Medicare Reimbursement for CPT Code 20690

This page covers a specific CPT procedure code (the official AMA descriptor is not reproduced here). It shows the Medicare Physician Fee Schedule (PFS) allowed amount at the national level and adjusted for a chosen locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$545.77	$545.77
ALASKA* (AK)	$675.92	$675.92
ALABAMA (AL)	$495.43	$495.43
ARKANSAS (AR)	$489.25	$489.25
ARIZONA (AZ)	$531.19	$531.19
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$622.56	$622.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$631.69	$631.69
OXNARD-THOUSAND OAKS-VENTURA (CA)	$568.77	$568.77
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$575.06	$575.06
NAPA (CA)	$599.61	$599.61
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$624.52	$624.52
VALLEJO (CA)	$596.78	$596.78
BAKERSFIELD (CA)	$548.01	$548.01
CHICO (CA)	$543.22	$543.22
FRESNO (CA)	$543.22	$543.22
HANFORD-CORCORAN (CA)	$543.22	$543.22
MADERA (CA)	$543.22	$543.22
MERCED (CA)	$543.22	$543.22
MODESTO (CA)	$543.22	$543.22
REDDING (CA)	$543.22	$543.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$561.82	$561.82
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$562.19	$562.19
SALINAS (CA)	$559.95	$559.95
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$639.73	$639.73
SANTA CRUZ-WATSONVILLE (CA)	$568.41	$568.41
SANTA ROSA-PETALUMA (CA)	$573.61	$573.61
STOCKTON (CA)	$543.22	$543.22
VISALIA (CA)	$543.22	$543.22
YUBA CITY (CA)	$543.22	$543.22
EL CENTRO (CA)	$543.51	$543.51
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$567.49	$567.49
SAN LUIS OBISPO-PASO ROBLES (CA)	$551.91	$551.91
SANTA MARIA-SANTA BARBARA (CA)	$560.51	$560.51
REST OF CALIFORNIA (CA)	$543.22	$543.22
COLORADO (CO)	$549.48	$549.48
CONNECTICUT (CT)	$579.18	$579.18
DC + MD/VA SUBURBS (DC)	$603.71	$603.71
DELAWARE (DE)	$538.94	$538.94
FORT LAUDERDALE (FL)	$595.09	$595.09
MIAMI (FL)	$642.41	$642.41
REST OF FLORIDA (FL)	$565.94	$565.94
ATLANTA (GA)	$561.48	$561.48
REST OF GEORGIA (GA)	$535.04	$535.04
HAWAII, GUAM (HI)	$549.13	$549.13
IOWA (IA)	$493.75	$493.75
IDAHO (ID)	$499.15	$499.15
EAST ST. LOUIS (IL)	$588.20	$588.20
SUBURBAN CHICAGO (IL)	$597.84	$597.84
CHICAGO (IL)	$623.61	$623.61
REST OF ILLINOIS (IL)	$560.72	$560.72
INDIANA (IN)	$501.32	$501.32
KANSAS (KS)	$497.71	$497.71
KENTUCKY (KY)	$518.43	$518.43
NEW ORLEANS (LA)	$541.71	$541.71
REST OF LOUISIANA (LA)	$520.11	$520.11
METROPOLITAN BOSTON (MA)	$590.34	$590.34
REST OF MASSACHUSETTS (MA)	$549.33	$549.33
BALTIMORE/SURR. CNTYS (MD)	$578.79	$578.79
REST OF MARYLAND (MD)	$546.32	$546.32
SOUTHERN MAINE (ME)	$522.63	$522.63
REST OF MAINE (ME)	$507.76	$507.76
DETROIT (MI)	$578.34	$578.34
REST OF MICHIGAN (MI)	$535.64	$535.64
MINNESOTA (MN)	$510.95	$510.95
METROPOLITAN ST. LOUIS (MO)	$536.19	$536.19
METROPOLITAN KANSAS CITY (MO)	$532.12	$532.12
REST OF MISSOURI (MO)	$516.38	$516.38
MISSISSIPPI (MS)	$502.60	$502.60
MONTANA** (MT)	$545.66	$545.66
NORTH CAROLINA (NC)	$511.37	$511.37
NORTH DAKOTA** (ND)	$511.45	$511.45
NEBRASKA (NE)	$494.27	$494.27
NEW HAMPSHIRE (NH)	$546.83	$546.83
NORTHERN NJ (NJ)	$600.04	$600.04
REST OF NEW JERSEY (NJ)	$581.40	$581.40
NEW MEXICO (NM)	$540.61	$540.61
NEVADA** (NV)	$536.32	$536.32
MANHATTAN (NY)	$630.67	$630.67
NYC SUBURBS/LONG ISLAND (NY)	$651.78	$651.78
POUGHKPSIE/N NYC SUBURBS (NY)	$589.97	$589.97
QUEENS (NY)	$626.39	$626.39
REST OF NEW YORK (NY)	$518.51	$518.51
OHIO (OH)	$528.65	$528.65
OKLAHOMA (OK)	$511.26	$511.26
PORTLAND (OR)	$557.98	$557.98
REST OF OREGON (OR)	$527.80	$527.80
METROPOLITAN PHILADELPHIA (PA)	$570.35	$570.35
REST OF PENNSYLVANIA (PA)	$526.02	$526.02
PUERTO RICO (PR)	$547.13	$547.13
RHODE ISLAND (RI)	$551.63	$551.63
SOUTH CAROLINA (SC)	$521.75	$521.75
SOUTH DAKOTA** (SD)	$507.40	$507.40
TENNESSEE (TN)	$500.63	$500.63
BRAZORIA (TX)	$533.53	$533.53
DALLAS (TX)	$539.33	$539.33
GALVESTON (TX)	$536.70	$536.70
HOUSTON (TX)	$568.37	$568.37
BEAUMONT (TX)	$523.48	$523.48
FORT WORTH (TX)	$538.06	$538.06
AUSTIN (TX)	$551.48	$551.48
REST OF TEXAS (TX)	$529.86	$529.86
UTAH (UT)	$527.75	$527.75
VIRGINIA (VA)	$525.35	$525.35
VIRGIN ISLANDS (VI)	$547.13	$547.13
VERMONT (VT)	$515.20	$515.20
SEATTLE (KING CNTY) (WA)	$595.36	$595.36
REST OF WASHINGTON (WA)	$546.39	$546.39
WISCONSIN (WI)	$497.30	$497.30
WEST VIRGINIA (WV)	$544.20	$544.20
WYOMING** (WY)	$530.75	$530.75

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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 Index (GPCI) for the locality where the service is performed, to reflect local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility amounts can differ because the practice-expense RVU changes depending on whether the service is furnished in a physician office (non-facility) versus a hospital or other facility setting; for this code, both settings currently use the same practice-expense RVU, so the amounts shown are equal.

RVUs — work 8.56, practice expense 6.05 (non-facility) / 6.05 (facility), malpractice 1.73 — × 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, sequestration reductions, and annual budget-neutrality adjustments to RVUs or the conversion factor.
Always confirm final payment amounts and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does the amount differ by locality?

The Geographic Practice Cost Index (GPCI) adjusts each RVU component — work, practice expense, and malpractice — to reflect regional differences in wages, rents, and other costs, so the same code can price differently across localities.

Why are the non-facility and facility amounts the same for this code?

The practice-expense RVU, which usually differs between settings to account for overhead the physician bears in an office versus a facility, is identical for this code, so both amounts calculate the same.

How much will Medicare actually pay?

After the Part B deductible is met, Medicare generally pays 80% of the allowed amount shown here; the patient or secondary payer is typically responsible for the remaining 20%, subject to any applicable modifiers or adjustments.

Does this reflect what I'll be reimbursed in 2026?

It reflects the PFS calculation using 2026 RVUs and conversion factor, but final payment can still be affected by claim-specific modifiers, sequestration, and any mid-year regulatory changes.

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.