Medicare Reimbursement for CPT 17274

CPT 17274 is a procedure code defined by the American Medical Association; its specific clinical description is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and 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)	$239.15	$138.95
ALASKA* (AK)	$287.74	$181.03
ALABAMA (AL)	$217.41	$129.73
ARKANSAS (AR)	$214.66	$128.59
ARIZONA (AZ)	$233.45	$136.36
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$301.94	$160.65
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$307.63	$163.14
OXNARD-THOUSAND OAKS-VENTURA (CA)	$264.79	$146.35
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$266.39	$147.85
NAPA (CA)	$286.55	$154.48
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$302.22	$160.94
VALLEJO (CA)	$286.14	$154.07
BAKERSFIELD (CA)	$251.43	$141.61
CHICO (CA)	$250.65	$140.83
FRESNO (CA)	$250.65	$140.83
HANFORD-CORCORAN (CA)	$250.65	$140.83
MADERA (CA)	$250.65	$140.83
MERCED (CA)	$250.65	$140.83
MODESTO (CA)	$250.65	$140.83
REDDING (CA)	$250.65	$140.83
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$253.38	$143.56
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$261.99	$145.46
SALINAS (CA)	$260.99	$144.85
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$308.79	$164.30
SANTA CRUZ-WATSONVILLE (CA)	$268.24	$146.50
SANTA ROSA-PETALUMA (CA)	$270.90	$147.85
STOCKTON (CA)	$250.65	$140.83
VISALIA (CA)	$250.65	$140.83
YUBA CITY (CA)	$250.65	$140.83
EL CENTRO (CA)	$250.69	$140.87
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$266.31	$146.47
SAN LUIS OBISPO-PASO ROBLES (CA)	$256.88	$142.75
SANTA MARIA-SANTA BARBARA (CA)	$261.74	$144.91
REST OF CALIFORNIA (CA)	$250.65	$140.83
COLORADO (CO)	$247.63	$141.01
CONNECTICUT (CT)	$253.78	$145.86
DC + MD/VA SUBURBS (DC)	$270.53	$152.49
DELAWARE (DE)	$237.00	$138.00
FORT LAUDERDALE (FL)	$247.78	$146.28
MIAMI (FL)	$257.86	$153.55
REST OF FLORIDA (FL)	$236.97	$141.18
ATLANTA (GA)	$243.41	$141.60
REST OF GEORGIA (GA)	$225.10	$135.72
HAWAII, GUAM (HI)	$255.49	$141.56
IOWA (IA)	$221.79	$130.11
IDAHO (ID)	$223.15	$130.97
EAST ST. LOUIS (IL)	$236.02	$143.83
SUBURBAN CHICAGO (IL)	$250.11	$147.20
CHICAGO (IL)	$251.29	$150.59
REST OF ILLINOIS (IL)	$231.24	$139.76
INDIANA (IN)	$224.28	$131.39
KANSAS (KS)	$221.09	$130.51
KENTUCKY (KY)	$222.35	$133.27
NEW ORLEANS (LA)	$231.73	$137.44
REST OF LOUISIANA (LA)	$222.13	$133.45
METROPOLITAN BOSTON (MA)	$269.87	$150.23
REST OF MASSACHUSETTS (MA)	$246.51	$141.00
BALTIMORE/SURR. CNTYS (MD)	$253.08	$145.57
REST OF MARYLAND (MD)	$241.06	$139.66
SOUTHERN MAINE (ME)	$234.76	$135.46
REST OF MAINE (ME)	$224.40	$132.21
DETROIT (MI)	$239.81	$143.11
REST OF MICHIGAN (MI)	$227.62	$136.13
MINNESOTA (MN)	$237.48	$134.37
METROPOLITAN ST. LOUIS (MO)	$232.21	$136.82
METROPOLITAN KANSAS CITY (MO)	$230.12	$136.03
REST OF MISSOURI (MO)	$218.93	$132.55
MISSISSIPPI (MS)	$216.82	$130.55
MONTANA** (MT)	$239.13	$138.93
NORTH CAROLINA (NC)	$226.42	$132.93
NORTH DAKOTA** (ND)	$234.19	$133.99
NEBRASKA (NE)	$222.79	$130.31
NEW HAMPSHIRE (NH)	$244.05	$139.74
NORTHERN NJ (NJ)	$268.32	$152.08
REST OF NEW JERSEY (NJ)	$256.73	$147.31
NEW MEXICO (NM)	$228.80	$136.91
NEVADA** (NV)	$237.90	$137.60
MANHATTAN (NY)	$273.02	$156.59
NYC SUBURBS/LONG ISLAND (NY)	$279.20	$160.06
POUGHKPSIE/N NYC SUBURBS (NY)	$258.54	$148.82
QUEENS (NY)	$274.72	$156.28
REST OF NEW YORK (NY)	$229.42	$134.23
OHIO (OH)	$226.61	$135.12
OKLAHOMA (OK)	$221.78	$132.30
PORTLAND (OR)	$254.48	$143.15
REST OF OREGON (OR)	$236.09	$136.29
METROPOLITAN PHILADELPHIA (PA)	$248.25	$143.94
REST OF PENNSYLVANIA (PA)	$226.80	$134.82
PUERTO RICO (PR)	$240.62	$139.31
RHODE ISLAND (RI)	$244.66	$141.15
SOUTH CAROLINA (SC)	$226.88	$134.29
SOUTH DAKOTA** (SD)	$233.61	$133.40
TENNESSEE (TN)	$222.09	$131.01
BRAZORIA (TX)	$236.70	$137.39
DALLAS (TX)	$238.16	$138.36
GALVESTON (TX)	$237.39	$137.88
HOUSTON (TX)	$241.96	$142.46
BEAUMONT (TX)	$225.51	$134.33
FORT WORTH (TX)	$236.82	$138.02
AUSTIN (TX)	$246.78	$140.76
REST OF TEXAS (TX)	$230.95	$135.86
UTAH (UT)	$229.60	$135.41
VIRGINIA (VA)	$234.23	$135.73
VIRGIN ISLANDS (VI)	$240.62	$139.31
VERMONT (VT)	$233.58	$134.38
SEATTLE (KING CNTY) (WA)	$274.82	$151.87
REST OF WASHINGTON (WA)	$245.95	$140.44
WISCONSIN (WI)	$227.28	$131.29
WEST VIRGINIA (WV)	$223.76	$136.68
WYOMING** (WY)	$236.98	$136.78

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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's PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, to reflect local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the dollar amount. Non-facility and facility amounts differ mainly because the practice-expense RVU is lower in facility settings, reflecting that the facility (not the billing physician) incurs certain overhead costs.

RVUs — work 2.57, practice expense 4.34 (non-facility) / 1.34 (facility), malpractice 0.25 — × 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 deductible; the patient or secondary insurer is generally responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, place of service, sequestration reductions, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why is the facility amount lower than the non-facility amount?

The facility amount uses a lower practice-expense RVU because the facility, rather than the physician's practice, absorbs certain overhead costs like equipment and supplies.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare-allowed amount before cost-sharing; Medicare generally pays 80% of this figure after the deductible, and the final payment can be affected by modifiers, sequestration, and locality-specific adjustments.

Why don't you show the CPT code's description?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so we reference the code generically rather than reproducing the official language.

Why does the amount differ by locality?

Medicare applies Geographic Practice Cost Indices (GPCIs) to adjust for regional differences in the cost of physician work, practice expenses, and malpractice insurance.

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.