Medicare Reimbursement for CPT 20240

CPT 20240 is a procedure code used in Medicare billing; the full code descriptor is not reproduced here due to AMA licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted by locality, broken out by non-facility and facility place of service.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$126.59	$126.59
ALASKA* (AK)	$166.57	$166.57
ALABAMA (AL)	$118.27	$118.27
ARKANSAS (AR)	$117.26	$117.26
ARIZONA (AZ)	$124.16	$124.16
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$141.90	$141.90
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$143.90	$143.90
OXNARD-THOUSAND OAKS-VENTURA (CA)	$130.96	$130.96
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$132.51	$132.51
NAPA (CA)	$137.09	$137.09
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$142.24	$142.24
VALLEJO (CA)	$136.60	$136.60
BAKERSFIELD (CA)	$127.33	$127.33
CHICO (CA)	$126.43	$126.43
FRESNO (CA)	$126.43	$126.43
HANFORD-CORCORAN (CA)	$126.43	$126.43
MADERA (CA)	$126.43	$126.43
MERCED (CA)	$126.43	$126.43
MODESTO (CA)	$126.43	$126.43
REDDING (CA)	$126.43	$126.43
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$129.69	$129.69
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$130.17	$130.17
SALINAS (CA)	$129.62	$129.62
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$145.30	$145.30
SANTA CRUZ-WATSONVILLE (CA)	$130.54	$130.54
SANTA ROSA-PETALUMA (CA)	$131.72	$131.72
STOCKTON (CA)	$126.43	$126.43
VISALIA (CA)	$126.43	$126.43
YUBA CITY (CA)	$126.43	$126.43
EL CENTRO (CA)	$126.48	$126.48
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$130.76	$130.76
SAN LUIS OBISPO-PASO ROBLES (CA)	$127.79	$127.79
SANTA MARIA-SANTA BARBARA (CA)	$129.58	$129.58
REST OF CALIFORNIA (CA)	$126.43	$126.43
COLORADO (CO)	$127.44	$127.44
CONNECTICUT (CT)	$132.83	$132.83
DC + MD/VA SUBURBS (DC)	$137.95	$137.95
DELAWARE (DE)	$125.62	$125.62
FORT LAUDERDALE (FL)	$135.10	$135.10
MIAMI (FL)	$143.21	$143.21
REST OF FLORIDA (FL)	$130.23	$130.23
ATLANTA (GA)	$129.37	$129.37
REST OF GEORGIA (GA)	$125.09	$125.09
HAWAII, GUAM (HI)	$126.72	$126.72
IOWA (IA)	$117.85	$117.85
IDAHO (ID)	$118.77	$118.77
EAST ST. LOUIS (IL)	$134.21	$134.21
SUBURBAN CHICAGO (IL)	$135.78	$135.78
CHICAGO (IL)	$140.32	$140.32
REST OF ILLINOIS (IL)	$129.47	$129.47
INDIANA (IN)	$119.12	$119.12
KANSAS (KS)	$118.57	$118.57
KENTUCKY (KY)	$122.22	$122.22
NEW ORLEANS (LA)	$126.08	$126.08
REST OF LOUISIANA (LA)	$122.52	$122.52
METROPOLITAN BOSTON (MA)	$135.12	$135.12
REST OF MASSACHUSETTS (MA)	$127.59	$127.59
BALTIMORE/SURR. CNTYS (MD)	$132.64	$132.64
REST OF MARYLAND (MD)	$127.00	$127.00
SOUTHERN MAINE (ME)	$122.61	$122.61
REST OF MAINE (ME)	$120.26	$120.26
DETROIT (MI)	$132.35	$132.35
REST OF MICHIGAN (MI)	$125.12	$125.12
MINNESOTA (MN)	$120.46	$120.46
METROPOLITAN ST. LOUIS (MO)	$125.09	$125.09
METROPOLITAN KANSAS CITY (MO)	$124.42	$124.42
REST OF MISSOURI (MO)	$121.95	$121.95
MISSISSIPPI (MS)	$119.56	$119.56
MONTANA** (MT)	$126.57	$126.57
NORTH CAROLINA (NC)	$120.85	$120.85
NORTH DAKOTA** (ND)	$120.64	$120.64
NEBRASKA (NE)	$117.91	$117.91
NEW HAMPSHIRE (NH)	$126.64	$126.64
NORTHERN NJ (NJ)	$137.69	$137.69
REST OF NEW JERSEY (NJ)	$133.87	$133.87
NEW MEXICO (NM)	$125.97	$125.97
NEVADA** (NV)	$124.95	$124.95
MANHATTAN (NY)	$143.03	$143.03
NYC SUBURBS/LONG ISLAND (NY)	$146.60	$146.60
POUGHKPSIE/N NYC SUBURBS (NY)	$135.53	$135.53
QUEENS (NY)	$142.22	$142.22
REST OF NEW YORK (NY)	$122.03	$122.03
OHIO (OH)	$123.91	$123.91
OKLAHOMA (OK)	$120.96	$120.96
PORTLAND (OR)	$128.90	$128.90
REST OF OREGON (OR)	$123.49	$123.49
METROPOLITAN PHILADELPHIA (PA)	$131.35	$131.35
REST OF PENNSYLVANIA (PA)	$123.44	$123.44
PUERTO RICO (PR)	$126.79	$126.79
RHODE ISLAND (RI)	$128.17	$128.17
SOUTH CAROLINA (SC)	$122.67	$122.67
SOUTH DAKOTA** (SD)	$119.94	$119.94
TENNESSEE (TN)	$119.06	$119.06
BRAZORIA (TX)	$124.78	$124.78
DALLAS (TX)	$125.80	$125.80
GALVESTON (TX)	$125.32	$125.32
HOUSTON (TX)	$130.81	$130.81
BEAUMONT (TX)	$123.02	$123.02
FORT WORTH (TX)	$125.62	$125.62
AUSTIN (TX)	$127.46	$127.46
REST OF TEXAS (TX)	$124.00	$124.00
UTAH (UT)	$123.66	$123.66
VIRGINIA (VA)	$123.10	$123.10
VIRGIN ISLANDS (VI)	$126.79	$126.79
VERMONT (VT)	$121.32	$121.32
SEATTLE (KING CNTY) (WA)	$136.20	$136.20
REST OF WASHINGTON (WA)	$126.98	$126.98
WISCONSIN (WI)	$118.32	$118.32
WEST VIRGINIA (WV)	$126.75	$126.75
WYOMING** (WY)	$123.98	$123.98

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 4 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 billed, to reflect regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs (and therefore the final amount) can differ between non-facility settings (e.g., physician office) and facility settings (e.g., hospital), since Medicare assumes different overhead costs in each.

RVUs — work 2.54, practice expense 0.95 (non-facility) / 0.95 (facility), malpractice 0.3 — × 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's deductible is met; the beneficiary or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Locality-specific GPCI values and the conversion factor are updated periodically and may change year to year.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why do the non-facility and facility amounts sometimes differ?

Medicare assigns different practice-expense RVUs depending on whether the service is furnished in a non-facility setting (like a physician's office, where the practice bears more overhead) versus a facility setting (like a hospital, where the facility bears some costs). When the two amounts shown are equal, it typically means the practice-expense RVU for this code doesn't vary by site of service.

Does this amount reflect what my practice will actually be paid?

Not exactly. It reflects the Medicare-allowed amount before the beneficiary's coinsurance and deductible are applied, and before any modifier-driven or claim-specific adjustments.

Why does the amount vary by locality?

Medicare adjusts payment using Geographic Practice Cost Indices (GPCIs) to account for regional differences in wages, rent, and malpractice costs, so the same code can pay differently depending on where the service is billed.

Will this amount change next year?

Yes, it can. The conversion factor, RVUs, and GPCIs are all subject to annual updates and budget-neutrality adjustments from CMS.

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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.