Medicare Reimbursement for CPT 20501

CPT 20501 is a physician 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 (where available) by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$135.61	$31.06
ALASKA* (AK)	$153.97	$42.63
ALABAMA (AL)	$121.02	$29.55
ARKANSAS (AR)	$119.17	$29.36
ARIZONA (AZ)	$131.91	$30.60
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$181.12	$33.71
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$184.90	$34.14
OXNARD-THOUSAND OAKS-VENTURA (CA)	$155.17	$31.60
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$155.70	$32.02
NAPA (CA)	$170.53	$32.74
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$181.20	$33.79
VALLEJO (CA)	$170.42	$32.63
BAKERSFIELD (CA)	$145.58	$31.00
CHICO (CA)	$145.36	$30.78
FRESNO (CA)	$145.36	$30.78
HANFORD-CORCORAN (CA)	$145.36	$30.78
MADERA (CA)	$145.36	$30.78
MERCED (CA)	$145.36	$30.78
MODESTO (CA)	$145.36	$30.78
REDDING (CA)	$145.36	$30.78
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$146.13	$31.55
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$153.11	$31.52
SALINAS (CA)	$152.55	$31.38
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$185.22	$34.47
SANTA CRUZ-WATSONVILLE (CA)	$158.38	$31.36
SANTA ROSA-PETALUMA (CA)	$160.01	$31.63
STOCKTON (CA)	$145.36	$30.78
VISALIA (CA)	$145.36	$30.78
YUBA CITY (CA)	$145.36	$30.78
EL CENTRO (CA)	$145.38	$30.79
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$156.55	$31.52
SAN LUIS OBISPO-PASO ROBLES (CA)	$150.03	$30.96
SANTA MARIA-SANTA BARBARA (CA)	$153.23	$31.34
REST OF CALIFORNIA (CA)	$145.36	$30.78
COLORADO (CO)	$142.34	$31.10
CONNECTICUT (CT)	$144.95	$32.36
DC + MD/VA SUBURBS (DC)	$156.53	$33.38
DELAWARE (DE)	$134.19	$30.90
FORT LAUDERDALE (FL)	$138.91	$33.00
MIAMI (FL)	$143.63	$34.80
REST OF FLORIDA (FL)	$132.01	$32.06
ATLANTA (GA)	$137.89	$31.67
REST OF GEORGIA (GA)	$124.33	$31.08
HAWAII, GUAM (HI)	$149.50	$30.63
IOWA (IA)	$124.97	$29.31
IDAHO (ID)	$125.69	$29.51
EAST ST. LOUIS (IL)	$129.29	$33.11
SUBURBAN CHICAGO (IL)	$140.52	$33.15
CHICAGO (IL)	$139.35	$34.28
REST OF ILLINOIS (IL)	$127.48	$32.03
INDIANA (IN)	$126.48	$29.57
KANSAS (KS)	$124.03	$29.52
KENTUCKY (KY)	$123.36	$30.42
NEW ORLEANS (LA)	$129.52	$31.14
REST OF LOUISIANA (LA)	$123.03	$30.50
METROPOLITAN BOSTON (MA)	$157.42	$32.60
REST OF MASSACHUSETTS (MA)	$141.28	$31.20
BALTIMORE/SURR. CNTYS (MD)	$144.48	$32.31
REST OF MARYLAND (MD)	$136.97	$31.17
SOUTHERN MAINE (ME)	$133.77	$30.16
REST OF MAINE (ME)	$126.04	$29.86
DETROIT (MI)	$133.41	$32.53
REST OF MICHIGAN (MI)	$126.47	$31.02
MINNESOTA (MN)	$137.11	$29.53
METROPOLITAN ST. LOUIS (MO)	$130.40	$30.88
METROPOLITAN KANSAS CITY (MO)	$128.93	$30.76
REST OF MISSOURI (MO)	$120.57	$30.45
MISSISSIPPI (MS)	$119.91	$29.90
MONTANA** (MT)	$135.60	$31.06
NORTH CAROLINA (NC)	$127.49	$29.95
NORTH DAKOTA** (ND)	$134.22	$29.67
NEBRASKA (NE)	$125.79	$29.30
NEW HAMPSHIRE (NH)	$139.77	$30.93
NORTHERN NJ (NJ)	$154.69	$33.42
REST OF NEW JERSEY (NJ)	$146.81	$32.65
NEW MEXICO (NM)	$127.07	$31.20
NEVADA** (NV)	$135.33	$30.68
MANHATTAN (NY)	$156.15	$34.66
NYC SUBURBS/LONG ISLAND (NY)	$159.71	$35.41
POUGHKPSIE/N NYC SUBURBS (NY)	$147.52	$33.05
QUEENS (NY)	$157.98	$34.41
REST OF NEW YORK (NY)	$129.49	$30.17
OHIO (OH)	$126.18	$30.73
OKLAHOMA (OK)	$123.47	$30.11
PORTLAND (OR)	$147.45	$31.30
REST OF OREGON (OR)	$134.48	$30.35
METROPOLITAN PHILADELPHIA (PA)	$140.95	$32.12
REST OF PENNSYLVANIA (PA)	$126.58	$30.61
PUERTO RICO (PR)	$136.77	$31.07
RHODE ISLAND (RI)	$139.41	$31.41
SOUTH CAROLINA (SC)	$127.01	$30.41
SOUTH DAKOTA** (SD)	$134.06	$29.51
TENNESSEE (TN)	$124.65	$29.62
BRAZORIA (TX)	$134.31	$30.71
DALLAS (TX)	$135.06	$30.94
GALVESTON (TX)	$134.64	$30.83
HOUSTON (TX)	$135.92	$32.11
BEAUMONT (TX)	$125.67	$30.54
FORT WORTH (TX)	$134.01	$30.93
AUSTIN (TX)	$141.69	$31.08
REST OF TEXAS (TX)	$129.84	$30.63
UTAH (UT)	$128.86	$30.58
VIRGINIA (VA)	$133.07	$30.31
VIRGIN ISLANDS (VI)	$136.77	$31.07
VERMONT (VT)	$133.37	$29.87
SEATTLE (KING CNTY) (WA)	$161.06	$32.78
REST OF WASHINGTON (WA)	$141.12	$31.04
WISCONSIN (WI)	$129.43	$29.28
WEST VIRGINIA (WV)	$122.39	$31.55
WYOMING** (WY)	$135.00	$30.45

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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 starts with three Relative Value Units (RVUs) assigned to the 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 conversion factor to produce a dollar amount. Practice-expense RVUs differ depending on whether the service is reported in a non-facility setting (e.g., physician office) versus a facility setting (e.g., hospital outpatient or ASC), which is why non-facility and facility amounts differ. These figures update annually and can change due to RVU revisions, GPCI updates, or a new conversion factor.

RVUs — work 0.74, practice expense 3.25 (non-facility) / 0.12 (facility), malpractice 0.07 — × 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 patient or secondary payer is responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can reduce or otherwise change the final paid amount.
Annual budget-neutrality adjustments and mid-year rule changes can alter RVUs or the conversion factor.
Always verify the current, locality-specific amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the amount for CPT 20501 differ between facility and non-facility settings?

Facility and non-facility rates use different practice-expense RVUs because the resources a physician must supply differ — in a facility, the facility itself bears many of the direct costs, so the physician's practice-expense RVU is lower.

Why might the amount I was paid differ from the national figure shown here?

The national amount uses national average GPCIs; actual payments are calculated using the GPCIs for the specific locality where the service was rendered, so local amounts can be higher or lower.

Does this page tell me what the patient will owe?

No. This page shows the Medicare-allowed amount only. Patient responsibility depends on deductible status, coinsurance, and any secondary coverage.

Can this amount change during the year?

Yes. CMS can issue correction notices, and sequestration or other statutory adjustments can affect the actual amount paid even though the PFS rates are set annually.

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.