Medicare Reimbursement for CPT 20693

CPT code 20693 (descriptor not shown due to AMA licensing) is a physician procedure code priced under the Medicare Physician Fee Schedule (PFS). This page shows the estimated national Medicare allowed amount, along with how the amount can vary by locality and by site of service (non-facility vs. facility).

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$429.87	$429.87
ALASKA* (AK)	$525.65	$525.65
ALABAMA (AL)	$389.97	$389.97
ARKANSAS (AR)	$385.03	$385.03
ARIZONA (AZ)	$418.70	$418.70
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$509.39	$509.39
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$517.69	$517.69
OXNARD-THOUSAND OAKS-VENTURA (CA)	$458.10	$458.10
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$462.30	$462.30
NAPA (CA)	$487.82	$487.82
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$510.58	$510.58
VALLEJO (CA)	$486.11	$486.11
BAKERSFIELD (CA)	$438.86	$438.86
CHICO (CA)	$435.90	$435.90
FRESNO (CA)	$435.90	$435.90
HANFORD-CORCORAN (CA)	$435.90	$435.90
MADERA (CA)	$435.90	$435.90
MERCED (CA)	$435.90	$435.90
MODESTO (CA)	$435.90	$435.90
REDDING (CA)	$435.90	$435.90
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$447.22	$447.22
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$452.88	$452.88
SALINAS (CA)	$451.10	$451.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$522.56	$522.56
SANTA CRUZ-WATSONVILLE (CA)	$460.18	$460.18
SANTA ROSA-PETALUMA (CA)	$464.53	$464.53
STOCKTON (CA)	$435.90	$435.90
VISALIA (CA)	$435.90	$435.90
YUBA CITY (CA)	$435.90	$435.90
EL CENTRO (CA)	$436.08	$436.08
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$458.42	$458.42
SAN LUIS OBISPO-PASO ROBLES (CA)	$444.39	$444.39
SANTA MARIA-SANTA BARBARA (CA)	$451.89	$451.89
REST OF CALIFORNIA (CA)	$435.90	$435.90
COLORADO (CO)	$437.19	$437.19
CONNECTICUT (CT)	$456.38	$456.38
DC + MD/VA SUBURBS (DC)	$479.63	$479.63
DELAWARE (DE)	$424.95	$424.95
FORT LAUDERDALE (FL)	$460.77	$460.77
MIAMI (FL)	$491.59	$491.59
REST OF FLORIDA (FL)	$438.82	$438.82
ATLANTA (GA)	$440.67	$440.67
REST OF GEORGIA (GA)	$415.28	$415.28
HAWAII, GUAM (HI)	$442.15	$442.15
IOWA (IA)	$391.94	$391.94
IDAHO (ID)	$395.60	$395.60
EAST ST. LOUIS (IL)	$449.64	$449.64
SUBURBAN CHICAGO (IL)	$463.66	$463.66
CHICAGO (IL)	$477.66	$477.66
REST OF ILLINOIS (IL)	$432.44	$432.44
INDIANA (IN)	$397.43	$397.43
KANSAS (KS)	$393.52	$393.52
KENTUCKY (KY)	$404.98	$404.98
NEW ORLEANS (LA)	$422.99	$422.99
REST OF LOUISIANA (LA)	$405.70	$405.70
METROPOLITAN BOSTON (MA)	$472.40	$472.40
REST OF MASSACHUSETTS (MA)	$436.37	$436.37
BALTIMORE/SURR. CNTYS (MD)	$455.75	$455.75
REST OF MARYLAND (MD)	$431.34	$431.34
SOUTHERN MAINE (ME)	$415.15	$415.15
REST OF MAINE (ME)	$400.82	$400.82
DETROIT (MI)	$447.02	$447.02
REST OF MICHIGAN (MI)	$417.22	$417.22
MINNESOTA (MN)	$410.90	$410.90
METROPOLITAN ST. LOUIS (MO)	$420.46	$420.46
METROPOLITAN KANSAS CITY (MO)	$417.02	$417.02
REST OF MISSOURI (MO)	$401.72	$401.72
MISSISSIPPI (MS)	$393.28	$393.28
MONTANA** (MT)	$429.80	$429.80
NORTH CAROLINA (NC)	$403.98	$403.98
NORTH DAKOTA** (ND)	$409.04	$409.04
NEBRASKA (NE)	$392.86	$392.86
NEW HAMPSHIRE (NH)	$433.58	$433.58
NORTHERN NJ (NJ)	$476.27	$476.27
REST OF NEW JERSEY (NJ)	$459.33	$459.33
NEW MEXICO (NM)	$420.53	$420.53
NEVADA** (NV)	$424.21	$424.21
MANHATTAN (NY)	$495.03	$495.03
NYC SUBURBS/LONG ISLAND (NY)	$509.87	$509.87
POUGHKPSIE/N NYC SUBURBS (NY)	$464.87	$464.87
QUEENS (NY)	$493.93	$493.93
REST OF NEW YORK (NY)	$409.58	$409.58
OHIO (OH)	$412.98	$412.98
OKLAHOMA (OK)	$400.93	$400.93
PORTLAND (OR)	$445.96	$445.96
REST OF OREGON (OR)	$418.66	$418.66
METROPOLITAN PHILADELPHIA (PA)	$448.28	$448.28
REST OF PENNSYLVANIA (PA)	$411.75	$411.75
PUERTO RICO (PR)	$431.51	$431.51
RHODE ISLAND (RI)	$436.35	$436.35
SOUTH CAROLINA (SC)	$409.61	$409.61
SOUTH DAKOTA** (SD)	$406.58	$406.58
TENNESSEE (TN)	$395.67	$395.67
BRAZORIA (TX)	$421.96	$421.96
DALLAS (TX)	$425.88	$425.88
GALVESTON (TX)	$424.03	$424.03
HOUSTON (TX)	$443.25	$443.25
BEAUMONT (TX)	$409.61	$409.61
FORT WORTH (TX)	$424.36	$424.36
AUSTIN (TX)	$437.72	$437.72
REST OF TEXAS (TX)	$416.40	$416.40
UTAH (UT)	$414.45	$414.45
VIRGINIA (VA)	$416.20	$416.20
VIRGIN ISLANDS (VI)	$431.51	$431.51
VERMONT (VT)	$410.57	$410.57
SEATTLE (KING CNTY) (WA)	$478.13	$478.13
REST OF WASHINGTON (WA)	$434.52	$434.52
WISCONSIN (WI)	$397.31	$397.31
WEST VIRGINIA (WV)	$419.13	$419.13
WYOMING** (WY)	$420.75	$420.75

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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 fee for each code is built from three Relative Value Units (RVUs): physician work, practice expense (PE), and malpractice (MP). Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed, to reflect regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different PE RVUs because facility settings assume the facility absorbs certain overhead costs, which can result in different allowed amounts for the same code.

RVUs — work 5.91, practice expense 5.91 (non-facility) / 5.91 (facility), malpractice 1.05 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on published national RVUs and conversion factor; actual payment can differ.
Medicare typically pays 80% of the allowed amount after the patient meets the annual Part B deductible.
Modifiers, bilateral/multiple procedure rules, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs affect the final allowed amount and are not reflected in the national figure alone.
Confirm current-year rates and any local coverage or billing rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why might the allowed amount differ in my locality?

Medicare applies locality-specific GPCIs to the work, practice expense, and malpractice RVUs before multiplying by the conversion factor, so the same code can price differently across regions.

Why are the non-facility and facility amounts sometimes the same?

If the practice expense RVU is identical for both settings for this code, the non-facility and facility allowed amounts will match; this isn't the case for every code.

Does this page show what Medicare will actually pay me?

No. It shows the estimated allowed amount. Actual payment depends on the beneficiary's deductible status, coinsurance (typically 20%), modifiers, and any sequestration or other adjustments.

Where can I find the official CPT descriptor for this code?

CPT code descriptors are copyrighted by the American Medical Association (AMA); consult your CPT codebook or AMA resources 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.