Medicare Reimbursement for CPT 17276
This page covers CPT code 17276, a physician procedure code reimbursed under the Medicare Physician Fee Schedule (PFS). It shows the estimated Medicare-allowed amount nationally and by locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital outpatient) settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $279.23 | $167.67 |
| ALASKA* (AK) | $337.60 | $218.79 |
| ALABAMA (AL) | $254.05 | $156.44 |
| ARKANSAS (AR) | $250.88 | $155.05 |
| ARIZONA (AZ) | $272.57 | $164.47 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $349.18 | $191.88 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $355.63 | $194.76 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $307.40 | $175.54 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $309.40 | $177.43 |
| NAPA (CA) | $331.83 | $184.79 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $349.56 | $192.27 |
| VALLEJO (CA) | $331.27 | $184.24 |
| BAKERSFIELD (CA) | $292.35 | $170.09 |
| CHICO (CA) | $291.31 | $169.04 |
| FRESNO (CA) | $291.31 | $169.04 |
| HANFORD-CORCORAN (CA) | $291.31 | $169.04 |
| MADERA (CA) | $291.31 | $169.04 |
| MERCED (CA) | $291.31 | $169.04 |
| MODESTO (CA) | $291.31 | $169.04 |
| REDDING (CA) | $291.31 | $169.04 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $295.02 | $172.75 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $304.18 | $174.44 |
| SALINAS (CA) | $303.00 | $173.70 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $357.21 | $196.34 |
| SANTA CRUZ-WATSONVILLE (CA) | $311.01 | $175.47 |
| SANTA ROSA-PETALUMA (CA) | $314.07 | $177.08 |
| STOCKTON (CA) | $291.31 | $169.04 |
| VISALIA (CA) | $291.31 | $169.04 |
| YUBA CITY (CA) | $291.31 | $169.04 |
| EL CENTRO (CA) | $291.37 | $169.10 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $308.96 | $175.53 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $298.28 | $171.21 |
| SANTA MARIA-SANTA BARBARA (CA) | $303.82 | $173.74 |
| REST OF CALIFORNIA (CA) | $291.31 | $169.04 |
| COLORADO (CO) | $288.38 | $169.68 |
| CONNECTICUT (CT) | $296.21 | $176.06 |
| DC + MD/VA SUBURBS (DC) | $315.07 | $183.65 |
| DELAWARE (DE) | $276.67 | $166.45 |
| FORT LAUDERDALE (FL) | $290.51 | $177.50 |
| MIAMI (FL) | $303.24 | $187.10 |
| REST OF FLORIDA (FL) | $277.82 | $171.17 |
| ATLANTA (GA) | $284.42 | $171.08 |
| REST OF GEORGIA (GA) | $263.92 | $164.41 |
| HAWAII, GUAM (HI) | $296.64 | $169.80 |
| IOWA (IA) | $258.61 | $156.54 |
| IDAHO (ID) | $260.29 | $157.65 |
| EAST ST. LOUIS (IL) | $277.79 | $175.15 |
| SUBURBAN CHICAGO (IL) | $293.11 | $178.54 |
| CHICAGO (IL) | $295.49 | $183.37 |
| REST OF ILLINOIS (IL) | $271.53 | $169.68 |
| INDIANA (IN) | $261.57 | $158.15 |
| KANSAS (KS) | $258.05 | $157.20 |
| KENTUCKY (KY) | $260.28 | $161.11 |
| NEW ORLEANS (LA) | $271.22 | $166.24 |
| REST OF LOUISIANA (LA) | $260.13 | $161.40 |
| METROPOLITAN BOSTON (MA) | $313.75 | $180.55 |
| REST OF MASSACHUSETTS (MA) | $287.21 | $169.73 |
| BALTIMORE/SURR. CNTYS (MD) | $295.44 | $175.74 |
| REST OF MARYLAND (MD) | $281.30 | $168.41 |
| SOUTHERN MAINE (ME) | $273.58 | $163.03 |
| REST OF MAINE (ME) | $261.98 | $159.35 |
| DETROIT (MI) | $281.35 | $173.70 |
| REST OF MICHIGAN (MI) | $266.60 | $164.75 |
| MINNESOTA (MN) | $275.93 | $161.14 |
| METROPOLITAN ST. LOUIS (MO) | $271.48 | $165.27 |
| METROPOLITAN KANSAS CITY (MO) | $269.09 | $164.33 |
| REST OF MISSOURI (MO) | $256.58 | $160.42 |
| MISSISSIPPI (MS) | $253.75 | $157.70 |
| MONTANA** (MT) | $279.21 | $167.65 |
| NORTH CAROLINA (NC) | $264.28 | $160.19 |
| NORTH DAKOTA** (ND) | $272.49 | $160.93 |
| NEBRASKA (NE) | $259.69 | $156.73 |
| NEW HAMPSHIRE (NH) | $284.45 | $168.32 |
| NORTHERN NJ (NJ) | $312.59 | $183.18 |
| REST OF NEW JERSEY (NJ) | $299.47 | $177.65 |
| NEW MEXICO (NM) | $268.07 | $165.77 |
| NEVADA** (NV) | $277.50 | $165.83 |
| MANHATTAN (NY) | $318.91 | $189.27 |
| NYC SUBURBS/LONG ISLAND (NY) | $326.36 | $193.71 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $301.77 | $179.61 |
| QUEENS (NY) | $320.51 | $188.65 |
| REST OF NEW YORK (NY) | $267.76 | $161.78 |
| OHIO (OH) | $265.23 | $163.38 |
| OKLAHOMA (OK) | $259.37 | $159.74 |
| PORTLAND (OR) | $296.00 | $172.06 |
| REST OF OREGON (OR) | $275.21 | $164.10 |
| METROPOLITAN PHILADELPHIA (PA) | $289.97 | $173.84 |
| REST OF PENNSYLVANIA (PA) | $265.32 | $162.91 |
| PUERTO RICO (PR) | $280.84 | $168.06 |
| RHODE ISLAND (RI) | $285.36 | $170.12 |
| SOUTH CAROLINA (SC) | $265.22 | $162.14 |
| SOUTH DAKOTA** (SD) | $271.69 | $160.13 |
| TENNESSEE (TN) | $259.23 | $157.82 |
| BRAZORIA (TX) | $276.12 | $165.57 |
| DALLAS (TX) | $277.92 | $166.81 |
| GALVESTON (TX) | $276.99 | $166.21 |
| HOUSTON (TX) | $283.21 | $172.44 |
| BEAUMONT (TX) | $263.85 | $162.33 |
| FORT WORTH (TX) | $276.45 | $166.45 |
| AUSTIN (TX) | $287.54 | $169.51 |
| REST OF TEXAS (TX) | $269.87 | $164.00 |
| UTAH (UT) | $268.35 | $163.49 |
| VIRGINIA (VA) | $273.14 | $163.48 |
| VIRGIN ISLANDS (VI) | $280.84 | $168.06 |
| VERMONT (VT) | $272.00 | $161.56 |
| SEATTLE (KING CNTY) (WA) | $319.22 | $182.34 |
| REST OF WASHINGTON (WA) | $286.48 | $169.01 |
| WISCONSIN (WI) | $264.57 | $157.70 |
| WEST VIRGINIA (WV) | $262.90 | $165.96 |
| WYOMING** (WY) | $276.28 | $164.72 |
Look up another code or locality →
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 pricing for this code is based on three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — which are each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the Medicare locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility and facility settings because overhead costs (equipment, supplies, staff) are treated differently depending on where the service is furnished. The resulting allowed amount is recalculated each year as RVUs, GPCIs, and the conversion factor are updated.
RVUs — work 3.17, practice expense 4.85 (non-facility) / 1.51 (facility), malpractice 0.34 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- All figures are estimates based on the national PFS formula; actual payment depends on your specific Medicare Administrative Contractor (MAC) and locality.
- Medicare typically pays 80% of the allowed amount after the patient meets their annual Part B deductible; the patient or secondary payer is responsible for the remainder.
- Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
- Rates shown are for the stated calendar year and may not reflect mid-year or retroactive CMS corrections.
- Always confirm current rates and coverage rules with your MAC before billing or appealing a claim.
Frequently asked
Why is the facility amount lower than the non-facility amount for this code?
In the facility setting, Medicare assumes the facility (not the physician's practice) bears most overhead costs like equipment and supplies, so the practice-expense RVU component is lower, reducing the total allowed amount.
Why does the Medicare payment for this code vary by location?
Each Medicare locality has its own Geographic Practice Cost Indices (GPCIs) reflecting local differences in wages, rent, and malpractice costs, which adjust the RVUs before the conversion factor is applied.
Does this page show what Medicare will actually pay me?
No — this is an estimated allowed amount under the standard PFS formula. Actual reimbursement can differ due to modifiers, claim-specific adjustments, sequestration, and MAC-specific policies.
Why might this year's conversion factor differ from last year's?
CMS updates the conversion factor annually based on statutory requirements, budget-neutrality adjustments, and other policy changes finalized in the Medicare Physician Fee Schedule rule.
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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