Medicare Reimbursement for CPT 17280

CPT 17280 is a procedure code billed under the Medicare Physician Fee Schedule (PFS); the specific clinical descriptor is licensed by the AMA and not reproduced here. This page shows the estimated Medicare-allowed amount for this code 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)	$138.28	$74.48
ALASKA* (AK)	$162.50	$94.56
ALABAMA (AL)	$124.72	$68.90
ARKANSAS (AR)	$123.01	$68.21
ARIZONA (AZ)	$134.77	$72.95
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$178.51	$88.55
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$182.01	$90.02
OXNARD-THOUSAND OAKS-VENTURA (CA)	$155.09	$79.68
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$155.86	$80.39
NAPA (CA)	$168.87	$84.79
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$178.64	$88.69
VALLEJO (CA)	$168.67	$84.59
BAKERSFIELD (CA)	$146.54	$76.62
CHICO (CA)	$146.17	$76.25
FRESNO (CA)	$146.17	$76.25
HANFORD-CORCORAN (CA)	$146.17	$76.25
MADERA (CA)	$146.17	$76.25
MERCED (CA)	$146.17	$76.25
MODESTO (CA)	$146.17	$76.25
REDDING (CA)	$146.17	$76.25
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$147.48	$77.56
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$153.26	$79.06
SALINAS (CA)	$152.68	$78.74
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$182.57	$90.58
SANTA CRUZ-WATSONVILLE (CA)	$157.58	$80.07
SANTA ROSA-PETALUMA (CA)	$159.16	$80.82
STOCKTON (CA)	$146.17	$76.25
VISALIA (CA)	$146.17	$76.25
YUBA CITY (CA)	$146.17	$76.25
EL CENTRO (CA)	$146.19	$76.27
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$156.16	$79.86
SAN LUIS OBISPO-PASO ROBLES (CA)	$150.23	$77.57
SANTA MARIA-SANTA BARBARA (CA)	$153.22	$78.84
REST OF CALIFORNIA (CA)	$146.17	$76.25
COLORADO (CO)	$143.93	$76.05
CONNECTICUT (CT)	$147.19	$78.49
DC + MD/VA SUBURBS (DC)	$157.70	$82.55
DELAWARE (DE)	$136.94	$73.91
FORT LAUDERDALE (FL)	$142.75	$78.12
MIAMI (FL)	$148.28	$81.87
REST OF FLORIDA (FL)	$136.14	$75.15
ATLANTA (GA)	$140.72	$75.90
REST OF GEORGIA (GA)	$128.84	$71.93
HAWAII, GUAM (HI)	$149.54	$77.01
IOWA (IA)	$127.83	$69.46
IDAHO (ID)	$128.61	$69.91
EAST ST. LOUIS (IL)	$134.78	$76.09
SUBURBAN CHICAGO (IL)	$144.20	$78.69
CHICAGO (IL)	$144.22	$80.11
REST OF ILLINOIS (IL)	$132.31	$74.07
INDIANA (IN)	$129.32	$70.18
KANSAS (KS)	$127.22	$69.55
KENTUCKY (KY)	$127.45	$70.73
NEW ORLEANS (LA)	$133.25	$73.22
REST OF LOUISIANA (LA)	$127.24	$70.78
METROPOLITAN BOSTON (MA)	$157.81	$81.63
REST OF MASSACHUSETTS (MA)	$143.11	$75.93
BALTIMORE/SURR. CNTYS (MD)	$146.77	$78.31
REST OF MARYLAND (MD)	$139.48	$74.92
SOUTHERN MAINE (ME)	$135.95	$72.73
REST OF MAINE (ME)	$129.20	$70.51
DETROIT (MI)	$137.72	$76.16
REST OF MICHIGAN (MI)	$130.57	$72.33
MINNESOTA (MN)	$138.20	$72.55
METROPOLITAN ST. LOUIS (MO)	$133.75	$73.02
METROPOLITAN KANSAS CITY (MO)	$132.42	$72.52
REST OF MISSOURI (MO)	$125.13	$70.14
MISSISSIPPI (MS)	$124.09	$69.17
MONTANA** (MT)	$138.27	$74.48
NORTH CAROLINA (NC)	$130.50	$70.98
NORTH DAKOTA** (ND)	$135.90	$72.10
NEBRASKA (NE)	$128.51	$69.62
NEW HAMPSHIRE (NH)	$141.65	$75.24
NORTHERN NJ (NJ)	$156.18	$82.18
REST OF NEW JERSEY (NJ)	$148.95	$79.29
NEW MEXICO (NM)	$131.24	$72.74
NEVADA** (NV)	$137.70	$73.85
MANHATTAN (NY)	$158.49	$84.35
NYC SUBURBS/LONG ISLAND (NY)	$162.12	$86.27
POUGHKPSIE/N NYC SUBURBS (NY)	$149.89	$80.03
QUEENS (NY)	$159.80	$84.39
REST OF NEW YORK (NY)	$132.36	$71.76
OHIO (OH)	$130.09	$71.84
OKLAHOMA (OK)	$127.27	$70.30
PORTLAND (OR)	$148.38	$77.50
REST OF OREGON (OR)	$136.71	$73.17
METROPOLITAN PHILADELPHIA (PA)	$143.64	$77.23
REST OF PENNSYLVANIA (PA)	$130.31	$71.74
PUERTO RICO (PR)	$139.26	$74.76
RHODE ISLAND (RI)	$141.72	$75.82
SOUTH CAROLINA (SC)	$130.49	$71.55
SOUTH DAKOTA** (SD)	$135.62	$71.82
TENNESSEE (TN)	$127.82	$69.83
BRAZORIA (TX)	$136.87	$73.64
DALLAS (TX)	$137.69	$74.15
GALVESTON (TX)	$137.25	$73.90
HOUSTON (TX)	$139.44	$76.09
BEAUMONT (TX)	$129.49	$71.43
FORT WORTH (TX)	$136.80	$73.89
AUSTIN (TX)	$143.38	$75.89
REST OF TEXAS (TX)	$133.07	$72.53
UTAH (UT)	$132.20	$72.23
VIRGINIA (VA)	$135.49	$72.78
VIRGIN ISLANDS (VI)	$139.26	$74.76
VERMONT (VT)	$135.35	$72.20
SEATTLE (KING CNTY) (WA)	$160.99	$82.71
REST OF WASHINGTON (WA)	$142.85	$75.67
WISCONSIN (WI)	$131.54	$70.42
WEST VIRGINIA (WV)	$127.62	$72.19
WYOMING** (WY)	$137.24	$73.44

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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) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice-expense RVUs differ depending on whether the service is reported in a non-facility (e.g., physician office) or facility (e.g., hospital outpatient, ASC) setting, which is why the two amounts differ. Work and malpractice RVUs generally stay the same across settings, while the practice-expense RVU is typically lower in facility settings because overhead costs are assumed to be borne by the facility.

RVUs — work 1.19, practice expense 2.83 (non-facility) / 0.92 (facility), malpractice 0.12 — × 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 Part B deductible; the beneficiary or secondary payer is generally responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claims-processing adjustments, sequestration, and annual budget-neutrality or other regulatory changes.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why are there two different amounts for the same code?

Medicare uses separate practice-expense RVUs for non-facility and facility settings, reflecting different assumed overhead costs, which results in two different allowed amounts for the same code.

Does this amount reflect what the patient will owe?

No. The PFS amount shown is the Medicare-allowed amount; the patient's out-of-pocket responsibility depends on deductible status, coinsurance, and any secondary coverage.

Why might my MAC pay a different amount than shown here?

Locality-specific GPCIs, modifiers, sequestration, and periodic budget-neutrality adjustments can all cause the actual paid amount to differ from a national or generic locality estimate.

Is the conversion factor the same every year?

No. CMS updates the conversion factor annually, and RVUs can also change from year to year, so estimates should be recalculated for each applicable year.

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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.