Medicare Reimbursement for CPT 20824

CPT 20824 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and, where selected, adjusted for a specific locality, broken out by non-facility and facility place of service.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1841.06	$1841.06
ALASKA* (AK)	$2299.49	$2299.49
ALABAMA (AL)	$1672.55	$1672.55
ARKANSAS (AR)	$1651.99	$1651.99
ARIZONA (AZ)	$1791.21	$1791.21
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2050.03	$2050.03
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2077.97	$2077.97
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1892.11	$1892.11
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1915.30	$1915.30
NAPA (CA)	$1981.83	$1981.83
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2057.56	$2057.56
VALLEJO (CA)	$1970.98	$1970.98
BAKERSFIELD (CA)	$1829.84	$1829.84
CHICO (CA)	$1811.59	$1811.59
FRESNO (CA)	$1811.59	$1811.59
HANFORD-CORCORAN (CA)	$1811.59	$1811.59
MADERA (CA)	$1811.59	$1811.59
MERCED (CA)	$1811.59	$1811.59
MODESTO (CA)	$1811.59	$1811.59
REDDING (CA)	$1811.59	$1811.59
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1882.83	$1882.83
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1870.17	$1870.17
SALINAS (CA)	$1862.65	$1862.65
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2108.75	$2108.75
SANTA CRUZ-WATSONVILLE (CA)	$1884.68	$1884.68
SANTA ROSA-PETALUMA (CA)	$1901.57	$1901.57
STOCKTON (CA)	$1811.59	$1811.59
VISALIA (CA)	$1811.59	$1811.59
YUBA CITY (CA)	$1811.59	$1811.59
EL CENTRO (CA)	$1812.70	$1812.70
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1884.37	$1884.37
SAN LUIS OBISPO-PASO ROBLES (CA)	$1836.50	$1836.50
SANTA MARIA-SANTA BARBARA (CA)	$1863.58	$1863.58
REST OF CALIFORNIA (CA)	$1811.59	$1811.59
COLORADO (CO)	$1842.11	$1842.11
CONNECTICUT (CT)	$1952.97	$1952.97
DC + MD/VA SUBURBS (DC)	$2025.36	$2025.36
DELAWARE (DE)	$1816.94	$1816.94
FORT LAUDERDALE (FL)	$2027.52	$2027.52
MIAMI (FL)	$2203.40	$2203.40
REST OF FLORIDA (FL)	$1926.96	$1926.96
ATLANTA (GA)	$1897.96	$1897.96
REST OF GEORGIA (GA)	$1821.03	$1821.03
HAWAII, GUAM (HI)	$1827.17	$1827.17
IOWA (IA)	$1658.29	$1658.29
IDAHO (ID)	$1678.02	$1678.02
EAST ST. LOUIS (IL)	$2019.27	$2019.27
SUBURBAN CHICAGO (IL)	$2034.94	$2034.94
CHICAGO (IL)	$2138.01	$2138.01
REST OF ILLINOIS (IL)	$1915.34	$1915.34
INDIANA (IN)	$1684.95	$1684.95
KANSAS (KS)	$1675.62	$1675.62
KENTUCKY (KY)	$1757.95	$1757.95
NEW ORLEANS (LA)	$1837.00	$1837.00
REST OF LOUISIANA (LA)	$1765.15	$1765.15
METROPOLITAN BOSTON (MA)	$1971.72	$1971.72
REST OF MASSACHUSETTS (MA)	$1843.45	$1843.45
BALTIMORE/SURR. CNTYS (MD)	$1952.47	$1952.47
REST OF MARYLAND (MD)	$1840.25	$1840.25
SOUTHERN MAINE (ME)	$1754.13	$1754.13
REST OF MAINE (ME)	$1711.02	$1711.02
DETROIT (MI)	$1972.70	$1972.70
REST OF MICHIGAN (MI)	$1819.24	$1819.24
MINNESOTA (MN)	$1701.95	$1701.95
METROPOLITAN ST. LOUIS (MO)	$1813.70	$1813.70
METROPOLITAN KANSAS CITY (MO)	$1800.63	$1800.63
REST OF MISSOURI (MO)	$1755.37	$1755.37
MISSISSIPPI (MS)	$1702.75	$1702.75
MONTANA** (MT)	$1840.61	$1840.61
NORTH CAROLINA (NC)	$1722.31	$1722.31
NORTH DAKOTA** (ND)	$1709.52	$1709.52
NEBRASKA (NE)	$1658.72	$1658.72
NEW HAMPSHIRE (NH)	$1837.12	$1837.12
NORTHERN NJ (NJ)	$2014.33	$2014.33
REST OF NEW JERSEY (NJ)	$1957.44	$1957.44
NEW MEXICO (NM)	$1837.50	$1837.50
NEVADA** (NV)	$1804.65	$1804.65
MANHATTAN (NY)	$2131.24	$2131.24
NYC SUBURBS/LONG ISLAND (NY)	$2206.89	$2206.89
POUGHKPSIE/N NYC SUBURBS (NY)	$1989.40	$1989.40
QUEENS (NY)	$2110.93	$2110.93
REST OF NEW YORK (NY)	$1746.33	$1746.33
OHIO (OH)	$1792.44	$1792.44
OKLAHOMA (OK)	$1729.70	$1729.70
PORTLAND (OR)	$1865.30	$1865.30
REST OF OREGON (OR)	$1772.97	$1772.97
METROPOLITAN PHILADELPHIA (PA)	$1926.27	$1926.27
REST OF PENNSYLVANIA (PA)	$1781.39	$1781.39
PUERTO RICO (PR)	$1844.11	$1844.11
RHODE ISLAND (RI)	$1856.02	$1856.02
SOUTH CAROLINA (SC)	$1763.82	$1763.82
SOUTH DAKOTA** (SD)	$1694.02	$1694.02
TENNESSEE (TN)	$1685.82	$1685.82
BRAZORIA (TX)	$1795.45	$1795.45
DALLAS (TX)	$1816.66	$1816.66
GALVESTON (TX)	$1807.24	$1807.24
HOUSTON (TX)	$1928.59	$1928.59
BEAUMONT (TX)	$1773.21	$1773.21
FORT WORTH (TX)	$1813.75	$1813.75
AUSTIN (TX)	$1851.49	$1851.49
REST OF TEXAS (TX)	$1790.04	$1790.04
UTAH (UT)	$1783.72	$1783.72
VIRGINIA (VA)	$1766.11	$1766.11
VIRGIN ISLANDS (VI)	$1844.11	$1844.11
VERMONT (VT)	$1725.87	$1725.87
SEATTLE (KING CNTY) (WA)	$1984.03	$1984.03
REST OF WASHINGTON (WA)	$1832.35	$1832.35
WISCONSIN (WI)	$1663.49	$1663.49
WEST VIRGINIA (WV)	$1860.63	$1860.63
WYOMING** (WY)	$1783.48	$1783.48

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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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Index (GPCI) for the locality where the service is billed. The GPCI-adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar allowance. Non-facility (e.g., office) and facility (e.g., hospital) settings often differ because the practice-expense RVU changes depending on who bears the overhead cost; for this code, the practice-expense RVU is the same in both settings, so the resulting allowed amounts are identical. Localities with higher GPCIs (reflecting higher local costs) produce higher allowed amounts than the national average, and vice versa.

RVUs — work 31.15, practice expense 17.34 (non-facility) / 17.34 (facility), malpractice 6.63 — × 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 patient meets the annual deductible; the patient or secondary insurer is generally responsible for the remainder.
Modifiers, bilateral or multiple-procedure rules, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Allowed amounts vary by locality and MAC; always confirm the exact figure with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

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

The practice-expense RVU used to calculate the allowed amount is identical for both settings for this code, so the formula produces the same result regardless of place of service.

Why does the allowed amount change by locality?

Each locality has its own GPCI values for work, practice expense, and malpractice, which adjust the RVUs to reflect local cost differences before the conversion factor is applied.

Does this amount reflect what Medicare will actually pay?

No — it reflects the estimated allowed amount. Medicare generally pays 80% of that amount after the deductible, and the final payment can be affected by modifiers, sequestration, or claim-specific adjustments.

Where can I verify the exact payment for a denied or underpaid claim?

Check your Medicare Administrative Contractor's (MAC) published fee schedule for the specific locality and year, since posted PFS lookups can differ slightly from the amount on a remittance advice.

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.