Medicare Reimbursement for CPT 20665

CPT 20665 is a procedure code defined by the AMA; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjustable by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$117.91	$85.84
ALASKA* (AK)	$143.00	$108.86
ALABAMA (AL)	$107.58	$79.53
ARKANSAS (AR)	$106.28	$78.74
ARIZONA (AZ)	$115.21	$84.14
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$148.63	$103.42
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$151.43	$105.19
OXNARD-THOUSAND OAKS-VENTURA (CA)	$130.47	$92.57
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$131.27	$93.33
NAPA (CA)	$141.10	$98.83
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$148.76	$103.55
VALLEJO (CA)	$140.92	$98.65
BAKERSFIELD (CA)	$124.01	$88.87
CHICO (CA)	$123.66	$88.51
FRESNO (CA)	$123.66	$88.51
HANFORD-CORCORAN (CA)	$123.66	$88.51
MADERA (CA)	$123.66	$88.51
MERCED (CA)	$123.66	$88.51
MODESTO (CA)	$123.66	$88.51
REDDING (CA)	$123.66	$88.51
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$124.87	$89.72
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$129.18	$91.89
SALINAS (CA)	$128.68	$91.51
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$151.94	$105.70
SANTA CRUZ-WATSONVILLE (CA)	$132.14	$93.18
SANTA ROSA-PETALUMA (CA)	$133.45	$94.07
STOCKTON (CA)	$123.66	$88.51
VISALIA (CA)	$123.66	$88.51
YUBA CITY (CA)	$123.66	$88.51
EL CENTRO (CA)	$123.68	$88.53
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$131.24	$92.89
SAN LUIS OBISPO-PASO ROBLES (CA)	$126.66	$90.14
SANTA MARIA-SANTA BARBARA (CA)	$129.03	$91.64
REST OF CALIFORNIA (CA)	$123.66	$88.51
COLORADO (CO)	$122.10	$87.98
CONNECTICUT (CT)	$124.94	$90.41
DC + MD/VA SUBURBS (DC)	$133.15	$95.37
DELAWARE (DE)	$116.92	$85.24
FORT LAUDERDALE (FL)	$121.78	$89.30
MIAMI (FL)	$126.38	$93.01
REST OF FLORIDA (FL)	$116.68	$86.03
ATLANTA (GA)	$119.89	$87.32
REST OF GEORGIA (GA)	$111.07	$82.47
HAWAII, GUAM (HI)	$125.92	$89.46
IOWA (IA)	$109.76	$80.42
IDAHO (ID)	$110.38	$80.88
EAST ST. LOUIS (IL)	$116.05	$86.55
SUBURBAN CHICAGO (IL)	$122.94	$90.01
CHICAGO (IL)	$123.32	$91.10
REST OF ILLINOIS (IL)	$113.90	$84.63
INDIANA (IN)	$110.92	$81.20
KANSAS (KS)	$109.38	$80.39
KENTUCKY (KY)	$109.84	$81.34
NEW ORLEANS (LA)	$114.29	$84.11
REST OF LOUISIANA (LA)	$109.72	$81.35
METROPOLITAN BOSTON (MA)	$132.87	$94.58
REST OF MASSACHUSETTS (MA)	$121.57	$87.81
BALTIMORE/SURR. CNTYS (MD)	$124.58	$90.18
REST OF MARYLAND (MD)	$118.89	$86.44
SOUTHERN MAINE (ME)	$115.92	$84.14
REST OF MAINE (ME)	$110.93	$81.43
DETROIT (MI)	$117.98	$87.04
REST OF MICHIGAN (MI)	$112.31	$83.03
MINNESOTA (MN)	$117.34	$84.35
METROPOLITAN ST. LOUIS (MO)	$114.56	$84.04
METROPOLITAN KANSAS CITY (MO)	$113.56	$83.45
REST OF MISSOURI (MO)	$108.18	$80.54
MISSISSIPPI (MS)	$107.24	$79.64
MONTANA** (MT)	$117.90	$85.83
NORTH CAROLINA (NC)	$111.90	$81.99
NORTH DAKOTA** (ND)	$115.72	$83.66
NEBRASKA (NE)	$110.24	$80.65
NEW HAMPSHIRE (NH)	$120.31	$86.93
NORTHERN NJ (NJ)	$132.12	$94.93
REST OF NEW JERSEY (NJ)	$126.46	$91.45
NEW MEXICO (NM)	$112.85	$83.45
NEVADA** (NV)	$117.36	$85.26
MANHATTAN (NY)	$134.21	$96.95
NYC SUBURBS/LONG ISLAND (NY)	$137.09	$98.97
POUGHKPSIE/N NYC SUBURBS (NY)	$127.31	$92.20
QUEENS (NY)	$135.08	$97.18
REST OF NEW YORK (NY)	$113.32	$82.86
OHIO (OH)	$111.86	$82.59
OKLAHOMA (OK)	$109.62	$80.98
PORTLAND (OR)	$125.42	$89.80
REST OF OREGON (OR)	$116.53	$84.60
METROPOLITAN PHILADELPHIA (PA)	$122.28	$88.90
REST OF PENNSYLVANIA (PA)	$111.98	$82.54
PUERTO RICO (PR)	$118.62	$86.20
RHODE ISLAND (RI)	$120.66	$87.53
SOUTH CAROLINA (SC)	$112.05	$82.42
SOUTH DAKOTA** (SD)	$115.47	$83.40
TENNESSEE (TN)	$109.85	$80.70
BRAZORIA (TX)	$116.82	$85.05
DALLAS (TX)	$117.50	$85.57
GALVESTON (TX)	$117.14	$85.30
HOUSTON (TX)	$119.15	$87.31
BEAUMONT (TX)	$111.36	$82.18
FORT WORTH (TX)	$116.85	$85.24
AUSTIN (TX)	$121.62	$87.70
REST OF TEXAS (TX)	$113.99	$83.56
UTAH (UT)	$113.34	$83.20
VIRGINIA (VA)	$115.64	$84.12
VIRGIN ISLANDS (VI)	$118.62	$86.20
VERMONT (VT)	$115.39	$83.65
SEATTLE (KING CNTY) (WA)	$135.30	$95.96
REST OF WASHINGTON (WA)	$121.30	$87.54
WISCONSIN (WI)	$112.43	$81.71
WEST VIRGINIA (WV)	$110.34	$82.48
WYOMING** (WY)	$116.95	$84.89

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. 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 allowed amount is built from three Relative Value Units (RVUs) — work, practice expense, and malpractice — that reflect the physician effort, overhead costs, and liability risk associated with the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, accounting for regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings, since overhead costs vary by site of service, which is why the two amounts differ.

RVUs — work 1.33, practice expense 2.09 (non-facility) / 1.13 (facility), malpractice 0.11 — × 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 beneficiary or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claims-processing adjustments, and sequestration.
Annual updates to RVUs, GPCIs, and the conversion factor — as well as budget-neutrality adjustments — can change this amount each year.
Verify 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?

The facility amount uses a lower practice-expense RVU because Medicare assumes the facility (e.g., hospital) — not the billing physician — incurs most of the overhead costs like equipment and supplies.

Does this amount reflect what the patient will owe?

No. This is the Medicare-allowed amount before cost-sharing. Patients are typically responsible for 20% coinsurance after the deductible, unless they have supplemental coverage.

Why might my MAC's actual payment differ from this estimate?

Locality-specific GPCIs, applied modifiers, claim-level adjustments, sequestration, and mid-year or annual policy updates can all cause the final paid amount to differ from this estimate.

Can I use this figure to predict reimbursement for a denied claim appeal?

This figure can serve as a reference point, but appeals should rely on the specific allowed amount from your remittance advice and your MAC's locality-specific fee schedule.

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.