Medicare Reimbursement for CPT 20939

CPT 20939 is a physician procedure code covering a specific service defined by the American Medical Association's CPT code set. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both nationally and adjustable by locality, with non-facility and facility rate comparisons.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$61.46	$61.46
ALASKA* (AK)	$76.03	$76.03
ALABAMA (AL)	$54.98	$54.98
ARKANSAS (AR)	$54.21	$54.21
ARIZONA (AZ)	$59.44	$59.44
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$63.58	$63.58
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$64.22	$64.22
OXNARD-THOUSAND OAKS-VENTURA (CA)	$60.48	$60.48
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$61.45	$61.45
NAPA (CA)	$62.18	$62.18
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$63.97	$63.97
VALLEJO (CA)	$61.62	$61.62
BAKERSFIELD (CA)	$58.92	$58.92
CHICO (CA)	$58.02	$58.02
FRESNO (CA)	$58.02	$58.02
HANFORD-CORCORAN (CA)	$58.02	$58.02
MADERA (CA)	$58.02	$58.02
MERCED (CA)	$58.02	$58.02
MODESTO (CA)	$58.02	$58.02
REDDING (CA)	$58.02	$58.02
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$61.65	$61.65
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$59.56	$59.56
SALINAS (CA)	$59.32	$59.32
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$65.80	$65.80
SANTA CRUZ-WATSONVILLE (CA)	$59.64	$59.64
SANTA ROSA-PETALUMA (CA)	$60.14	$60.14
STOCKTON (CA)	$58.02	$58.02
VISALIA (CA)	$58.02	$58.02
YUBA CITY (CA)	$58.02	$58.02
EL CENTRO (CA)	$58.07	$58.07
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$59.81	$59.81
SAN LUIS OBISPO-PASO ROBLES (CA)	$58.55	$58.55
SANTA MARIA-SANTA BARBARA (CA)	$59.30	$59.30
REST OF CALIFORNIA (CA)	$58.02	$58.02
COLORADO (CO)	$60.21	$60.21
CONNECTICUT (CT)	$65.55	$65.55
DC + MD/VA SUBURBS (DC)	$66.98	$66.98
DELAWARE (DE)	$60.35	$60.35
FORT LAUDERDALE (FL)	$70.79	$70.79
MIAMI (FL)	$79.33	$79.33
REST OF FLORIDA (FL)	$66.63	$66.63
ATLANTA (GA)	$64.05	$64.05
REST OF GEORGIA (GA)	$62.30	$62.30
HAWAII, GUAM (HI)	$58.37	$58.37
IOWA (IA)	$53.56	$53.56
IDAHO (ID)	$54.48	$54.48
EAST ST. LOUIS (IL)	$71.98	$71.98
SUBURBAN CHICAGO (IL)	$70.82	$70.82
CHICAGO (IL)	$76.49	$76.49
REST OF ILLINOIS (IL)	$66.78	$66.78
INDIANA (IN)	$54.72	$54.72
KANSAS (KS)	$54.64	$54.64
KENTUCKY (KY)	$59.12	$59.12
NEW ORLEANS (LA)	$62.27	$62.27
REST OF LOUISIANA (LA)	$59.56	$59.56
METROPOLITAN BOSTON (MA)	$64.15	$64.15
REST OF MASSACHUSETTS (MA)	$60.41	$60.41
BALTIMORE/SURR. CNTYS (MD)	$65.66	$65.66
REST OF MARYLAND (MD)	$61.05	$61.05
SOUTHERN MAINE (ME)	$57.16	$57.16
REST OF MAINE (ME)	$56.18	$56.18
DETROIT (MI)	$68.82	$68.82
REST OF MICHIGAN (MI)	$61.85	$61.85
MINNESOTA (MN)	$53.82	$53.82
METROPOLITAN ST. LOUIS (MO)	$60.89	$60.89
METROPOLITAN KANSAS CITY (MO)	$60.44	$60.44
REST OF MISSOURI (MO)	$59.46	$59.46
MISSISSIPPI (MS)	$56.78	$56.78
MONTANA** (MT)	$61.43	$61.43
NORTH CAROLINA (NC)	$56.53	$56.53
NORTH DAKOTA** (ND)	$54.71	$54.71
NEBRASKA (NE)	$53.44	$53.44
NEW HAMPSHIRE (NH)	$60.54	$60.54
NORTHERN NJ (NJ)	$66.59	$66.59
REST OF NEW JERSEY (NJ)	$65.21	$65.21
NEW MEXICO (NM)	$62.71	$62.71
NEVADA** (NV)	$59.57	$59.57
MANHATTAN (NY)	$72.53	$72.53
NYC SUBURBS/LONG ISLAND (NY)	$75.94	$75.94
POUGHKPSIE/N NYC SUBURBS (NY)	$66.71	$66.71
QUEENS (NY)	$71.14	$71.14
REST OF NEW YORK (NY)	$57.47	$57.47
OHIO (OH)	$60.47	$60.47
OKLAHOMA (OK)	$57.60	$57.60
PORTLAND (OR)	$60.53	$60.53
REST OF OREGON (OR)	$58.04	$58.04
METROPOLITAN PHILADELPHIA (PA)	$64.84	$64.84
REST OF PENNSYLVANIA (PA)	$59.82	$59.82
PUERTO RICO (PR)	$61.42	$61.42
RHODE ISLAND (RI)	$61.36	$61.36
SOUTH CAROLINA (SC)	$58.81	$58.81
SOUTH DAKOTA** (SD)	$53.92	$53.92
TENNESSEE (TN)	$55.08	$55.08
BRAZORIA (TX)	$59.15	$59.15
DALLAS (TX)	$60.14	$60.14
GALVESTON (TX)	$59.72	$59.72
HOUSTON (TX)	$65.94	$65.94
BEAUMONT (TX)	$59.54	$59.54
FORT WORTH (TX)	$60.16	$60.16
AUSTIN (TX)	$60.96	$60.96
REST OF TEXAS (TX)	$59.73	$59.73
UTAH (UT)	$59.56	$59.56
VIRGINIA (VA)	$57.91	$57.91
VIRGIN ISLANDS (VI)	$61.42	$61.42
VERMONT (VT)	$55.72	$55.72
SEATTLE (KING CNTY) (WA)	$64.07	$64.07
REST OF WASHINGTON (WA)	$59.89	$59.89
WISCONSIN (WI)	$53.08	$53.08
WEST VIRGINIA (WV)	$64.73	$64.73
WYOMING** (WY)	$58.51	$58.51

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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 payment for this procedure code is based on three Relative Value Units (RVUs): physician work, practice expense, and malpractice risk. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility rates generally apply when the service is performed in a physician's office, while facility rates apply in hospital or ambulatory surgical center settings, and the two can differ because practice-expense RVUs are typically lower in facility settings. For this code, the practice-expense RVU is the same for both settings, so facility and non-facility estimates align.

RVUs — work 1.13, practice expense 0.37 (non-facility) / 0.37 (facility), malpractice 0.34 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only — actual Medicare payment may differ based on your specific Medicare Administrative Contractor (MAC) and claim processing rules.
Medicare typically pays 80% of the allowed amount after the patient meets their annual deductible; the beneficiary or secondary insurer is responsible for the remainder.
Modifiers (e.g., bilateral, multiple procedure, assistant surgeon) can increase or decrease the final payment.
Sequestration and annual budget-neutrality adjustments can alter the conversion factor and final payment from year to year.
Locality-specific GPCIs mean the national rate shown may not match your local Medicare payment — verify with your MAC's fee schedule tool.

Frequently asked

Why does the Medicare payment for CPT 20939 vary by location?

Medicare adjusts the work, practice expense, and malpractice RVUs using Geographic Practice Cost Indices (GPCIs) that reflect local cost-of-living and practice cost differences, so the same code can have different allowed amounts in different localities.

Is the amount shown what Medicare actually pays?

The amount shown is the Medicare-allowed amount before cost-sharing. Medicare generally pays 80% of this allowed amount after the deductible is met, with the patient or secondary payer responsible for the rest.

Why are facility and non-facility rates sometimes the same for this code?

When the practice-expense RVU is identical for both settings, as is the case here, the facility and non-facility allowed amounts will be the same because the only difference between the two rates comes from that RVU component.

Where can I get the exact rate for my locality?

Your Medicare Administrative Contractor (MAC) publishes the official locality-adjusted fee schedule, which should be used to confirm exact payment amounts for billing purposes.

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.