Medicare Reimbursement for CPT 20827

CPT 20827 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount for this code at the national level and adjusted for your specific locality, with separate figures for non-facility and facility settings where they differ.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1643.66	$1643.66
ALASKA* (AK)	$2041.71	$2041.71
ALABAMA (AL)	$1491.12	$1491.12
ARKANSAS (AR)	$1472.46	$1472.46
ARIZONA (AZ)	$1598.89	$1598.89
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1847.83	$1847.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1873.78	$1873.78
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1698.39	$1698.39
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1718.40	$1718.40
NAPA (CA)	$1783.68	$1783.68
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1854.32	$1854.32
VALLEJO (CA)	$1774.34	$1774.34
BAKERSFIELD (CA)	$1639.67	$1639.67
CHICO (CA)	$1623.96	$1623.96
FRESNO (CA)	$1623.96	$1623.96
HANFORD-CORCORAN (CA)	$1623.96	$1623.96
MADERA (CA)	$1623.96	$1623.96
MERCED (CA)	$1623.96	$1623.96
MODESTO (CA)	$1623.96	$1623.96
REDDING (CA)	$1623.96	$1623.96
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1685.31	$1685.31
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1678.35	$1678.35
SALINAS (CA)	$1671.65	$1671.65
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1900.29	$1900.29
SANTA CRUZ-WATSONVILLE (CA)	$1693.95	$1693.95
SANTA ROSA-PETALUMA (CA)	$1709.26	$1709.26
STOCKTON (CA)	$1623.96	$1623.96
VISALIA (CA)	$1623.96	$1623.96
YUBA CITY (CA)	$1623.96	$1623.96
EL CENTRO (CA)	$1624.91	$1624.91
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1692.55	$1692.55
SAN LUIS OBISPO-PASO ROBLES (CA)	$1647.96	$1647.96
SANTA MARIA-SANTA BARBARA (CA)	$1672.87	$1672.87
REST OF CALIFORNIA (CA)	$1623.96	$1623.96
COLORADO (CO)	$1648.35	$1648.35
CONNECTICUT (CT)	$1744.58	$1744.58
DC + MD/VA SUBURBS (DC)	$1812.88	$1812.88
DELAWARE (DE)	$1622.17	$1622.17
FORT LAUDERDALE (FL)	$1805.02	$1805.02
MIAMI (FL)	$1958.15	$1958.15
REST OF FLORIDA (FL)	$1715.03	$1715.03
ATLANTA (GA)	$1693.61	$1693.61
REST OF GEORGIA (GA)	$1620.00	$1620.00
HAWAII, GUAM (HI)	$1639.83	$1639.83
IOWA (IA)	$1481.21	$1481.21
IDAHO (ID)	$1498.50	$1498.50
EAST ST. LOUIS (IL)	$1792.40	$1792.40
SUBURBAN CHICAGO (IL)	$1812.23	$1812.23
CHICAGO (IL)	$1899.69	$1899.69
REST OF ILLINOIS (IL)	$1702.48	$1702.48
INDIANA (IN)	$1504.89	$1504.89
KANSAS (KS)	$1495.48	$1495.48
KENTUCKY (KY)	$1565.49	$1565.49
NEW ORLEANS (LA)	$1636.67	$1636.67
REST OF LOUISIANA (LA)	$1571.46	$1571.46
METROPOLITAN BOSTON (MA)	$1767.64	$1767.64
REST OF MASSACHUSETTS (MA)	$1648.84	$1648.84
BALTIMORE/SURR. CNTYS (MD)	$1743.92	$1743.92
REST OF MARYLAND (MD)	$1643.66	$1643.66
SOUTHERN MAINE (ME)	$1568.26	$1568.26
REST OF MAINE (ME)	$1526.92	$1526.92
DETROIT (MI)	$1754.96	$1754.96
REST OF MICHIGAN (MI)	$1619.70	$1619.70
MINNESOTA (MN)	$1525.58	$1525.58
METROPOLITAN ST. LOUIS (MO)	$1617.25	$1617.25
METROPOLITAN KANSAS CITY (MO)	$1605.23	$1605.23
REST OF MISSOURI (MO)	$1561.68	$1561.68
MISSISSIPPI (MS)	$1516.30	$1516.30
MONTANA** (MT)	$1643.28	$1643.28
NORTH CAROLINA (NC)	$1537.41	$1537.41
NORTH DAKOTA** (ND)	$1530.37	$1530.37
NEBRASKA (NE)	$1482.06	$1482.06
NEW HAMPSHIRE (NH)	$1642.70	$1642.70
NORTHERN NJ (NJ)	$1802.30	$1802.30
REST OF NEW JERSEY (NJ)	$1749.30	$1749.30
NEW MEXICO (NM)	$1635.67	$1635.67
NEVADA** (NV)	$1612.37	$1612.37
MANHATTAN (NY)	$1903.10	$1903.10
NYC SUBURBS/LONG ISLAND (NY)	$1969.86	$1969.86
POUGHKPSIE/N NYC SUBURBS (NY)	$1777.00	$1777.00
QUEENS (NY)	$1886.80	$1886.80
REST OF NEW YORK (NY)	$1559.11	$1559.11
OHIO (OH)	$1596.63	$1596.63
OKLAHOMA (OK)	$1541.41	$1541.41
PORTLAND (OR)	$1671.10	$1671.10
REST OF OREGON (OR)	$1584.78	$1584.78
METROPOLITAN PHILADELPHIA (PA)	$1719.46	$1719.46
REST OF PENNSYLVANIA (PA)	$1587.40	$1587.40
PUERTO RICO (PR)	$1646.94	$1646.94
RHODE ISLAND (RI)	$1658.48	$1658.48
SOUTH CAROLINA (SC)	$1572.63	$1572.63
SOUTH DAKOTA** (SD)	$1517.02	$1517.02
TENNESSEE (TN)	$1504.57	$1504.57
BRAZORIA (TX)	$1603.84	$1603.84
DALLAS (TX)	$1622.40	$1622.40
GALVESTON (TX)	$1614.11	$1614.11
HOUSTON (TX)	$1718.62	$1718.62
BEAUMONT (TX)	$1579.89	$1579.89
FORT WORTH (TX)	$1619.30	$1619.30
AUSTIN (TX)	$1656.08	$1656.08
REST OF TEXAS (TX)	$1596.69	$1596.69
UTAH (UT)	$1590.72	$1590.72
VIRGINIA (VA)	$1578.10	$1578.10
VIRGIN ISLANDS (VI)	$1646.94	$1646.94
VERMONT (VT)	$1543.86	$1543.86
SEATTLE (KING CNTY) (WA)	$1780.19	$1780.19
REST OF WASHINGTON (WA)	$1639.29	$1639.29
WISCONSIN (WI)	$1488.24	$1488.24
WEST VIRGINIA (WV)	$1652.74	$1652.74
WYOMING** (WY)	$1594.07	$1594.07

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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 pricing starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, to reflect local 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 practice-expense RVUs, which is why separate amounts are often shown; for this code, the practice-expense RVU is the same in both settings, so the allowed amount does not differ by place of service.

RVUs — work 26.79, practice expense 16.71 (non-facility) / 16.71 (facility), malpractice 5.71 — × 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 their deductible; the patient or secondary payer is responsible for the remainder.
Actual payment can vary based on modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Always verify the current allowed amount and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why is the non-facility amount the same as the facility amount for this code?

The allowed amount depends on the practice-expense RVU assigned to each setting. When the non-facility and facility practice-expense RVUs are identical, as they are for this code, the resulting allowed amounts are also the same.

Why might my local Medicare payment differ from the national figure shown here?

The national amount uses a standard conversion factor and average cost assumptions, while your local payment reflects your locality's specific GPCI adjustments, which can raise or lower the amount relative to the national average.

Does this amount reflect what the patient will actually owe?

No. The figure shown is the Medicare-allowed amount before cost-sharing. Patients typically owe any unmet deductible plus 20% coinsurance, unless a secondary payer covers that portion.

Could this amount change during the year?

Yes. CMS can apply mid-year adjustments, sequestration, or budget-neutrality corrections, and the conversion factor and RVUs are updated annually, so amounts can change from year to year.

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.