Medicare Reimbursement for CPT 20924

This page covers CPT code 20924, a procedure code reported to Medicare Part B. It shows the Medicare Physician Fee Schedule (PFS) allowed amount, both at the national level and adjusted for locality, and distinguishes between non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$469.95	$469.95
ALASKA* (AK)	$573.97	$573.97
ALABAMA (AL)	$425.69	$425.69
ARKANSAS (AR)	$420.21	$420.21
ARIZONA (AZ)	$457.48	$457.48
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$553.67	$553.67
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$562.55	$562.55
OXNARD-THOUSAND OAKS-VENTURA (CA)	$499.03	$499.03
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$503.75	$503.75
NAPA (CA)	$530.67	$530.67
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$555.07	$555.07
VALLEJO (CA)	$528.66	$528.66
BAKERSFIELD (CA)	$478.32	$478.32
CHICO (CA)	$474.88	$474.88
FRESNO (CA)	$474.88	$474.88
HANFORD-CORCORAN (CA)	$474.88	$474.88
MADERA (CA)	$474.88	$474.88
MERCED (CA)	$474.88	$474.88
MODESTO (CA)	$474.88	$474.88
REDDING (CA)	$474.88	$474.88
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$488.12	$488.12
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$493.18	$493.18
SALINAS (CA)	$491.25	$491.25
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$568.26	$568.26
SANTA CRUZ-WATSONVILLE (CA)	$500.91	$500.91
SANTA ROSA-PETALUMA (CA)	$505.62	$505.62
STOCKTON (CA)	$474.88	$474.88
VISALIA (CA)	$474.88	$474.88
YUBA CITY (CA)	$474.88	$474.88
EL CENTRO (CA)	$475.09	$475.09
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$499.10	$499.10
SAN LUIS OBISPO-PASO ROBLES (CA)	$483.97	$483.97
SANTA MARIA-SANTA BARBARA (CA)	$492.07	$492.07
REST OF CALIFORNIA (CA)	$474.88	$474.88
COLORADO (CO)	$477.09	$477.09
CONNECTICUT (CT)	$499.21	$499.21
DC + MD/VA SUBURBS (DC)	$523.97	$523.97
DELAWARE (DE)	$464.35	$464.35
FORT LAUDERDALE (FL)	$505.89	$505.89
MIAMI (FL)	$541.44	$541.44
REST OF FLORIDA (FL)	$481.31	$481.31
ATLANTA (GA)	$482.24	$482.24
REST OF GEORGIA (GA)	$455.00	$455.00
HAWAII, GUAM (HI)	$481.62	$481.62
IOWA (IA)	$427.21	$427.21
IDAHO (ID)	$431.39	$431.39
EAST ST. LOUIS (IL)	$494.69	$494.69
SUBURBAN CHICAGO (IL)	$508.90	$508.90
CHICAGO (IL)	$525.73	$525.73
REST OF ILLINOIS (IL)	$474.69	$474.69
INDIANA (IN)	$433.40	$433.40
KANSAS (KS)	$429.28	$429.28
KENTUCKY (KY)	$442.99	$442.99
NEW ORLEANS (LA)	$463.06	$463.06
REST OF LOUISIANA (LA)	$443.91	$443.91
METROPOLITAN BOSTON (MA)	$515.36	$515.36
REST OF MASSACHUSETTS (MA)	$476.30	$476.30
BALTIMORE/SURR. CNTYS (MD)	$498.60	$498.60
REST OF MARYLAND (MD)	$471.29	$471.29
SOUTHERN MAINE (ME)	$452.89	$452.89
REST OF MAINE (ME)	$437.51	$437.51
DETROIT (MI)	$490.73	$490.73
REST OF MICHIGAN (MI)	$456.86	$456.86
MINNESOTA (MN)	$447.16	$447.16
METROPOLITAN ST. LOUIS (MO)	$459.88	$459.88
METROPOLITAN KANSAS CITY (MO)	$456.11	$456.11
REST OF MISSOURI (MO)	$439.71	$439.71
MISSISSIPPI (MS)	$429.84	$429.84
MONTANA** (MT)	$469.87	$469.87
NORTH CAROLINA (NC)	$440.95	$440.95
NORTH DAKOTA** (ND)	$445.55	$445.55
NEBRASKA (NE)	$428.12	$428.12
NEW HAMPSHIRE (NH)	$473.48	$473.48
NORTHERN NJ (NJ)	$520.27	$520.27
REST OF NEW JERSEY (NJ)	$502.08	$502.08
NEW MEXICO (NM)	$460.66	$460.66
NEVADA** (NV)	$463.30	$463.30
MANHATTAN (NY)	$542.19	$542.19
NYC SUBURBS/LONG ISLAND (NY)	$559.03	$559.03
POUGHKPSIE/N NYC SUBURBS (NY)	$508.45	$508.45
QUEENS (NY)	$540.51	$540.51
REST OF NEW YORK (NY)	$447.18	$447.18
OHIO (OH)	$451.89	$451.89
OKLAHOMA (OK)	$438.17	$438.17
PORTLAND (OR)	$486.38	$486.38
REST OF OREGON (OR)	$456.90	$456.90
METROPOLITAN PHILADELPHIA (PA)	$490.46	$490.46
REST OF PENNSYLVANIA (PA)	$450.35	$450.35
PUERTO RICO (PR)	$471.66	$471.66
RHODE ISLAND (RI)	$476.62	$476.62
SOUTH CAROLINA (SC)	$447.72	$447.72
SOUTH DAKOTA** (SD)	$442.67	$442.67
TENNESSEE (TN)	$431.69	$431.69
BRAZORIA (TX)	$460.75	$460.75
DALLAS (TX)	$465.23	$465.23
GALVESTON (TX)	$463.14	$463.14
HOUSTON (TX)	$485.66	$485.66
BEAUMONT (TX)	$448.01	$448.01
FORT WORTH (TX)	$463.65	$463.65
AUSTIN (TX)	$477.96	$477.96
REST OF TEXAS (TX)	$455.18	$455.18
UTAH (UT)	$453.07	$453.07
VIRGINIA (VA)	$454.28	$454.28
VIRGIN ISLANDS (VI)	$471.66	$471.66
VERMONT (VT)	$447.54	$447.54
SEATTLE (KING CNTY) (WA)	$521.30	$521.30
REST OF WASHINGTON (WA)	$474.16	$474.16
WISCONSIN (WI)	$432.64	$432.64
WEST VIRGINIA (WV)	$459.96	$459.96
WYOMING** (WY)	$459.27	$459.27

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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 is built from 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 furnished, reflecting local cost-of-living and practice-cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs — and therefore the final amount — can differ between non-facility and facility settings because overhead costs vary by place of service.

RVUs — work 6.51, practice expense 6.33 (non-facility) / 6.33 (facility), malpractice 1.23 — × 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 insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Locality-specific GPCIs mean the national amount shown may not match what a specific Medicare Administrative Contractor (MAC) actually pays.
Always verify current rates and coverage policy with your local MAC before billing or appealing a claim.

Frequently asked

Why does the amount for this code differ by locality?

The PFS formula applies Geographic Practice Cost Indices (GPCIs) to each RVU component, so the same code can have different allowed amounts depending on the cost of practicing medicine in a given area.

Why might the facility and non-facility amounts be the same or different for this code?

The difference between settings comes from the practice-expense RVU, which reflects overhead costs like staff and supplies. If CMS assigns the same practice-expense RVU to both settings for a code, the allowed amounts will match; if not, they will differ.

Is the amount shown what Medicare actually pays?

No — it's the allowed amount before cost-sharing. Medicare generally pays 80% after the deductible, and the final payment can be further affected by sequestration or claim-specific modifiers.

Where can I confirm the exact payment for my locality?

Check your Medicare Administrative Contractor's (MAC) published fee schedule or the CMS Physician Fee Schedule Look-Up Tool for the specific locality and 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.