Medicare Reimbursement for CPT 20979
This page covers the Medicare Physician Fee Schedule (PFS) allowed amount for procedure code 20979. Because this is a CPT code, the specific procedure description is not shown here (CPT descriptors are licensed by the AMA). The figures below reflect the national PFS rate as well as locality-adjusted amounts, broken out by non-facility (e.g., office) and facility (e.g., hospital) settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $54.78 | $26.39 |
| ALASKA* (AK) | $65.85 | $35.62 |
| ALABAMA (AL) | $49.71 | $24.87 |
| ARKANSAS (AR) | $49.08 | $24.69 |
| ARIZONA (AZ) | $53.44 | $25.93 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $68.62 | $28.59 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $69.89 | $28.95 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $60.35 | $26.80 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $60.74 | $27.16 |
| NAPA (CA) | $65.19 | $27.77 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $68.70 | $28.67 |
| VALLEJO (CA) | $65.08 | $27.66 |
| BAKERSFIELD (CA) | $57.35 | $26.24 |
| CHICO (CA) | $57.14 | $26.03 |
| FRESNO (CA) | $57.14 | $26.03 |
| HANFORD-CORCORAN (CA) | $57.14 | $26.03 |
| MADERA (CA) | $57.14 | $26.03 |
| MERCED (CA) | $57.14 | $26.03 |
| MODESTO (CA) | $57.14 | $26.03 |
| REDDING (CA) | $57.14 | $26.03 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $57.90 | $26.79 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $59.70 | $26.68 |
| SALINAS (CA) | $59.47 | $26.56 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $70.22 | $29.28 |
| SANTA CRUZ-WATSONVILLE (CA) | $61.08 | $26.58 |
| SANTA ROSA-PETALUMA (CA) | $61.68 | $26.82 |
| STOCKTON (CA) | $57.14 | $26.03 |
| VISALIA (CA) | $57.14 | $26.03 |
| YUBA CITY (CA) | $57.14 | $26.03 |
| EL CENTRO (CA) | $57.16 | $26.04 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $60.66 | $26.70 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $58.54 | $26.20 |
| SANTA MARIA-SANTA BARBARA (CA) | $59.63 | $26.53 |
| REST OF CALIFORNIA (CA) | $57.14 | $26.03 |
| COLORADO (CO) | $56.58 | $26.37 |
| CONNECTICUT (CT) | $58.16 | $27.59 |
| DC + MD/VA SUBURBS (DC) | $61.89 | $28.45 |
| DELAWARE (DE) | $54.25 | $26.20 |
| FORT LAUDERDALE (FL) | $57.09 | $28.33 |
| MIAMI (FL) | $59.68 | $30.13 |
| REST OF FLORIDA (FL) | $54.53 | $27.39 |
| ATLANTA (GA) | $55.83 | $26.98 |
| REST OF GEORGIA (GA) | $51.73 | $26.40 |
| HAWAII, GUAM (HI) | $58.23 | $25.95 |
| IOWA (IA) | $50.61 | $24.64 |
| IDAHO (ID) | $50.95 | $24.83 |
| EAST ST. LOUIS (IL) | $54.56 | $28.44 |
| SUBURBAN CHICAGO (IL) | $57.60 | $28.44 |
| CHICAGO (IL) | $58.11 | $29.57 |
| REST OF ILLINOIS (IL) | $53.28 | $27.35 |
| INDIANA (IN) | $51.21 | $24.89 |
| KANSAS (KS) | $50.51 | $24.84 |
| KENTUCKY (KY) | $50.98 | $25.74 |
| NEW ORLEANS (LA) | $53.18 | $26.47 |
| REST OF LOUISIANA (LA) | $50.95 | $25.83 |
| METROPOLITAN BOSTON (MA) | $61.63 | $27.73 |
| REST OF MASSACHUSETTS (MA) | $56.34 | $26.45 |
| BALTIMORE/SURR. CNTYS (MD) | $58.02 | $27.55 |
| REST OF MARYLAND (MD) | $55.17 | $26.44 |
| SOUTHERN MAINE (ME) | $53.62 | $25.49 |
| REST OF MAINE (ME) | $51.30 | $25.18 |
| DETROIT (MI) | $55.25 | $27.85 |
| REST OF MICHIGAN (MI) | $52.26 | $26.34 |
| MINNESOTA (MN) | $54.07 | $24.86 |
| METROPOLITAN ST. LOUIS (MO) | $53.23 | $26.20 |
| METROPOLITAN KANSAS CITY (MO) | $52.75 | $26.09 |
| REST OF MISSOURI (MO) | $50.25 | $25.77 |
| MISSISSIPPI (MS) | $49.66 | $25.22 |
| MONTANA** (MT) | $54.77 | $26.38 |
| NORTH CAROLINA (NC) | $51.76 | $25.27 |
| NORTH DAKOTA** (ND) | $53.39 | $25.00 |
| NEBRASKA (NE) | $50.83 | $24.62 |
| NEW HAMPSHIRE (NH) | $55.81 | $26.26 |
| NORTHERN NJ (NJ) | $61.38 | $28.45 |
| REST OF NEW JERSEY (NJ) | $58.79 | $27.78 |
| NEW MEXICO (NM) | $52.56 | $26.52 |
| NEVADA** (NV) | $54.42 | $26.00 |
| MANHATTAN (NY) | $62.68 | $29.69 |
| NYC SUBURBS/LONG ISLAND (NY) | $64.19 | $30.43 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $59.25 | $28.16 |
| QUEENS (NY) | $62.99 | $29.43 |
| REST OF NEW YORK (NY) | $52.46 | $25.49 |
| OHIO (OH) | $51.98 | $26.06 |
| OKLAHOMA (OK) | $50.79 | $25.44 |
| PORTLAND (OR) | $58.10 | $26.55 |
| REST OF OREGON (OR) | $53.95 | $25.68 |
| METROPOLITAN PHILADELPHIA (PA) | $56.92 | $27.36 |
| REST OF PENNSYLVANIA (PA) | $51.99 | $25.93 |
| PUERTO RICO (PR) | $55.10 | $26.40 |
| RHODE ISLAND (RI) | $55.97 | $26.65 |
| SOUTH CAROLINA (SC) | $51.96 | $25.73 |
| SOUTH DAKOTA** (SD) | $53.23 | $24.83 |
| TENNESSEE (TN) | $50.75 | $24.94 |
| BRAZORIA (TX) | $54.13 | $26.00 |
| DALLAS (TX) | $54.50 | $26.22 |
| GALVESTON (TX) | $54.31 | $26.12 |
| HOUSTON (TX) | $55.59 | $27.40 |
| BEAUMONT (TX) | $51.70 | $25.86 |
| FORT WORTH (TX) | $54.20 | $26.21 |
| AUSTIN (TX) | $56.43 | $26.39 |
| REST OF TEXAS (TX) | $52.90 | $25.96 |
| UTAH (UT) | $52.60 | $25.91 |
| VIRGINIA (VA) | $53.54 | $25.63 |
| VIRGIN ISLANDS (VI) | $55.10 | $26.40 |
| VERMONT (VT) | $53.30 | $25.19 |
| SEATTLE (KING CNTY) (WA) | $62.71 | $27.87 |
| REST OF WASHINGTON (WA) | $56.20 | $26.30 |
| WISCONSIN (WI) | $51.80 | $24.60 |
| WEST VIRGINIA (WV) | $51.54 | $26.87 |
| WYOMING** (WY) | $54.17 | $25.78 |
Look up another code or locality →
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 code is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — which are each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility rates differ mainly because the practice-expense RVU is higher in non-facility settings, reflecting the overhead a physician's office absorbs that a hospital or facility would otherwise cover. These RVU, GPCI, and conversion factor values are updated annually and can change the final amount from year to year.
RVUs — work 0.6, practice expense 0.97 (non-facility) / 0.12 (facility), malpractice 0.07 — × 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 annual Part B deductible is met; the beneficiary or secondary insurer is generally 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 actual rate can differ meaningfully from the national average shown here.
- Always confirm the current rate and any applicable edits with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.
Frequently asked
Why does the facility rate differ from the non-facility rate for this code?
The practice-expense RVU is lower in the facility setting because the facility (e.g., hospital) — not the billing physician — absorbs most of the overhead costs, such as equipment and supplies.
Why might my locality's payment differ from the national amount shown?
Local wage and cost indices (GPCIs) adjust the work, practice-expense, and malpractice RVUs to reflect regional differences in practice costs, so the same code can pay differently across Medicare localities.
Does this amount reflect what the patient will owe?
No. The allowed amount is the total Medicare-approved payment; after the deductible, Medicare generally pays 80% and the patient or secondary payer is responsible for the remaining 20%, subject to any applicable modifiers or coverage rules.
Will this rate stay the same next year?
No. RVUs, GPCIs, and the conversion factor are updated annually (and sometimes adjusted mid-year), so the allowed amount for this code can change from one year to the next.
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.
Bill accurately, get paid faster
Join providers across the country delivering modern virtual care with CareNiva. Free to start, ready in minutes.
100% Satisfaction Guaranteed — try it risk-free