Medicare Reimbursement for CPT 20606

CPT 20606 is a procedure code reported to Medicare and other payers for a specific physician service; the exact clinical descriptor is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, broken out separately for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$94.19	$44.76
ALASKA* (AK)	$112.49	$59.85
ALABAMA (AL)	$85.27	$42.02
ARKANSAS (AR)	$84.15	$41.68
ARIZONA (AZ)	$91.83	$43.93
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$118.55	$48.85
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$120.77	$49.48
OXNARD-THOUSAND OAKS-VENTURA (CA)	$104.05	$45.62
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$104.70	$46.22
NAPA (CA)	$112.55	$47.40
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$118.69	$48.99
VALLEJO (CA)	$112.35	$47.20
BAKERSFIELD (CA)	$98.76	$44.58
CHICO (CA)	$98.40	$44.22
FRESNO (CA)	$98.40	$44.22
HANFORD-CORCORAN (CA)	$98.40	$44.22
MADERA (CA)	$98.40	$44.22
MERCED (CA)	$98.40	$44.22
MODESTO (CA)	$98.40	$44.22
REDDING (CA)	$98.40	$44.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$99.71	$45.53
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$102.87	$45.38
SALINAS (CA)	$102.48	$45.19
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$121.32	$50.04
SANTA CRUZ-WATSONVILLE (CA)	$105.37	$45.31
SANTA ROSA-PETALUMA (CA)	$106.41	$45.71
STOCKTON (CA)	$98.40	$44.22
VISALIA (CA)	$98.40	$44.22
YUBA CITY (CA)	$98.40	$44.22
EL CENTRO (CA)	$98.42	$44.24
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$104.60	$45.47
SAN LUIS OBISPO-PASO ROBLES (CA)	$100.87	$44.57
SANTA MARIA-SANTA BARBARA (CA)	$102.78	$45.14
REST OF CALIFORNIA (CA)	$98.40	$44.22
COLORADO (CO)	$97.38	$44.79
CONNECTICUT (CT)	$100.11	$46.87
DC + MD/VA SUBURBS (DC)	$106.64	$48.40
DELAWARE (DE)	$93.26	$44.42
FORT LAUDERDALE (FL)	$98.18	$48.10
MIAMI (FL)	$102.67	$51.21
REST OF FLORIDA (FL)	$93.68	$46.42
ATLANTA (GA)	$96.01	$45.79
REST OF GEORGIA (GA)	$88.76	$44.66
HAWAII, GUAM (HI)	$100.37	$44.17
IOWA (IA)	$86.89	$41.66
IDAHO (ID)	$87.48	$42.00
EAST ST. LOUIS (IL)	$93.66	$48.18
SUBURBAN CHICAGO (IL)	$99.07	$48.30
CHICAGO (IL)	$99.90	$50.22
REST OF ILLINOIS (IL)	$91.45	$46.32
INDIANA (IN)	$87.94	$42.11
KANSAS (KS)	$86.69	$42.00
KENTUCKY (KY)	$87.47	$43.53
NEW ORLEANS (LA)	$91.35	$44.83
REST OF LOUISIANA (LA)	$87.42	$43.67
METROPOLITAN BOSTON (MA)	$106.24	$47.21
REST OF MASSACHUSETTS (MA)	$96.95	$44.89
BALTIMORE/SURR. CNTYS (MD)	$99.86	$46.82
REST OF MARYLAND (MD)	$94.88	$44.85
SOUTHERN MAINE (ME)	$92.19	$43.21
REST OF MAINE (ME)	$88.08	$42.60
DETROIT (MI)	$94.93	$47.23
REST OF MICHIGAN (MI)	$89.71	$44.58
MINNESOTA (MN)	$93.03	$42.17
METROPOLITAN ST. LOUIS (MO)	$91.44	$44.38
METROPOLITAN KANSAS CITY (MO)	$90.59	$44.18
REST OF MISSOURI (MO)	$86.16	$43.55
MISSISSIPPI (MS)	$85.16	$42.60
MONTANA** (MT)	$94.18	$44.75
NORTH CAROLINA (NC)	$88.89	$42.77
NORTH DAKOTA** (ND)	$91.81	$42.38
NEBRASKA (NE)	$87.27	$41.65
NEW HAMPSHIRE (NH)	$96.04	$44.58
NORTHERN NJ (NJ)	$105.72	$48.37
REST OF NEW JERSEY (NJ)	$101.17	$47.19
NEW MEXICO (NM)	$90.23	$44.90
NEVADA** (NV)	$93.58	$44.10
MANHATTAN (NY)	$107.94	$50.50
NYC SUBURBS/LONG ISLAND (NY)	$110.58	$51.80
POUGHKPSIE/N NYC SUBURBS (NY)	$101.96	$47.83
QUEENS (NY)	$108.51	$50.08
REST OF NEW YORK (NY)	$90.13	$43.17
OHIO (OH)	$89.22	$44.09
OKLAHOMA (OK)	$87.15	$43.01
PORTLAND (OR)	$100.07	$45.14
REST OF OREGON (OR)	$92.77	$43.53
METROPOLITAN PHILADELPHIA (PA)	$97.91	$46.45
REST OF PENNSYLVANIA (PA)	$89.26	$43.88
PUERTO RICO (PR)	$94.76	$44.79
RHODE ISLAND (RI)	$96.28	$45.21
SOUTH CAROLINA (SC)	$89.22	$43.55
SOUTH DAKOTA** (SD)	$91.53	$42.10
TENNESSEE (TN)	$87.11	$42.17
BRAZORIA (TX)	$93.05	$44.07
DALLAS (TX)	$93.69	$44.45
GALVESTON (TX)	$93.36	$44.27
HOUSTON (TX)	$95.56	$46.47
BEAUMONT (TX)	$88.74	$43.75
FORT WORTH (TX)	$93.16	$44.42
AUSTIN (TX)	$97.13	$44.83
REST OF TEXAS (TX)	$90.87	$43.96
UTAH (UT)	$90.33	$43.87
VIRGINIA (VA)	$92.04	$43.44
VIRGIN ISLANDS (VI)	$94.76	$44.79
VERMONT (VT)	$91.64	$42.70
SEATTLE (KING CNTY) (WA)	$108.13	$47.48
REST OF WASHINGTON (WA)	$96.70	$44.65
WISCONSIN (WI)	$89.00	$41.65
WEST VIRGINIA (WV)	$88.39	$45.43
WYOMING** (WY)	$93.15	$43.72

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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's PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because overhead costs differ, which is why the two allowed amounts shown on this page differ.

RVUs — work 0.98, practice expense 1.72 (non-facility) / 0.24 (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 Part B deductible is met; the beneficiary or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and other claim-specific adjustments can change the final paid amount.
Annual budget-neutrality adjustments and conversion factor updates change these figures each year.
Actual payment varies by locality and Medicare Administrative Contractor (MAC); verify current rates with your MAC before billing.

Frequently asked

Why does the facility amount differ from the non-facility amount for this code?

Facility and non-facility payments use different practice-expense RVUs because the overhead costs (staff, supplies, equipment) assumed for a hospital or facility setting differ from those in an office setting.

Why might the amount Medicare actually pays differ from the national figure shown here?

The national amount is a baseline; actual payment is adjusted by locality-specific GPCIs, and may be further affected by modifiers, sequestration, or site-of-service differentials.

Does this page show what the patient owes?

No. This page shows the Medicare-allowed amount. Medicare generally pays 80% of that amount after the deductible is met, with the patient or secondary insurance typically responsible for the rest.

Where can I find the official descriptor for CPT 20606?

CPT code descriptors are copyrighted by the American Medical Association. Refer to your current CPT codebook or AMA-licensed coding resource for the official language.

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.