Medicare Reimbursement for CPT 17272
CPT 17272 is a physician procedure code reimbursed under the Medicare Physician Fee Schedule (PFS). This page shows the estimated national Medicare allowed amount for this code, along with locality-adjusted figures for both non-facility (e.g., office) and facility (e.g., hospital) settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $183.37 | $101.54 |
| ALASKA* (AK) | $217.92 | $130.77 |
| ALABAMA (AL) | $165.98 | $94.38 |
| ARKANSAS (AR) | $163.78 | $93.49 |
| ARIZONA (AZ) | $178.84 | $99.54 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $234.01 | $118.62 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $238.51 | $120.51 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $204.28 | $107.55 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $205.41 | $108.61 |
| NAPA (CA) | $221.74 | $113.88 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $234.21 | $118.83 |
| VALLEJO (CA) | $221.44 | $113.59 |
| BAKERSFIELD (CA) | $193.49 | $103.81 |
| CHICO (CA) | $192.94 | $103.25 |
| FRESNO (CA) | $192.94 | $103.25 |
| HANFORD-CORCORAN (CA) | $192.94 | $103.25 |
| MADERA (CA) | $192.94 | $103.25 |
| MERCED (CA) | $192.94 | $103.25 |
| MODESTO (CA) | $192.94 | $103.25 |
| REDDING (CA) | $192.94 | $103.25 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $194.90 | $105.21 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $201.98 | $106.81 |
| SALINAS (CA) | $201.21 | $106.37 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $239.35 | $121.34 |
| SANTA CRUZ-WATSONVILLE (CA) | $207.24 | $107.82 |
| SANTA ROSA-PETALUMA (CA) | $209.31 | $108.82 |
| STOCKTON (CA) | $192.94 | $103.25 |
| VISALIA (CA) | $192.94 | $103.25 |
| YUBA CITY (CA) | $192.94 | $103.25 |
| EL CENTRO (CA) | $192.97 | $103.28 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $205.57 | $107.69 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $198.02 | $104.81 |
| SANTA MARIA-SANTA BARBARA (CA) | $201.86 | $106.45 |
| REST OF CALIFORNIA (CA) | $192.94 | $103.25 |
| COLORADO (CO) | $190.33 | $103.26 |
| CONNECTICUT (CT) | $194.92 | $106.79 |
| DC + MD/VA SUBURBS (DC) | $208.29 | $111.89 |
| DELAWARE (DE) | $181.64 | $100.79 |
| FORT LAUDERDALE (FL) | $189.77 | $106.87 |
| MIAMI (FL) | $197.41 | $112.22 |
| REST OF FLORIDA (FL) | $181.19 | $102.96 |
| ATLANTA (GA) | $186.65 | $103.51 |
| REST OF GEORGIA (GA) | $171.76 | $98.76 |
| HAWAII, GUAM (HI) | $197.04 | $104.00 |
| IOWA (IA) | $169.70 | $94.82 |
| IDAHO (ID) | $170.74 | $95.46 |
| EAST ST. LOUIS (IL) | $180.01 | $104.72 |
| SUBURBAN CHICAGO (IL) | $191.62 | $107.58 |
| CHICAGO (IL) | $192.16 | $109.92 |
| REST OF ILLINOIS (IL) | $176.47 | $101.76 |
| INDIANA (IN) | $171.65 | $95.79 |
| KANSAS (KS) | $169.04 | $95.06 |
| KENTUCKY (KY) | $169.74 | $96.99 |
| NEW ORLEANS (LA) | $177.21 | $100.21 |
| REST OF LOUISIANA (LA) | $169.52 | $97.10 |
| METROPOLITAN BOSTON (MA) | $208.07 | $110.36 |
| REST OF MASSACHUSETTS (MA) | $189.36 | $103.19 |
| BALTIMORE/SURR. CNTYS (MD) | $194.37 | $106.57 |
| REST OF MARYLAND (MD) | $184.89 | $102.07 |
| SOUTHERN MAINE (ME) | $180.09 | $98.99 |
| REST OF MAINE (ME) | $171.64 | $96.35 |
| DETROIT (MI) | $183.36 | $104.39 |
| REST OF MICHIGAN (MI) | $173.86 | $99.15 |
| MINNESOTA (MN) | $182.57 | $98.36 |
| METROPOLITAN ST. LOUIS (MO) | $177.71 | $99.80 |
| METROPOLITAN KANSAS CITY (MO) | $176.02 | $99.18 |
| REST OF MISSOURI (MO) | $166.90 | $96.36 |
| MISSISSIPPI (MS) | $165.37 | $94.91 |
| MONTANA** (MT) | $183.36 | $101.53 |
| NORTH CAROLINA (NC) | $173.28 | $96.93 |
| NORTH DAKOTA** (ND) | $179.80 | $97.97 |
| NEBRASKA (NE) | $170.53 | $95.00 |
| NEW HAMPSHIRE (NH) | $187.47 | $102.28 |
| NORTHERN NJ (NJ) | $206.42 | $111.50 |
| REST OF NEW JERSEY (NJ) | $197.20 | $107.84 |
| NEW MEXICO (NM) | $174.77 | $99.73 |
| NEVADA** (NV) | $182.49 | $100.57 |
| MANHATTAN (NY) | $209.83 | $114.74 |
| NYC SUBURBS/LONG ISLAND (NY) | $214.65 | $117.36 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $198.53 | $108.92 |
| QUEENS (NY) | $211.33 | $114.61 |
| REST OF NEW YORK (NY) | $175.67 | $97.93 |
| OHIO (OH) | $173.13 | $98.42 |
| OKLAHOMA (OK) | $169.38 | $96.30 |
| PORTLAND (OR) | $195.90 | $104.99 |
| REST OF OREGON (OR) | $181.11 | $99.61 |
| METROPOLITAN PHILADELPHIA (PA) | $190.44 | $105.26 |
| REST OF PENNSYLVANIA (PA) | $173.34 | $98.22 |
| PUERTO RICO (PR) | $184.58 | $101.85 |
| RHODE ISLAND (RI) | $187.75 | $103.21 |
| SOUTH CAROLINA (SC) | $173.48 | $97.87 |
| SOUTH DAKOTA** (SD) | $179.38 | $97.55 |
| TENNESSEE (TN) | $169.83 | $95.44 |
| BRAZORIA (TX) | $181.46 | $100.36 |
| DALLAS (TX) | $182.58 | $101.07 |
| GALVESTON (TX) | $181.98 | $100.72 |
| HOUSTON (TX) | $185.28 | $104.02 |
| BEAUMONT (TX) | $172.30 | $97.84 |
| FORT WORTH (TX) | $181.47 | $100.79 |
| AUSTIN (TX) | $189.66 | $103.08 |
| REST OF TEXAS (TX) | $176.76 | $99.10 |
| UTAH (UT) | $175.66 | $98.74 |
| VIRGINIA (VA) | $179.59 | $99.15 |
| VIRGIN ISLANDS (VI) | $184.58 | $101.85 |
| VERMONT (VT) | $179.22 | $98.20 |
| SEATTLE (KING CNTY) (WA) | $212.07 | $111.66 |
| REST OF WASHINGTON (WA) | $188.97 | $102.80 |
| WISCONSIN (WI) | $174.24 | $95.85 |
| WEST VIRGINIA (WV) | $170.47 | $99.36 |
| WYOMING** (WY) | $181.81 | $99.98 |
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Maximum units per day (MUE)
Medicare’s Medically Unlikely Edit caps this code at 5 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 payments are 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 national conversion factor to produce the allowed amount. Non-facility and facility amounts differ because practice-expense RVUs are lower in facility settings, where the facility itself bears some of the overhead costs.
RVUs — work 1.77, practice expense 3.54 (non-facility) / 1.09 (facility), malpractice 0.18 — × 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.
- Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
- Locality-specific GPCIs mean actual payment can differ from the national average shown here.
- Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC).
Frequently asked
Why does the facility amount differ from the non-facility amount?
The facility rate uses a lower practice-expense RVU because overhead costs (equipment, supplies, staff) are assumed to be borne by the facility rather than the billing physician's office.
Does this amount include the patient's deductible and coinsurance?
No. The figures shown represent the full Medicare-allowed amount before the standard 80/20 split and any unmet deductible are applied.
Why might my local Medicare payment differ from the national figure?
Local wage and cost indices (GPCIs) adjust each RVU component for the specific locality, so allowed amounts vary by geographic area.
Can modifiers change this amount?
Yes. Modifiers such as those for bilateral procedures, multiple procedures, or reduced services can increase or decrease the final payment relative to the base PFS amount 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.
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