Medicare Reimbursement for CPT 20704

This page covers Medicare Physician Fee Schedule (PFS) estimated allowed amounts for this procedure code (CPT descriptors are AMA-licensed and not reproduced here). Amounts are shown nationally and can vary by locality, and are broken out by non-facility (e.g., office) and facility (e.g., hospital) settings. These figures reflect the estimated Medicare-allowed payment before patient cost-sharing is applied.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$155.65	$128.59
ALASKA* (AK)	$193.91	$165.10
ALABAMA (AL)	$141.53	$117.86
ARKANSAS (AR)	$139.80	$116.56
ARIZONA (AZ)	$151.53	$125.31
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$175.96	$137.81
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$178.48	$139.46
OXNARD-THOUSAND OAKS-VENTURA (CA)	$161.39	$129.41
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$163.24	$131.24
NAPA (CA)	$169.71	$134.05
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$176.54	$138.39
VALLEJO (CA)	$168.88	$133.22
BAKERSFIELD (CA)	$155.76	$126.11
CHICO (CA)	$154.35	$124.70
FRESNO (CA)	$154.35	$124.70
HANFORD-CORCORAN (CA)	$154.35	$124.70
MADERA (CA)	$154.35	$124.70
MERCED (CA)	$154.35	$124.70
MODESTO (CA)	$154.35	$124.70
REDDING (CA)	$154.35	$124.70
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$159.83	$130.18
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$159.56	$128.10
SALINAS (CA)	$158.92	$127.57
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$180.85	$141.83
SANTA CRUZ-WATSONVILLE (CA)	$161.09	$128.22
SANTA ROSA-PETALUMA (CA)	$162.55	$129.33
STOCKTON (CA)	$154.35	$124.70
VISALIA (CA)	$154.35	$124.70
YUBA CITY (CA)	$154.35	$124.70
EL CENTRO (CA)	$154.43	$124.78
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$160.93	$128.57
SAN LUIS OBISPO-PASO ROBLES (CA)	$156.66	$125.85
SANTA MARIA-SANTA BARBARA (CA)	$159.05	$127.50
REST OF CALIFORNIA (CA)	$154.35	$124.70
COLORADO (CO)	$156.38	$127.59
CONNECTICUT (CT)	$165.06	$135.92
DC + MD/VA SUBURBS (DC)	$171.73	$139.86
DELAWARE (DE)	$153.71	$126.98
FORT LAUDERDALE (FL)	$170.11	$142.70
MIAMI (FL)	$183.90	$155.73
REST OF FLORIDA (FL)	$161.85	$135.99
ATLANTA (GA)	$160.19	$132.70
REST OF GEORGIA (GA)	$153.11	$128.98
HAWAII, GUAM (HI)	$155.84	$125.08
IOWA (IA)	$140.81	$116.05
IDAHO (ID)	$142.37	$117.48
EAST ST. LOUIS (IL)	$168.62	$143.73
SUBURBAN CHICAGO (IL)	$170.84	$143.06
CHICAGO (IL)	$178.57	$151.38
REST OF ILLINOIS (IL)	$160.56	$135.86
INDIANA (IN)	$142.97	$117.89
KANSAS (KS)	$142.04	$117.58
KENTUCKY (KY)	$148.23	$124.18
NEW ORLEANS (LA)	$154.79	$129.33
REST OF LOUISIANA (LA)	$148.75	$124.81
METROPOLITAN BOSTON (MA)	$167.69	$135.38
REST OF MASSACHUSETTS (MA)	$156.40	$127.91
BALTIMORE/SURR. CNTYS (MD)	$164.97	$135.94
REST OF MARYLAND (MD)	$155.75	$128.37
SOUTHERN MAINE (ME)	$148.88	$122.07
REST OF MAINE (ME)	$144.91	$120.02
DETROIT (MI)	$165.45	$139.34
REST OF MICHIGAN (MI)	$153.17	$128.47
MINNESOTA (MN)	$145.22	$117.38
METROPOLITAN ST. LOUIS (MO)	$153.10	$127.34
METROPOLITAN KANSAS CITY (MO)	$151.98	$126.57
REST OF MISSOURI (MO)	$147.78	$124.46
MISSISSIPPI (MS)	$143.73	$120.43
MONTANA** (MT)	$155.61	$128.56
NORTH CAROLINA (NC)	$145.90	$120.65
NORTH DAKOTA** (ND)	$145.53	$118.47
NEBRASKA (NE)	$140.91	$115.94
NEW HAMPSHIRE (NH)	$155.72	$127.56
NORTHERN NJ (NJ)	$170.76	$139.37
REST OF NEW JERSEY (NJ)	$165.64	$136.10
NEW MEXICO (NM)	$154.61	$129.80
NEVADA** (NV)	$152.86	$125.78
MANHATTAN (NY)	$179.77	$148.33
NYC SUBURBS/LONG ISLAND (NY)	$185.84	$153.67
POUGHKPSIE/N NYC SUBURBS (NY)	$168.15	$138.53
QUEENS (NY)	$178.39	$146.42
REST OF NEW YORK (NY)	$147.90	$122.20
OHIO (OH)	$151.11	$126.41
OKLAHOMA (OK)	$146.10	$121.94
PORTLAND (OR)	$158.61	$128.56
REST OF OREGON (OR)	$150.37	$123.43
METROPOLITAN PHILADELPHIA (PA)	$162.67	$134.50
REST OF PENNSYLVANIA (PA)	$150.30	$125.47
PUERTO RICO (PR)	$155.98	$128.63
RHODE ISLAND (RI)	$157.19	$129.25
SOUTH CAROLINA (SC)	$149.01	$124.01
SOUTH DAKOTA** (SD)	$144.34	$117.28
TENNESSEE (TN)	$142.87	$118.27
BRAZORIA (TX)	$152.10	$125.28
DALLAS (TX)	$153.78	$126.83
GALVESTON (TX)	$153.02	$126.16
HOUSTON (TX)	$162.36	$135.49
BEAUMONT (TX)	$149.60	$124.98
FORT WORTH (TX)	$153.46	$126.79
AUSTIN (TX)	$156.99	$128.37
REST OF TEXAS (TX)	$151.25	$125.58
UTAH (UT)	$150.68	$125.25
VIRGINIA (VA)	$149.73	$123.13
VIRGIN ISLANDS (VI)	$155.98	$128.63
VERMONT (VT)	$146.70	$119.91
SEATTLE (KING CNTY) (WA)	$168.98	$135.78
REST OF WASHINGTON (WA)	$155.53	$127.04
WISCONSIN (WI)	$141.60	$115.68
WEST VIRGINIA (WV)	$155.95	$132.43
WYOMING** (WY)	$151.22	$124.16

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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: 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 payment is built from three Relative Value Units (RVUs): physician work, practice expense (PE), and malpractice (MP). Each RVU component is adjusted by a locality-specific Geographic Practice Cost Index (GPCI) to reflect regional cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility (e.g., physician office) and facility (e.g., hospital outpatient, ASC) settings because overhead costs differ, which is why the two allowed amounts differ. The conversion factor and RVUs are updated annually and can change due to legislation or budget-neutrality adjustments.

RVUs — work 2.54, practice expense 1.61 (non-facility) / 0.8 (facility), malpractice 0.51 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only — actual payment can differ based on your specific Medicare Administrative Contractor (MAC), locality, and claim-specific factors.
Medicare typically pays 80% of the allowed amount after the patient meets the Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers (e.g., bilateral, multiple procedure, assistant-at-surgery), sequestration, and annual budget-neutrality adjustments can increase or decrease the final paid amount.
Always verify current-year rates and locality-specific amounts with your MAC or the official CMS Physician Fee Schedule Look-Up Tool before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The practice-expense RVU is lower in the facility setting because Medicare assumes the facility (not the physician's office) absorbs certain overhead costs like equipment and supplies, resulting in a lower total RVU and payment for the same code.

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

No. It's a national or locality-adjusted estimate based on standard RVUs and the conversion factor. Your actual payment depends on your specific locality GPCI, any applicable modifiers, your contract status, and sequestration or other federal adjustments in effect at time of service.

Why might my remittance advice show a different amount than this estimate?

Remittance amounts can reflect modifier adjustments, multiple-procedure reductions, bundling edits, sequestration, secondary payer coordination, or a locality GPCI different from the one assumed in this estimate.

How often do these RVUs and the conversion factor change?

CMS updates RVUs and the conversion factor annually through rulemaking, and mid-year changes can occur due to legislation, so figures should be checked each calendar year.

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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.