Medicare Reimbursement for CPT 20900

CPT 20900 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and, where available, by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$398.14	$160.66
ALASKA* (AK)	$458.35	$205.43
ALABAMA (AL)	$355.65	$147.86
ARKANSAS (AR)	$350.28	$146.29
ARIZONA (AZ)	$387.02	$156.90
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$514.76	$179.91
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$524.87	$182.42
OXNARD-THOUSAND OAKS-VENTURA (CA)	$446.57	$165.86
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$448.78	$167.84
NAPA (CA)	$486.81	$173.81
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$515.30	$180.45
VALLEJO (CA)	$486.02	$173.02
BAKERSFIELD (CA)	$421.02	$160.74
CHICO (CA)	$419.65	$159.37
FRESNO (CA)	$419.65	$159.37
HANFORD-CORCORAN (CA)	$419.65	$159.37
MADERA (CA)	$419.65	$159.37
MERCED (CA)	$419.65	$159.37
MODESTO (CA)	$419.65	$159.37
REDDING (CA)	$419.65	$159.37
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$424.83	$164.55
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$440.55	$164.36
SALINAS (CA)	$438.93	$163.69
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$527.10	$184.65
SANTA CRUZ-WATSONVILLE (CA)	$453.87	$165.33
SANTA ROSA-PETALUMA (CA)	$458.44	$166.82
STOCKTON (CA)	$419.65	$159.37
VISALIA (CA)	$419.65	$159.37
YUBA CITY (CA)	$419.65	$159.37
EL CENTRO (CA)	$419.73	$159.45
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$449.44	$165.42
SAN LUIS OBISPO-PASO ROBLES (CA)	$431.87	$161.38
SANTA MARIA-SANTA BARBARA (CA)	$440.62	$163.72
REST OF CALIFORNIA (CA)	$419.65	$159.37
COLORADO (CO)	$413.99	$161.31
CONNECTICUT (CT)	$425.35	$169.58
DC + MD/VA SUBURBS (DC)	$455.83	$176.08
DELAWARE (DE)	$393.60	$158.97
FORT LAUDERDALE (FL)	$414.79	$174.22
MIAMI (FL)	$434.31	$187.09
REST OF FLORIDA (FL)	$393.70	$166.67
ATLANTA (GA)	$406.20	$164.92
REST OF GEORGIA (GA)	$370.52	$158.69
HAWAII, GUAM (HI)	$430.33	$160.31
IOWA (IA)	$364.31	$147.02
IDAHO (ID)	$366.95	$148.47
EAST ST. LOUIS (IL)	$391.66	$173.17
SUBURBAN CHICAGO (IL)	$418.88	$174.98
CHICAGO (IL)	$421.01	$182.34
REST OF ILLINOIS (IL)	$382.44	$165.62
INDIANA (IN)	$369.15	$149.00
KANSAS (KS)	$362.90	$148.22
KENTUCKY (KY)	$365.23	$154.11
NEW ORLEANS (LA)	$383.55	$160.08
REST OF LOUISIANA (LA)	$364.78	$154.61
METROPOLITAN BOSTON (MA)	$455.53	$171.98
REST OF MASSACHUSETTS (MA)	$411.51	$161.45
BALTIMORE/SURR. CNTYS (MD)	$424.25	$169.44
REST OF MARYLAND (MD)	$401.21	$160.88
SOUTHERN MAINE (ME)	$389.66	$154.32
REST OF MAINE (ME)	$369.34	$150.86
DETROIT (MI)	$399.19	$170.02
REST OF MICHIGAN (MI)	$375.48	$158.66
MINNESOTA (MN)	$395.09	$150.73
METROPOLITAN ST. LOUIS (MO)	$384.53	$158.45
METROPOLITAN KANSAS CITY (MO)	$380.43	$157.44
REST OF MISSOURI (MO)	$358.50	$153.79
MISSISSIPPI (MS)	$354.44	$149.97
MONTANA** (MT)	$398.11	$160.63
NORTH CAROLINA (NC)	$373.31	$151.74
NORTH DAKOTA** (ND)	$388.62	$151.14
NEBRASKA (NE)	$366.28	$147.09
NEW HAMPSHIRE (NH)	$407.79	$160.57
NORTHERN NJ (NJ)	$450.87	$175.40
REST OF NEW JERSEY (NJ)	$429.76	$170.43
NEW MEXICO (NM)	$377.77	$160.00
NEVADA** (NV)	$395.75	$158.03
MANHATTAN (NY)	$459.84	$183.89
NYC SUBURBS/LONG ISLAND (NY)	$471.86	$189.50
POUGHKPSIE/N NYC SUBURBS (NY)	$432.91	$172.87
QUEENS (NY)	$463.22	$182.52
REST OF NEW YORK (NY)	$379.17	$153.56
OHIO (OH)	$373.54	$156.72
OKLAHOMA (OK)	$364.15	$152.08
PORTLAND (OR)	$427.15	$163.31
REST OF OREGON (OR)	$392.24	$155.71
METROPOLITAN PHILADELPHIA (PA)	$414.65	$167.43
REST OF PENNSYLVANIA (PA)	$373.95	$155.94
PUERTO RICO (PR)	$401.02	$160.93
RHODE ISLAND (RI)	$407.65	$162.33
SOUTH CAROLINA (SC)	$374.13	$154.70
SOUTH DAKOTA** (SD)	$387.49	$150.01
TENNESSEE (TN)	$364.85	$148.98
BRAZORIA (TX)	$392.84	$157.49
DALLAS (TX)	$395.61	$159.08
GALVESTON (TX)	$394.17	$158.36
HOUSTON (TX)	$402.96	$167.14
BEAUMONT (TX)	$371.42	$155.31
FORT WORTH (TX)	$392.97	$158.82
AUSTIN (TX)	$412.99	$161.74
REST OF TEXAS (TX)	$382.09	$156.72
UTAH (UT)	$379.45	$156.22
VIRGINIA (VA)	$388.59	$155.15
VIRGIN ISLANDS (VI)	$401.02	$160.93
VERMONT (VT)	$387.38	$152.27
SEATTLE (KING CNTY) (WA)	$464.62	$173.23
REST OF WASHINGTON (WA)	$410.64	$160.58
WISCONSIN (WI)	$375.11	$147.60
WEST VIRGINIA (WV)	$367.81	$161.44
WYOMING** (WY)	$393.97	$156.49

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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 PFS amounts are built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality to reflect local cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings typically use different practice-expense RVUs because overhead costs differ, which is why two separate amounts are shown. The resulting figure is the full Medicare-allowed amount before patient cost-sharing is applied.

RVUs — work 2.93, practice expense 8.51 (non-facility) / 1.4 (facility), malpractice 0.48 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment or coverage.
Medicare typically pays 80% of the allowed amount after the patient meets the Part B deductible; the patient or secondary payer is generally responsible for the remainder.
Modifiers, sequestration, multiple-procedure reductions, and annual budget-neutrality adjustments can change the actual paid amount.
Amounts vary by locality due to GPCI differences; the national figure is a reference, not a locality-specific guarantee.
Always verify current rates and edits with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why do non-facility and facility amounts differ for this code?

The practice-expense RVU is lower in the facility setting because the facility (e.g., hospital) absorbs certain overhead and equipment costs, while in non-facility settings the billing provider bears those costs directly.

Does this amount include the patient's co-insurance?

No. The figures shown represent the full Medicare-allowed amount. Medicare generally pays 80% after the deductible, with the remaining 20% owed by the patient or a secondary payer.

Why might my MAC pay a different amount than shown here?

Local GPCI values, applied modifiers, claim-specific adjustments, sequestration, and mid-year or annual rule changes can all cause the actual payment to differ from this estimate.

Can I use this figure to predict exact reimbursement for my practice?

No. Use it as a planning reference only; confirm exact, locality-specific rates and any applicable edits directly with your MAC or current CMS fee schedule files.

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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.