Medicare Reimbursement for CPT 20950

CPT 20950 is a procedure code billed under Medicare Part B. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjustable by locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$278.23	$83.50
ALASKA* (AK)	$310.41	$103.02
ALABAMA (AL)	$246.32	$75.93
ARKANSAS (AR)	$242.26	$74.99
ARIZONA (AZ)	$270.05	$81.36
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$372.12	$97.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$379.89	$99.09
OXNARD-THOUSAND OAKS-VENTURA (CA)	$318.43	$88.27
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$319.50	$89.14
NAPA (CA)	$350.28	$93.63
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$372.37	$97.81
VALLEJO (CA)	$349.92	$93.27
BAKERSFIELD (CA)	$298.20	$84.78
CHICO (CA)	$297.58	$84.16
FRESNO (CA)	$297.58	$84.16
HANFORD-CORCORAN (CA)	$297.58	$84.16
MADERA (CA)	$297.58	$84.16
MERCED (CA)	$297.58	$84.16
MODESTO (CA)	$297.58	$84.16
REDDING (CA)	$297.58	$84.16
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$299.95	$86.53
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$313.76	$87.29
SALINAS (CA)	$312.63	$86.94
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$380.91	$100.11
SANTA CRUZ-WATSONVILLE (CA)	$325.09	$88.50
SANTA ROSA-PETALUMA (CA)	$328.45	$89.32
STOCKTON (CA)	$297.58	$84.16
VISALIA (CA)	$297.58	$84.16
YUBA CITY (CA)	$297.58	$84.16
EL CENTRO (CA)	$297.62	$84.19
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$321.14	$88.24
SAN LUIS OBISPO-PASO ROBLES (CA)	$307.46	$85.67
SANTA MARIA-SANTA BARBARA (CA)	$314.12	$87.06
REST OF CALIFORNIA (CA)	$297.58	$84.16
COLORADO (CO)	$291.82	$84.63
CONNECTICUT (CT)	$298.29	$88.57
DC + MD/VA SUBURBS (DC)	$322.18	$92.79
DELAWARE (DE)	$274.94	$82.54
FORT LAUDERDALE (FL)	$287.15	$89.90
MIAMI (FL)	$298.89	$96.18
REST OF FLORIDA (FL)	$271.81	$85.66
ATLANTA (GA)	$283.51	$85.66
REST OF GEORGIA (GA)	$254.82	$81.13
HAWAII, GUAM (HI)	$306.62	$85.21
IOWA (IA)	$254.27	$76.09
IDAHO (ID)	$255.97	$76.82
EAST ST. LOUIS (IL)	$267.30	$88.15
SUBURBAN CHICAGO (IL)	$290.39	$90.41
CHICAGO (IL)	$289.18	$93.48
REST OF ILLINOIS (IL)	$262.37	$84.59
INDIANA (IN)	$257.68	$77.17
KANSAS (KS)	$252.52	$76.49
KENTUCKY (KY)	$252.10	$78.98
NEW ORLEANS (LA)	$265.67	$82.43
REST OF LOUISIANA (LA)	$251.49	$79.16
METROPOLITAN BOSTON (MA)	$323.69	$91.18
REST OF MASSACHUSETTS (MA)	$289.57	$84.53
BALTIMORE/SURR. CNTYS (MD)	$297.40	$88.46
REST OF MARYLAND (MD)	$280.80	$83.73
SOUTHERN MAINE (ME)	$273.45	$80.48
REST OF MAINE (ME)	$257.07	$77.92
DETROIT (MI)	$275.23	$87.32
REST OF MICHIGAN (MI)	$259.18	$81.40
MINNESOTA (MN)	$279.72	$79.35
METROPOLITAN ST. LOUIS (MO)	$267.21	$81.83
METROPOLITAN KANSAS CITY (MO)	$264.04	$81.19
REST OF MISSOURI (MO)	$246.33	$78.47
MISSISSIPPI (MS)	$244.37	$76.71
MONTANA** (MT)	$278.21	$83.49
NORTH CAROLINA (NC)	$260.18	$78.50
NORTH DAKOTA** (ND)	$273.86	$79.14
NEBRASKA (NE)	$255.96	$76.23
NEW HAMPSHIRE (NH)	$286.73	$84.02
NORTHERN NJ (NJ)	$318.09	$92.20
REST OF NEW JERSEY (NJ)	$301.73	$89.08
NEW MEXICO (NM)	$260.63	$82.07
NEVADA** (NV)	$277.23	$82.31
MANHATTAN (NY)	$322.39	$96.12
NYC SUBURBS/LONG ISLAND (NY)	$330.59	$99.06
POUGHKPSIE/N NYC SUBURBS (NY)	$303.45	$90.23
QUEENS (NY)	$325.93	$95.76
REST OF NEW YORK (NY)	$264.56	$79.57
OHIO (OH)	$258.30	$80.51
OKLAHOMA (OK)	$252.00	$78.11
PORTLAND (OR)	$302.51	$86.17
REST OF OREGON (OR)	$275.13	$81.18
METROPOLITAN PHILADELPHIA (PA)	$289.81	$87.10
REST OF PENNSYLVANIA (PA)	$258.98	$80.22
PUERTO RICO (PR)	$280.65	$83.78
RHODE ISLAND (RI)	$285.80	$84.65
SOUTH CAROLINA (SC)	$259.66	$79.73
SOUTH DAKOTA** (SD)	$273.35	$78.62
TENNESSEE (TN)	$253.92	$76.91
BRAZORIA (TX)	$274.87	$81.90
DALLAS (TX)	$276.64	$82.69
GALVESTON (TX)	$275.69	$82.32
HOUSTON (TX)	$279.71	$86.35
BEAUMONT (TX)	$257.03	$79.82
FORT WORTH (TX)	$274.43	$82.43
AUSTIN (TX)	$290.80	$84.78
REST OF TEXAS (TX)	$265.80	$81.00
UTAH (UT)	$263.69	$80.65
VIRGINIA (VA)	$272.16	$80.75
VIRGIN ISLANDS (VI)	$280.65	$83.78
VERMONT (VT)	$272.30	$79.52
SEATTLE (KING CNTY) (WA)	$331.10	$92.17
REST OF WASHINGTON (WA)	$289.19	$84.14
WISCONSIN (WI)	$263.49	$76.94
WEST VIRGINIA (WV)	$251.29	$82.08
WYOMING** (WY)	$276.32	$81.59

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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) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed. These locality-adjusted RVUs are summed and then multiplied by the annual Conversion Factor set by CMS to produce a dollar amount. Non-facility and facility settings use different practice-expense RVUs, since overhead costs differ depending on where the service is rendered, which is why the two amounts shown differ.

RVUs — work 1.23, practice expense 6.88 (non-facility) / 1.05 (facility), malpractice 0.22 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimated allowed amount only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets their Part B deductible; the patient or secondary payer is generally responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claims-based adjustments, sequestration, and annual budget-neutrality changes.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why is the facility amount lower than the non-facility amount?

The facility rate uses a lower practice-expense RVU because Medicare assumes the facility (e.g., hospital) absorbs certain overhead costs, whereas the non-facility rate reflects the full cost of performing the service in a physician's office.

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

Not necessarily. The national amount uses national averages, but actual payment is adjusted using GPCIs specific to the locality where the service was furnished, which can raise or lower the amount.

Does this amount include the patient's share?

No. The PFS allowed amount is the total expected payment before cost-sharing. Medicare generally pays 80%, with the remaining 20% owed by the patient or a secondary payer, subject to the deductible.

Can modifiers change this amount?

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

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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.