Medicare Reimbursement for CPT 20610

This page explains the Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code (CPT descriptors are proprietary to the AMA and are not reproduced here). It shows the national estimate as well as locality-adjusted figures, broken out by non-facility (e.g., office) and facility (e.g., hospital outpatient/ASC) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$68.81	$39.75
ALASKA* (AK)	$82.23	$51.29
ALABAMA (AL)	$62.08	$36.65
ARKANSAS (AR)	$61.24	$36.28
ARIZONA (AZ)	$66.98	$38.82
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$84.64	$43.66
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$86.14	$44.24
OXNARD-THOUSAND OAKS-VENTURA (CA)	$74.94	$40.59
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$75.49	$41.12
NAPA (CA)	$80.61	$42.31
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$84.79	$43.81
VALLEJO (CA)	$80.40	$42.10
BAKERSFIELD (CA)	$71.32	$39.47
CHICO (CA)	$70.95	$39.10
FRESNO (CA)	$70.95	$39.10
HANFORD-CORCORAN (CA)	$70.95	$39.10
MADERA (CA)	$70.95	$39.10
MERCED (CA)	$70.95	$39.10
MODESTO (CA)	$70.95	$39.10
REDDING (CA)	$70.95	$39.10
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$72.35	$40.50
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$74.03	$40.24
SALINAS (CA)	$73.75	$40.07
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$86.75	$44.84
SANTA CRUZ-WATSONVILLE (CA)	$75.66	$40.35
SANTA ROSA-PETALUMA (CA)	$76.40	$40.71
STOCKTON (CA)	$70.95	$39.10
VISALIA (CA)	$70.95	$39.10
YUBA CITY (CA)	$70.95	$39.10
EL CENTRO (CA)	$70.97	$39.12
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$75.18	$40.43
SAN LUIS OBISPO-PASO ROBLES (CA)	$72.61	$39.52
SANTA MARIA-SANTA BARBARA (CA)	$73.94	$40.06
REST OF CALIFORNIA (CA)	$70.95	$39.10
COLORADO (CO)	$70.64	$39.72
CONNECTICUT (CT)	$73.22	$41.92
DC + MD/VA SUBURBS (DC)	$77.58	$43.35
DELAWARE (DE)	$68.03	$39.32
FORT LAUDERDALE (FL)	$72.82	$43.38
MIAMI (FL)	$77.03	$46.78
REST OF FLORIDA (FL)	$69.29	$41.50
ATLANTA (GA)	$70.38	$40.85
REST OF GEORGIA (GA)	$65.46	$39.53
HAWAII, GUAM (HI)	$72.29	$39.25
IOWA (IA)	$62.89	$36.31
IDAHO (ID)	$63.42	$36.68
EAST ST. LOUIS (IL)	$70.11	$43.38
SUBURBAN CHICAGO (IL)	$73.38	$43.54
CHICAGO (IL)	$74.80	$45.60
REST OF ILLINOIS (IL)	$67.88	$41.35
INDIANA (IN)	$63.75	$36.81
KANSAS (KS)	$62.93	$36.66
KENTUCKY (KY)	$64.14	$38.30
NEW ORLEANS (LA)	$67.11	$39.77
REST OF LOUISIANA (LA)	$64.17	$38.45
METROPOLITAN BOSTON (MA)	$76.90	$42.20
REST OF MASSACHUSETTS (MA)	$70.39	$39.79
BALTIMORE/SURR. CNTYS (MD)	$73.07	$41.89
REST OF MARYLAND (MD)	$69.17	$39.76
SOUTHERN MAINE (ME)	$66.85	$38.06
REST OF MAINE (ME)	$64.06	$37.33
DETROIT (MI)	$70.43	$42.39
REST OF MICHIGAN (MI)	$66.00	$39.46
MINNESOTA (MN)	$66.87	$36.97
METROPOLITAN ST. LOUIS (MO)	$66.95	$39.29
METROPOLITAN KANSAS CITY (MO)	$66.34	$39.06
REST OF MISSOURI (MO)	$63.35	$38.30
MISSISSIPPI (MS)	$62.29	$37.27
MONTANA** (MT)	$68.80	$39.74
NORTH CAROLINA (NC)	$64.64	$37.53
NORTH DAKOTA** (ND)	$66.23	$37.17
NEBRASKA (NE)	$63.12	$36.30
NEW HAMPSHIRE (NH)	$69.85	$39.60
NORTHERN NJ (NJ)	$76.92	$43.21
REST OF NEW JERSEY (NJ)	$73.82	$42.09
NEW MEXICO (NM)	$66.46	$39.82
NEVADA** (NV)	$68.12	$39.03
MANHATTAN (NY)	$79.27	$45.51
NYC SUBURBS/LONG ISLAND (NY)	$81.50	$46.94
POUGHKPSIE/N NYC SUBURBS (NY)	$74.56	$42.74
QUEENS (NY)	$79.42	$45.08
REST OF NEW YORK (NY)	$65.58	$37.97
OHIO (OH)	$65.47	$38.94
OKLAHOMA (OK)	$63.69	$37.74
PORTLAND (OR)	$72.41	$40.12
REST OF OREGON (OR)	$67.36	$38.42
METROPOLITAN PHILADELPHIA (PA)	$71.70	$41.45
REST OF PENNSYLVANIA (PA)	$65.39	$38.71
PUERTO RICO (PR)	$69.17	$39.79
RHODE ISLAND (RI)	$70.10	$40.09
SOUTH CAROLINA (SC)	$65.21	$38.36
SOUTH DAKOTA** (SD)	$65.92	$36.86
TENNESSEE (TN)	$63.27	$36.86
BRAZORIA (TX)	$67.71	$38.91
DALLAS (TX)	$68.27	$39.32
GALVESTON (TX)	$67.99	$39.14
HOUSTON (TX)	$70.37	$41.52
BEAUMONT (TX)	$65.01	$38.57
FORT WORTH (TX)	$67.93	$39.28
AUSTIN (TX)	$70.61	$39.87
REST OF TEXAS (TX)	$66.41	$38.83
UTAH (UT)	$66.04	$38.72
VIRGINIA (VA)	$66.87	$38.31
VIRGIN ISLANDS (VI)	$69.17	$39.79
VERMONT (VT)	$66.27	$37.51
SEATTLE (KING CNTY) (WA)	$78.09	$42.44
REST OF WASHINGTON (WA)	$70.16	$39.56
WISCONSIN (WI)	$64.17	$36.34
WEST VIRGINIA (WV)	$65.60	$40.35
WYOMING** (WY)	$67.68	$38.62

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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 each code starts with three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality to account for regional cost differences, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility and facility rates differ mainly because the practice-expense RVU is higher in non-facility settings (where the practice bears more overhead) and lower in facility settings (where the facility is paid separately). The conversion factor and RVUs are updated annually by CMS, so amounts can change year to year even if the code itself does not.

RVUs — work 0.77, practice expense 1.16 (non-facility) / 0.29 (facility), malpractice 0.13 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

All figures are estimates 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 insurer is generally responsible for the remainder.
Actual payment can vary by locality, facility type, modifiers, provider participation status, sequestration, and annual budget-neutrality adjustments.
Always confirm the exact allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why is the facility amount lower than the non-facility amount for this code?

In facility settings, the facility itself is paid separately for overhead costs, so the practice-expense RVU used in the physician payment calculation is reduced compared to non-facility settings.

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

No. It is a PFS-based estimate before application of the patient's deductible, coinsurance, any applicable modifiers, and local contractor adjustments.

Why do the RVUs and conversion factor change each year?

CMS reviews and updates RVUs periodically and sets a new conversion factor annually, often adjusting for budget-neutrality requirements under the PFS final rule.

Can two different localities have different allowed amounts for the same code?

Yes. The GPCI values vary by locality, so the same RVUs can produce different final allowed amounts depending on where the service is furnished.

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.