Medicare Reimbursement for CPT 17312

This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for CPT code 17312, a procedure code whose official descriptor is maintained by the AMA and not reproduced here. Estimates are shown at the national level and can be adjusted by locality, and are broken out by non-facility (e.g., office) versus facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$402.81	$152.98
ALASKA* (AK)	$470.12	$204.04
ALABAMA (AL)	$362.50	$143.89
ARKANSAS (AR)	$357.39	$142.78
ARIZONA (AZ)	$392.42	$150.32
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$523.23	$170.96
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$533.63	$173.37
OXNARD-THOUSAND OAKS-VENTURA (CA)	$453.40	$158.09
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$455.54	$159.98
NAPA (CA)	$494.56	$165.27
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$523.61	$171.34
VALLEJO (CA)	$494.02	$164.73
BAKERSFIELD (CA)	$427.84	$154.01
CHICO (CA)	$426.82	$152.99
FRESNO (CA)	$426.82	$152.99
HANFORD-CORCORAN (CA)	$426.82	$152.99
MADERA (CA)	$426.82	$152.99
MERCED (CA)	$426.82	$152.99
MODESTO (CA)	$426.82	$152.99
REDDING (CA)	$426.82	$152.99
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$430.42	$156.59
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$447.90	$157.34
SALINAS (CA)	$446.23	$156.67
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$535.17	$174.90
SANTA CRUZ-WATSONVILLE (CA)	$461.07	$157.52
SANTA ROSA-PETALUMA (CA)	$465.73	$158.93
STOCKTON (CA)	$426.82	$152.99
VISALIA (CA)	$426.82	$152.99
YUBA CITY (CA)	$426.82	$152.99
EL CENTRO (CA)	$426.87	$153.05
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$456.70	$157.90
SAN LUIS OBISPO-PASO ROBLES (CA)	$439.04	$154.47
SANTA MARIA-SANTA BARBARA (CA)	$447.90	$156.58
REST OF CALIFORNIA (CA)	$426.82	$152.99
COLORADO (CO)	$419.88	$154.05
CONNECTICUT (CT)	$429.17	$160.09
DC + MD/VA SUBURBS (DC)	$460.46	$166.15
DELAWARE (DE)	$398.83	$151.99
FORT LAUDERDALE (FL)	$415.42	$162.33
MIAMI (FL)	$431.32	$171.24
REST OF FLORIDA (FL)	$395.85	$157.01
ATLANTA (GA)	$409.90	$156.06
REST OF GEORGIA (GA)	$374.23	$151.38
HAWAII, GUAM (HI)	$437.12	$153.05
IOWA (IA)	$372.01	$143.41
IDAHO (ID)	$374.27	$144.42
EAST ST. LOUIS (IL)	$391.25	$161.40
SUBURBAN CHICAGO (IL)	$419.75	$163.17
CHICAGO (IL)	$419.26	$168.17
REST OF ILLINOIS (IL)	$384.29	$156.19
INDIANA (IN)	$376.40	$144.80
KANSAS (KS)	$370.06	$144.21
KENTUCKY (KY)	$370.33	$148.22
NEW ORLEANS (LA)	$387.54	$152.45
REST OF LOUISIANA (LA)	$369.66	$148.56
METROPOLITAN BOSTON (MA)	$461.15	$162.85
REST OF MASSACHUSETTS (MA)	$417.36	$154.28
BALTIMORE/SURR. CNTYS (MD)	$427.90	$159.82
REST OF MARYLAND (MD)	$406.40	$153.56
SOUTHERN MAINE (ME)	$396.19	$148.60
REST OF MAINE (ME)	$375.91	$146.06
DETROIT (MI)	$400.43	$159.33
REST OF MICHIGAN (MI)	$379.51	$151.40
MINNESOTA (MN)	$403.30	$146.21
METROPOLITAN ST. LOUIS (MO)	$389.19	$151.35
METROPOLITAN KANSAS CITY (MO)	$385.22	$150.62
REST OF MISSOURI (MO)	$363.30	$147.94
MISSISSIPPI (MS)	$360.43	$145.32
MONTANA** (MT)	$402.79	$152.95
NORTH CAROLINA (NC)	$379.79	$146.69
NORTH DAKOTA** (ND)	$396.27	$146.43
NEBRASKA (NE)	$374.07	$143.47
NEW HAMPSHIRE (NH)	$413.09	$153.01
NORTHERN NJ (NJ)	$455.82	$166.01
REST OF NEW JERSEY (NJ)	$434.34	$161.51
NEW MEXICO (NM)	$381.44	$152.34
NEVADA** (NV)	$401.26	$151.17
MANHATTAN (NY)	$462.20	$171.89
NYC SUBURBS/LONG ISLAND (NY)	$472.87	$175.81
POUGHKPSIE/N NYC SUBURBS (NY)	$436.97	$163.40
QUEENS (NY)	$466.30	$170.99
REST OF NEW YORK (NY)	$385.33	$147.98
OHIO (OH)	$378.17	$150.07
OKLAHOMA (OK)	$369.94	$146.84
PORTLAND (OR)	$433.26	$155.69
REST OF OREGON (OR)	$398.40	$149.56
METROPOLITAN PHILADELPHIA (PA)	$418.53	$158.45
REST OF PENNSYLVANIA (PA)	$378.90	$149.55
PUERTO RICO (PR)	$405.78	$153.19
RHODE ISLAND (RI)	$413.05	$154.96
SOUTH CAROLINA (SC)	$379.56	$148.71
SOUTH DAKOTA** (SD)	$395.50	$145.66
TENNESSEE (TN)	$371.85	$144.74
BRAZORIA (TX)	$398.69	$151.10
DALLAS (TX)	$401.08	$152.24
GALVESTON (TX)	$399.79	$151.70
HOUSTON (TX)	$405.83	$157.74
BEAUMONT (TX)	$376.45	$149.10
FORT WORTH (TX)	$398.38	$152.04
AUSTIN (TX)	$418.26	$153.93
REST OF TEXAS (TX)	$387.25	$150.15
UTAH (UT)	$384.64	$149.79
VIRGINIA (VA)	$394.74	$149.15
VIRGIN ISLANDS (VI)	$405.78	$153.19
VERMONT (VT)	$394.53	$147.19
SEATTLE (KING CNTY) (WA)	$470.70	$164.15
REST OF WASHINGTON (WA)	$416.64	$153.56
WISCONSIN (WI)	$383.25	$143.90
WEST VIRGINIA (WV)	$370.33	$153.22
WYOMING** (WY)	$399.95	$150.11

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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 pricing for most physician services starts with three Relative Value Units (RVUs) — work, practice expense (PE), and malpractice (MP) — assigned to the code. Each RVU component is adjusted by a Geographic Practice Cost Index (GPCI) specific to the locality where the service is furnished, reflecting local cost differences. The locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility amounts differ mainly because the practice-expense RVU is higher in non-facility settings (reflecting the provider's overhead) and lower in facility settings (where the facility bears more of the overhead cost).

RVUs — work 3.22, practice expense 8.51 (non-facility) / 1.03 (facility), malpractice 0.33 — × 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 generally responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, multiple-procedure or bilateral adjustments, sequestration, and annual budget-neutrality adjustments to RVUs or the conversion factor.
Always confirm current rates and edits with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility amount differ from the non-facility amount for CPT 17312?

The facility rate uses a lower practice-expense RVU because the facility (e.g., hospital) — not the billing provider — is assumed to absorb most of the overhead costs, such as space, equipment, and supplies.

Will my local Medicare payment match the national amount shown?

Not necessarily. The national figure uses a standard GPCI of 1.0 for each component; actual payment in your area depends on the locality-specific GPCIs applied to the work, practice expense, and malpractice RVUs.

Does this amount include patient cost-sharing?

No. The figure represents the Medicare-allowed amount; Medicare generally pays 80% after the deductible, with the patient or secondary payer responsible for the rest.

Can modifiers change the payment for this code?

Yes. Modifiers (e.g., for bilateral procedures, reduced services, or multiple-procedure reductions) can increase or decrease the final allowed amount relative to the base PFS rate 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.