Medicare Reimbursement for CPT 20910

This page covers CPT code 20910, a physician procedure code. It shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for 2026, both at the national level and adjustable by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$463.94	$463.94
ALASKA* (AK)	$552.66	$552.66
ALABAMA (AL)	$416.58	$416.58
ARKANSAS (AR)	$410.69	$410.69
ARIZONA (AZ)	$450.80	$450.80
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$559.61	$559.61
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$569.09	$569.09
OXNARD-THOUSAND OAKS-VENTURA (CA)	$499.18	$499.18
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$503.34	$503.34
NAPA (CA)	$534.45	$534.45
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$560.91	$560.91
VALLEJO (CA)	$532.57	$532.57
BAKERSFIELD (CA)	$475.91	$475.91
CHICO (CA)	$472.74	$472.74
FRESNO (CA)	$472.74	$472.74
HANFORD-CORCORAN (CA)	$472.74	$472.74
MADERA (CA)	$472.74	$472.74
MERCED (CA)	$472.74	$472.74
MODESTO (CA)	$472.74	$472.74
REDDING (CA)	$472.74	$472.74
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$485.10	$485.10
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$492.61	$492.61
SALINAS (CA)	$490.73	$490.73
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$574.43	$574.43
SANTA CRUZ-WATSONVILLE (CA)	$502.68	$502.68
SANTA ROSA-PETALUMA (CA)	$507.49	$507.49
STOCKTON (CA)	$472.74	$472.74
VISALIA (CA)	$472.74	$472.74
YUBA CITY (CA)	$472.74	$472.74
EL CENTRO (CA)	$472.94	$472.94
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$499.86	$499.86
SAN LUIS OBISPO-PASO ROBLES (CA)	$483.30	$483.30
SANTA MARIA-SANTA BARBARA (CA)	$491.91	$491.91
REST OF CALIFORNIA (CA)	$472.74	$472.74
COLORADO (CO)	$473.40	$473.40
CONNECTICUT (CT)	$494.51	$494.51
DC + MD/VA SUBURBS (DC)	$521.70	$521.70
DELAWARE (DE)	$458.01	$458.01
FORT LAUDERDALE (FL)	$498.17	$498.17
MIAMI (FL)	$532.73	$532.73
REST OF FLORIDA (FL)	$472.46	$472.46
ATLANTA (GA)	$476.13	$476.13
REST OF GEORGIA (GA)	$444.80	$444.80
HAWAII, GUAM (HI)	$481.40	$481.40
IOWA (IA)	$419.91	$419.91
IDAHO (ID)	$424.06	$424.06
EAST ST. LOUIS (IL)	$483.25	$483.25
SUBURBAN CHICAGO (IL)	$501.48	$501.48
CHICAGO (IL)	$516.17	$516.17
REST OF ILLINOIS (IL)	$464.21	$464.21
INDIANA (IN)	$426.27	$426.27
KANSAS (KS)	$421.32	$421.32
KENTUCKY (KY)	$433.42	$433.42
NEW ORLEANS (LA)	$454.68	$454.68
REST OF LOUISIANA (LA)	$434.09	$434.09
METROPOLITAN BOSTON (MA)	$514.72	$514.72
REST OF MASSACHUSETTS (MA)	$472.03	$472.03
BALTIMORE/SURR. CNTYS (MD)	$493.84	$493.84
REST OF MARYLAND (MD)	$465.54	$465.54
SOUTHERN MAINE (ME)	$447.56	$447.56
REST OF MAINE (ME)	$429.78	$429.78
DETROIT (MI)	$481.70	$481.70
REST OF MICHIGAN (MI)	$447.54	$447.54
MINNESOTA (MN)	$444.02	$444.02
METROPOLITAN ST. LOUIS (MO)	$452.23	$452.23
METROPOLITAN KANSAS CITY (MO)	$448.08	$448.08
REST OF MISSOURI (MO)	$429.06	$429.06
MISSISSIPPI (MS)	$419.79	$419.79
MONTANA** (MT)	$463.86	$463.86
NORTH CAROLINA (NC)	$433.62	$433.62
NORTH DAKOTA** (ND)	$441.12	$441.12
NEBRASKA (NE)	$421.14	$421.14
NEW HAMPSHIRE (NH)	$469.20	$469.20
NORTHERN NJ (NJ)	$517.17	$517.17
REST OF NEW JERSEY (NJ)	$497.45	$497.45
NEW MEXICO (NM)	$451.28	$451.28
NEVADA** (NV)	$457.77	$457.77
MANHATTAN (NY)	$537.74	$537.74
NYC SUBURBS/LONG ISLAND (NY)	$554.78	$554.78
POUGHKPSIE/N NYC SUBURBS (NY)	$503.43	$503.43
QUEENS (NY)	$537.12	$537.12
REST OF NEW YORK (NY)	$440.26	$440.26
OHIO (OH)	$442.89	$442.89
OKLAHOMA (OK)	$429.10	$429.10
PORTLAND (OR)	$484.24	$484.24
REST OF OREGON (OR)	$451.55	$451.55
METROPOLITAN PHILADELPHIA (PA)	$484.66	$484.66
REST OF PENNSYLVANIA (PA)	$441.70	$441.70
PUERTO RICO (PR)	$466.06	$466.06
RHODE ISLAND (RI)	$471.31	$471.31
SOUTH CAROLINA (SC)	$439.52	$439.52
SOUTH DAKOTA** (SD)	$438.43	$438.43
TENNESSEE (TN)	$423.81	$423.81
BRAZORIA (TX)	$454.72	$454.72
DALLAS (TX)	$459.12	$459.12
GALVESTON (TX)	$457.05	$457.05
HOUSTON (TX)	$478.10	$478.10
BEAUMONT (TX)	$439.12	$439.12
FORT WORTH (TX)	$457.17	$457.17
AUSTIN (TX)	$474.16	$474.16
REST OF TEXAS (TX)	$447.69	$447.69
UTAH (UT)	$445.29	$445.29
VIRGINIA (VA)	$448.47	$448.47
VIRGIN ISLANDS (VI)	$466.06	$466.06
VERMONT (VT)	$442.51	$442.51
SEATTLE (KING CNTY) (WA)	$521.64	$521.64
REST OF WASHINGTON (WA)	$470.11	$470.11
WISCONSIN (WI)	$427.05	$427.05
WEST VIRGINIA (WV)	$448.33	$448.33
WYOMING** (WY)	$453.95	$453.95

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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 Physician Fee Schedule amount is built from three Relative Value Units (RVUs) — work, practice expense, and malpractice — assigned to this procedure code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, to account for regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility settings can have different practice-expense RVUs, reflecting whether the provider or the facility bears the overhead costs of performing the service.

RVUs — work 5.39, practice expense 7.35 (non-facility) / 7.35 (facility), malpractice 1.15 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
Modifiers, sequestration, multiple-procedure reductions, and annual budget-neutrality adjustments can change the actual paid amount.
Locality-specific GPCIs mean the actual allowed amount can differ from the national figure shown here.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the allowed amount differ between non-facility and facility settings?

The practice-expense RVU component differs because non-facility settings (like a physician's office) include overhead costs the provider bears directly, while facility settings assume the facility covers certain overhead, resulting in a different RVU value for that component.

Will my locality's reimbursement match the national amount shown?

Not necessarily. The national amount uses a national average GPCI; actual payment in your locality depends on that area's specific GPCI values for work, practice expense, and malpractice.

Does this figure represent what the patient and Medicare each pay?

No, this is the total allowed amount. Medicare generally reimburses 80% of it after the deductible, with the remaining portion owed by the patient or a secondary payer.

Can modifiers change the final reimbursement for this code?

Yes. Modifiers (e.g., bilateral, multiple procedure, or reduced services) can increase or decrease the final paid amount relative to the base PFS figure shown here.

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.