.00
ARKANSAS (AR)	$206.30	$117.93
ARIZONA (AZ)	$224.87	$125.18
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$292.88	$147.82
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$298.47	$150.12
OXNARD-THOUSAND OAKS-VENTURA (CA)	$256.13	$134.53
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$257.60	$135.90
NAPA (CA)	$277.69	$142.10
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$293.14	$148.08
VALLEJO (CA)	$277.31	$141.72
BAKERSFIELD (CA)	$242.86	$130.11
CHICO (CA)	$242.14	$129.39
FRESNO (CA)	$242.14	$129.39
HANFORD-CORCORAN (CA)	$242.14	$129.39
MADERA (CA)	$242.14	$129.39
MERCED (CA)	$242.14	$129.39
MODESTO (CA)	$242.14	$129.39
REDDING (CA)	$242.14	$129.39
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$244.65	$131.90
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$253.33	$133.69
SALINAS (CA)	$252.36	$133.13
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$299.53	$151.19
SANTA CRUZ-WATSONVILLE (CA)	$259.70	$134.71
SANTA ROSA-PETALUMA (CA)	$262.29	$135.96
STOCKTON (CA)	$242.14	$129.39
VISALIA (CA)	$242.14	$129.39
YUBA CITY (CA)	$242.14	$129.39
EL CENTRO (CA)	$242.18	$129.43
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$257.69	$134.66
SAN LUIS OBISPO-PASO ROBLES (CA)	$248.37	$131.20
SANTA MARIA-SANTA BARBARA (CA)	$253.14	$133.19
REST OF CALIFORNIA (CA)	$242.14	$129.39
COLORADO (CO)	$239.00	$129.54
CONNECTICUT (CT)	$244.80	$134.00
DC + MD/VA SUBURBS (DC)	$261.34	$140.15
DELAWARE (DE)	$228.34	$126.70
FORT LAUDERDALE (FL)	$238.56	$134.35
MIAMI (FL)	$248.16	$141.06
REST OF FLORIDA (FL)	$227.95	$129.60
ATLANTA (GA)	$234.56	$130.04
REST OF GEORGIA (GA)	$216.29	$124.52
HAWAII, GUAM (HI)	$247.09	$130.12
IOWA (IA)	$213.51	$119.38
IDAHO (ID)	$214.82	$120.18
EAST ST. LOUIS (IL)	$226.66	$132.01
SUBURBAN CHICAGO (IL)	$240.86	$135.20
CHICAGO (IL)	$241.68	$138.30
REST OF ILLINOIS (IL)	$222.18	$128.26
INDIANA (IN)	$215.94	$120.57
KANSAS (KS)	$212.74	$119.74
KENTUCKY (KY)	$213.72	$122.27
NEW ORLEANS (LA)	$222.96	$126.15
REST OF LOUISIANA (LA)	$213.47	$122.43
METROPOLITAN BOSTON (MA)	$260.93	$138.10
REST OF MASSACHUSETTS (MA)	$237.83	$129.51
BALTIMORE/SURR. CNTYS (MD)	$244.11	$133.73
REST OF MARYLAND (MD)	$232.35	$128.24
SOUTHERN MAINE (ME)	$226.33	$124.38
REST OF MAINE (ME)	$215.97	$121.32
DETROIT (MI)	$230.66	$131.39
REST OF MICHIGAN (MI)	$218.85	$124.92
MINNESOTA (MN)	$229.26	$123.40
METROPOLITAN ST. LOUIS (MO)	$223.52	$125.59
METROPOLITAN KANSAS CITY (MO)	$221.45	$124.85
REST OF MISSOURI (MO)	$210.26	$121.58
MISSISSIPPI (MS)	$208.31	$119.74
MONTANA** (MT)	$230.45	$127.58
NORTH CAROLINA (NC)	$217.98	$122.00
NORTH DAKOTA** (ND)	$225.90	$123.03
NEBRASKA (NE)	$214.53	$119.57
NEW HAMPSHIRE (NH)	$235.45	$128.36
NORTHERN NJ (NJ)	$259.09	$139.75
REST OF NEW JERSEY (NJ)	$247.66	$135.32
NEW MEXICO (NM)	$219.98	$125.64
NEVADA** (NV)	$229.33	$126.35
MANHATTAN (NY)	$263.43	$143.89
NYC SUBURBS/LONG ISLAND (NY)	$269.43	$147.11
POUGHKPSIE/N NYC SUBURBS (NY)	$249.35	$136.70
QUEENS (NY)	$265.23	$143.63
REST OF NEW YORK (NY)	$220.94	$123.21
OHIO (OH)	$217.92	$123.99
OKLAHOMA (OK)	$213.24	$121.38
PORTLAND (OR)	$245.84	$131.54
REST OF OREGON (OR)	$227.60	$125.14
METROPOLITAN PHILADELPHIA (PA)	$239.29	$132.20
REST OF PENNSYLVANIA (PA)	$218.16	$123.72
PUERTO RICO (PR)	$231.95	$127.94
RHODE ISLAND (RI)	$235.90	$129.63
SOUTH CAROLINA (SC)	$218.30	$123.24
SOUTH DAKOTA** (SD)	$225.37	$122.49
TENNESSEE (TN)	$213.72	$120.20
BRAZORIA (TX)	$228.09	$126.15
DALLAS (TX)	$229.50	$127.03
GALVESTON (TX)	$228.75	$126.60
HOUSTON (TX)	$232.96	$130.81
BEAUMONT (TX)	$216.87	$123.26
FORT WORTH (TX)	$228.15	$126.71
AUSTIN (TX)	$238.15	$129.31
REST OF TEXAS (TX)	$222.33	$124.70
UTAH (UT)	$220.99	$124.28
VIRGINIA (VA)	$225.74	$124.62
VIRGIN ISLANDS (VI)	$231.95	$127.94
VERMONT (VT)	$225.22	$123.38
SEATTLE (KING CNTY) (WA)	$265.86	$139.63
REST OF WASHINGTON (WA)	$237.32	$129.00
WISCONSIN (WI)	$219.06	$120.51
WEST VIRGINIA (WV)	$214.79	$125.39
WYOMING** (WY)	$228.47	$125.59

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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 PFS amounts are built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each procedure code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) 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 a dollar amount. Non-facility and facility rates differ mainly in the practice-expense RVU, since facility settings (like hospitals) typically have Medicare pay the facility separately for overhead, resulting in a lower PE RVU and lower physician-side payment.

RVUs — work 2.33, practice expense 4.34 (non-facility) / 1.26 (facility), malpractice 0.23 — × 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 rest.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Rates vary by locality based on GPCI values; the national figure is a reference, not a locality-specific payment.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility rate differ from the non-facility rate for CPT 17266?

The facility rate uses a lower practice-expense RVU because Medicare assumes the facility (not the physician's office) is bearing most of the overhead costs, such as space, equipment, and supplies.

Does this amount reflect what Medicare will actually pay?

No. It's an estimate based on national RVUs and the conversion factor. Actual payment depends on the patient's specific locality GPCIs, applicable modifiers, deductible status, and any sequestration or policy adjustments in effect at the time of service.

How often do these amounts change?

The conversion factor and RVUs are typically updated annually by CMS, and can also be revised mid-year due to legislative or regulatory changes, so figures should be confirmed for the current year.

Can modifiers affect the payment for CPT 17266?

Yes. Modifiers such as those indicating bilateral procedures, multiple procedures, or reduced services can increase or decrease the allowed amount from the base rate shown here.

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.