Medicare Reimbursement for CPT 17286

CPT 17286 is a procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount for this code at the national level and adjusted by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital outpatient) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$352.05	$224.45
ALASKA* (AK)	$430.52	$294.64
ALABAMA (AL)	$321.54	$209.89
ARKANSAS (AR)	$317.70	$208.10
ARIZONA (AZ)	$343.92	$220.28
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$435.27	$255.37
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$443.13	$259.15
OXNARD-THOUSAND OAKS-VENTURA (CA)	$385.05	$234.24
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$387.77	$236.83
NAPA (CA)	$414.33	$246.16
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$435.79	$255.89
VALLEJO (CA)	$413.58	$245.41
BAKERSFIELD (CA)	$367.12	$227.28
CHICO (CA)	$365.71	$225.87
FRESNO (CA)	$365.71	$225.87
HANFORD-CORCORAN (CA)	$365.71	$225.87
MADERA (CA)	$365.71	$225.87
MERCED (CA)	$365.71	$225.87
MODESTO (CA)	$365.71	$225.87
REDDING (CA)	$365.71	$225.87
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$370.72	$230.88
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$381.26	$232.87
SALINAS (CA)	$379.77	$231.89
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$445.27	$261.28
SANTA CRUZ-WATSONVILLE (CA)	$388.99	$233.96
SANTA ROSA-PETALUMA (CA)	$392.78	$236.10
STOCKTON (CA)	$365.71	$225.87
VISALIA (CA)	$365.71	$225.87
YUBA CITY (CA)	$365.71	$225.87
EL CENTRO (CA)	$365.78	$225.94
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$386.77	$234.17
SAN LUIS OBISPO-PASO ROBLES (CA)	$373.91	$228.58
SANTA MARIA-SANTA BARBARA (CA)	$380.66	$231.89
REST OF CALIFORNIA (CA)	$365.71	$225.87
COLORADO (CO)	$362.64	$226.88
CONNECTICUT (CT)	$372.88	$235.46
DC + MD/VA SUBURBS (DC)	$395.61	$245.31
DELAWARE (DE)	$348.93	$222.87
FORT LAUDERDALE (FL)	$366.94	$237.69
MIAMI (FL)	$383.36	$250.53
REST OF FLORIDA (FL)	$351.38	$229.40
ATLANTA (GA)	$358.62	$228.99
REST OF GEORGIA (GA)	$334.40	$220.59
HAWAII, GUAM (HI)	$371.71	$226.63
IOWA (IA)	$326.57	$209.82
IDAHO (ID)	$328.69	$211.31
EAST ST. LOUIS (IL)	$352.37	$234.98
SUBURBAN CHICAGO (IL)	$370.08	$239.04
CHICAGO (IL)	$373.92	$245.69
REST OF ILLINOIS (IL)	$344.10	$227.61
INDIANA (IN)	$330.23	$211.95
KANSAS (KS)	$326.12	$210.77
KENTUCKY (KY)	$329.57	$216.14
NEW ORLEANS (LA)	$342.88	$222.82
REST OF LOUISIANA (LA)	$329.47	$216.55
METROPOLITAN BOSTON (MA)	$393.34	$241.00
REST OF MASSACHUSETTS (MA)	$361.37	$227.02
BALTIMORE/SURR. CNTYS (MD)	$371.94	$235.04
REST OF MARYLAND (MD)	$354.53	$225.41
SOUTHERN MAINE (ME)	$344.66	$218.22
REST OF MAINE (ME)	$330.98	$213.60
DETROIT (MI)	$355.91	$232.78
REST OF MICHIGAN (MI)	$337.43	$220.94
MINNESOTA (MN)	$346.76	$215.47
METROPOLITAN ST. LOUIS (MO)	$342.92	$221.45
METROPOLITAN KANSAS CITY (MO)	$340.06	$220.25
REST OF MISSOURI (MO)	$325.33	$215.34
MISSISSIPPI (MS)	$321.53	$211.67
MONTANA** (MT)	$352.01	$224.42
NORTH CAROLINA (NC)	$333.72	$214.68
NORTH DAKOTA** (ND)	$342.92	$215.33
NEBRASKA (NE)	$327.80	$210.04
NEW HAMPSHIRE (NH)	$357.94	$225.12
NORTHERN NJ (NJ)	$392.80	$244.79
REST OF NEW JERSEY (NJ)	$376.92	$237.59
NEW MEXICO (NM)	$339.30	$222.30
NEVADA** (NV)	$349.67	$221.95
MANHATTAN (NY)	$401.29	$253.03
NYC SUBURBS/LONG ISLAND (NY)	$410.60	$258.89
POUGHKPSIE/N NYC SUBURBS (NY)	$379.96	$240.25
QUEENS (NY)	$402.89	$252.08
REST OF NEW YORK (NY)	$337.95	$216.73
OHIO (OH)	$335.58	$219.08
OKLAHOMA (OK)	$328.21	$214.27
PORTLAND (OR)	$371.62	$229.86
REST OF OREGON (OR)	$346.72	$219.64
METROPOLITAN PHILADELPHIA (PA)	$365.46	$232.63
REST OF PENNSYLVANIA (PA)	$335.56	$218.43
PUERTO RICO (PR)	$353.91	$224.92
RHODE ISLAND (RI)	$359.45	$227.65
SOUTH CAROLINA (SC)	$335.25	$217.35
SOUTH DAKOTA** (SD)	$341.84	$214.25
TENNESSEE (TN)	$327.58	$211.60
BRAZORIA (TX)	$348.12	$221.67
DALLAS (TX)	$350.41	$223.33
GALVESTON (TX)	$349.24	$222.54
HOUSTON (TX)	$357.66	$230.96
BEAUMONT (TX)	$333.79	$217.68
FORT WORTH (TX)	$348.71	$222.90
AUSTIN (TX)	$361.65	$226.66
REST OF TEXAS (TX)	$340.83	$219.74
UTAH (UT)	$339.04	$219.10
VIRGINIA (VA)	$344.29	$218.86
VIRGIN ISLANDS (VI)	$353.91	$224.92
VERMONT (VT)	$342.55	$216.23
SEATTLE (KING CNTY) (WA)	$399.83	$243.27
REST OF WASHINGTON (WA)	$360.38	$226.03
WISCONSIN (WI)	$333.40	$211.17
WEST VIRGINIA (WV)	$333.68	$222.81
WYOMING** (WY)	$348.05	$220.46

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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 pricing for this code starts with three Relative Value Units (RVUs) — work, practice expense, and malpractice — that reflect physician effort, overhead costs, and liability risk. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality to account for regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Because practice-expense RVUs differ depending on where the service is performed, non-facility (e.g., physician office) and facility (e.g., hospital, ASC) rates are calculated separately, with non-facility typically reflecting higher overhead.

RVUs — work 4.37, practice expense 5.71 (non-facility) / 1.89 (facility), malpractice 0.46 — × 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 their annual deductible; the patient or secondary payer is responsible for the remainder.
Actual payment may vary due to modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Rates differ by locality based on GPCI values, so the national amount shown may not match your specific Medicare Administrative Contractor (MAC) locality.
Always verify current rates and coverage policy with your MAC before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The facility rate uses a lower practice-expense RVU because Medicare assumes the facility (not the physician's office) is absorbing certain overhead costs like equipment and supplies.

Why might my locality's payment differ from the national amount shown?

The national amount is before locality-specific GPCI adjustments. Actual payment depends on the GPCI values for the specific locality where the service was rendered.

Does this amount reflect what the patient owes?

No. The allowed amount is the total Medicare-approved rate. After the deductible is met, Medicare generally pays 80%, and the patient or secondary insurance is typically responsible for the remaining 20%.

Can modifiers change the reimbursement for this code?

Yes. Modifiers (such as those indicating bilateral procedures, reduced services, or multiple procedures) can increase, decrease, or otherwise adjust the base allowed amount.

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.