Medicare Reimbursement for CPT Code 20902

This page covers the Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code, shown both as a national average and adjusted for local cost differences. Because CPT descriptors are proprietary to the AMA, we refer to the code generically rather than reproducing its official description. Amounts are broken out by non-facility and facility settings, which can differ depending on where the service is performed.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$241.82	$241.82
ALASKA* (AK)	$308.24	$308.24
ALABAMA (AL)	$221.69	$221.69
ARKANSAS (AR)	$219.24	$219.24
ARIZONA (AZ)	$235.82	$235.82
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$266.63	$266.63
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$270.17	$270.17
OXNARD-THOUSAND OAKS-VENTURA (CA)	$247.34	$247.34
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$250.49	$250.49
NAPA (CA)	$258.19	$258.19
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$267.58	$267.58
VALLEJO (CA)	$256.84	$256.84
BAKERSFIELD (CA)	$240.04	$240.04
CHICO (CA)	$237.72	$237.72
FRESNO (CA)	$237.72	$237.72
HANFORD-CORCORAN (CA)	$237.72	$237.72
MADERA (CA)	$237.72	$237.72
MERCED (CA)	$237.72	$237.72
MODESTO (CA)	$237.72	$237.72
REDDING (CA)	$237.72	$237.72
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$246.66	$246.66
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$244.90	$244.90
SALINAS (CA)	$243.89	$243.89
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$274.02	$274.02
SANTA CRUZ-WATSONVILLE (CA)	$246.03	$246.03
SANTA ROSA-PETALUMA (CA)	$248.21	$248.21
STOCKTON (CA)	$237.72	$237.72
VISALIA (CA)	$237.72	$237.72
YUBA CITY (CA)	$237.72	$237.72
EL CENTRO (CA)	$237.86	$237.86
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$246.30	$246.30
SAN LUIS OBISPO-PASO ROBLES (CA)	$240.50	$240.50
SANTA MARIA-SANTA BARBARA (CA)	$243.90	$243.90
REST OF CALIFORNIA (CA)	$237.72	$237.72
COLORADO (CO)	$241.69	$241.69
CONNECTICUT (CT)	$255.62	$255.62
DC + MD/VA SUBURBS (DC)	$264.55	$264.55
DELAWARE (DE)	$238.99	$238.99
FORT LAUDERDALE (FL)	$265.06	$265.06
MIAMI (FL)	$286.87	$286.87
REST OF FLORIDA (FL)	$252.92	$252.92
ATLANTA (GA)	$248.88	$248.88
REST OF GEORGIA (GA)	$240.15	$240.15
HAWAII, GUAM (HI)	$239.03	$239.03
IOWA (IA)	$219.60	$219.60
IDAHO (ID)	$222.03	$222.03
EAST ST. LOUIS (IL)	$264.75	$264.75
SUBURBAN CHICAGO (IL)	$266.02	$266.02
CHICAGO (IL)	$279.09	$279.09
REST OF ILLINOIS (IL)	$251.79	$251.79
INDIANA (IN)	$222.84	$222.84
KANSAS (KS)	$221.85	$221.85
KENTUCKY (KY)	$232.27	$232.27
NEW ORLEANS (LA)	$241.77	$241.77
REST OF LOUISIANA (LA)	$233.21	$233.21
METROPOLITAN BOSTON (MA)	$257.47	$257.47
REST OF MASSACHUSETTS (MA)	$242.02	$242.02
BALTIMORE/SURR. CNTYS (MD)	$255.51	$255.51
REST OF MARYLAND (MD)	$241.82	$241.82
SOUTHERN MAINE (ME)	$231.01	$231.01
REST OF MAINE (ME)	$226.16	$226.16
DETROIT (MI)	$258.57	$258.57
REST OF MICHIGAN (MI)	$239.76	$239.76
MINNESOTA (MN)	$224.18	$224.18
METROPOLITAN ST. LOUIS (MO)	$238.77	$238.77
METROPOLITAN KANSAS CITY (MO)	$237.23	$237.23
REST OF MISSOURI (MO)	$232.16	$232.16
MISSISSIPPI (MS)	$225.58	$225.58
MONTANA** (MT)	$241.77	$241.77
NORTH CAROLINA (NC)	$227.47	$227.47
NORTH DAKOTA** (ND)	$225.36	$225.36
NEBRASKA (NE)	$219.59	$219.59
NEW HAMPSHIRE (NH)	$241.01	$241.01
NORTHERN NJ (NJ)	$263.48	$263.48
REST OF NEW JERSEY (NJ)	$256.45	$256.45
NEW MEXICO (NM)	$242.02	$242.02
NEVADA** (NV)	$237.26	$237.26
MANHATTAN (NY)	$278.12	$278.12
NYC SUBURBS/LONG ISLAND (NY)	$287.38	$287.38
POUGHKPSIE/N NYC SUBURBS (NY)	$260.52	$260.52
QUEENS (NY)	$275.42	$275.42
REST OF NEW YORK (NY)	$230.35	$230.35
OHIO (OH)	$236.41	$236.41
OKLAHOMA (OK)	$228.71	$228.71
PORTLAND (OR)	$244.31	$244.31
REST OF OREGON (OR)	$233.33	$233.33
METROPOLITAN PHILADELPHIA (PA)	$252.52	$252.52
REST OF PENNSYLVANIA (PA)	$234.98	$234.98
PUERTO RICO (PR)	$242.12	$242.12
RHODE ISLAND (RI)	$243.80	$243.80
SOUTH CAROLINA (SC)	$232.74	$232.74
SOUTH DAKOTA** (SD)	$223.41	$223.41
TENNESSEE (TN)	$223.09	$223.09
BRAZORIA (TX)	$236.33	$236.33
DALLAS (TX)	$238.97	$238.97
GALVESTON (TX)	$237.80	$237.80
HOUSTON (TX)	$252.99	$252.99
BEAUMONT (TX)	$234.02	$234.02
FORT WORTH (TX)	$238.68	$238.68
AUSTIN (TX)	$242.72	$242.72
REST OF TEXAS (TX)	$235.83	$235.83
UTAH (UT)	$235.11	$235.11
VIRGINIA (VA)	$232.57	$232.57
VIRGIN ISLANDS (VI)	$242.12	$242.12
VERMONT (VT)	$227.48	$227.48
SEATTLE (KING CNTY) (WA)	$258.92	$258.92
REST OF WASHINGTON (WA)	$240.57	$240.57
WISCONSIN (WI)	$219.92	$219.92
WEST VIRGINIA (WV)	$245.28	$245.28
WYOMING** (WY)	$234.61	$234.61

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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 PFS amount starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice risk. Each RVU component is adjusted by a Geographic Practice Cost Index (GPCI) specific to the locality where the service is billed, which accounts for differences in local wages and costs. The adjusted RVUs are summed and multiplied by the annual national conversion factor (a dollar figure set by CMS) to produce the allowed amount. Practice-expense RVUs — and therefore the final payment — can differ between non-facility settings (such as a physician's office) and facility settings (such as a hospital), since overhead costs differ in each environment.

RVUs — work 4.47, practice expense 1.94 (non-facility) / 1.94 (facility), malpractice 0.83 — × 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 Part B deductible is met; the patient or secondary insurance is responsible for the remainder.
Actual payment varies by locality, applicable modifiers, claim-specific circumstances, and federal sequestration reductions.
Annual budget-neutrality adjustments and conversion factor updates can change amounts from one year to the next.
Always confirm the exact allowed amount and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why do non-facility and facility amounts sometimes match or differ?

The practice-expense RVU component accounts for overhead costs, which can vary depending on whether the service is performed in a physician's office (non-facility) or a hospital/facility setting. When the underlying practice-expense RVUs are the same for both settings, the resulting allowed amounts will also be the same.

What is the conversion factor and why does it matter?

The conversion factor is a dollar amount set annually by CMS that converts total adjusted RVUs into a payment amount. Even if RVUs stay the same, a change in the conversion factor from year to year will change the allowed amount.

Will Medicare pay this full amount?

No. Medicare Part B generally pays 80% of the allowed amount after the annual deductible is satisfied; the remaining 20% is typically the patient's or secondary payer's responsibility.

Does this amount apply everywhere in the country?

No. The national figure is a baseline; actual payment is adjusted locality-by-locality using GPCIs that reflect regional cost-of-practice differences.

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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.