Medicare Reimbursement for CPT 20982
CPT 20982 is a physician procedure code billed under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount for this code, both nationally and adjusted 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) | $3482.38 | $321.65 |
| ALASKA* (AK) | $3789.57 | $423.40 |
| ALABAMA (AL) | $3064.49 | $298.86 |
| ARKANSAS (AR) | $3011.17 | $296.10 |
| ARIZONA (AZ) | $3377.43 | $314.69 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $4802.66 | $346.03 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $4908.04 | $350.27 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $4060.82 | $324.84 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $4068.49 | $329.35 |
| NAPA (CA) | $4502.30 | $336.46 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $4803.88 | $347.26 |
| VALLEJO (CA) | $4500.53 | $334.69 |
| BAKERSFIELD (CA) | $3781.53 | $317.37 |
| CHICO (CA) | $3778.44 | $314.28 |
| FRESNO (CA) | $3778.44 | $314.28 |
| HANFORD-CORCORAN (CA) | $3778.44 | $314.28 |
| MADERA (CA) | $3778.44 | $314.28 |
| MERCED (CA) | $3778.44 | $314.28 |
| MODESTO (CA) | $3778.44 | $314.28 |
| REDDING (CA) | $3778.44 | $314.28 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $3790.10 | $325.94 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $3998.37 | $322.45 |
| SALINAS (CA) | $3984.36 | $321.08 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $4913.06 | $355.29 |
| SANTA CRUZ-WATSONVILLE (CA) | $4162.27 | $321.99 |
| SANTA ROSA-PETALUMA (CA) | $4206.16 | $324.79 |
| STOCKTON (CA) | $3778.44 | $314.28 |
| VISALIA (CA) | $3778.44 | $314.28 |
| YUBA CITY (CA) | $3778.44 | $314.28 |
| EL CENTRO (CA) | $3778.62 | $314.46 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $4103.41 | $323.18 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $3916.80 | $316.74 |
| SANTA MARIA-SANTA BARBARA (CA) | $4006.20 | $320.79 |
| REST OF CALIFORNIA (CA) | $3778.44 | $314.28 |
| COLORADO (CO) | $3683.16 | $320.15 |
| CONNECTICUT (CT) | $3742.30 | $338.19 |
| DC + MD/VA SUBURBS (DC) | $4071.57 | $348.23 |
| DELAWARE (DE) | $3441.26 | $318.46 |
| FORT LAUDERDALE (FL) | $3553.36 | $351.54 |
| MIAMI (FL) | $3669.46 | $379.15 |
| REST OF FLORIDA (FL) | $3358.94 | $337.28 |
| ATLANTA (GA) | $3541.80 | $330.50 |
| REST OF GEORGIA (GA) | $3141.78 | $322.41 |
| HAWAII, GUAM (HI) | $3908.04 | $314.29 |
| IOWA (IA) | $3187.11 | $295.04 |
| IDAHO (ID) | $3205.94 | $298.07 |
| EAST ST. LOUIS (IL) | $3261.53 | $353.66 |
| SUBURBAN CHICAGO (IL) | $3598.71 | $352.64 |
| CHICAGO (IL) | $3546.78 | $370.25 |
| REST OF ILLINOIS (IL) | $3222.73 | $336.99 |
| INDIANA (IN) | $3228.93 | $298.94 |
| KANSAS (KS) | $3155.57 | $298.28 |
| KENTUCKY (KY) | $3122.13 | $312.24 |
| NEW ORLEANS (LA) | $3297.43 | $323.19 |
| REST OF LOUISIANA (LA) | $3110.81 | $313.57 |
| METROPOLITAN BOSTON (MA) | $4112.04 | $338.13 |
| REST OF MASSACHUSETTS (MA) | $3649.26 | $321.01 |
| BALTIMORE/SURR. CNTYS (MD) | $3729.49 | $338.02 |
| REST OF MARYLAND (MD) | $3520.32 | $321.66 |
| SOUTHERN MAINE (ME) | $3440.11 | $307.83 |
| REST OF MAINE (ME) | $3211.31 | $303.45 |
| DETROIT (MI) | $3394.50 | $344.40 |
| REST OF MICHIGAN (MI) | $3207.08 | $321.34 |
| MINNESOTA (MN) | $3550.30 | $297.91 |
| METROPOLITAN ST. LOUIS (MO) | $3327.99 | $318.98 |
| METROPOLITAN KANSAS CITY (MO) | $3285.26 | $317.34 |
| REST OF MISSOURI (MO) | $3037.38 | $312.83 |
| MISSISSIPPI (MS) | $3025.68 | $304.30 |
| MONTANA** (MT) | $3482.31 | $321.58 |
| NORTH CAROLINA (NC) | $3253.76 | $304.80 |
| NORTH DAKOTA** (ND) | $3460.95 | $300.22 |
| NEBRASKA (NE) | $3212.17 | $294.82 |
| NEW HAMPSHIRE (NH) | $3609.80 | $319.48 |
| NORTHERN NJ (NJ) | $4014.08 | $347.64 |
| REST OF NEW JERSEY (NJ) | $3791.06 | $339.54 |
| NEW MEXICO (NM) | $3222.55 | $324.16 |
| NEVADA** (NV) | $3479.57 | $315.68 |
| MANHATTAN (NY) | $4039.43 | $366.66 |
| NYC SUBURBS/LONG ISLAND (NY) | $4136.09 | $377.98 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $3805.93 | $344.93 |
| QUEENS (NY) | $4098.59 | $362.61 |
| REST OF NEW YORK (NY) | $3310.77 | $308.08 |
| OHIO (OH) | $3202.71 | $316.97 |
| OKLAHOMA (OK) | $3130.02 | $307.50 |
| PORTLAND (OR) | $3833.98 | $322.41 |
| REST OF OREGON (OR) | $3458.79 | $310.71 |
| METROPOLITAN PHILADELPHIA (PA) | $3625.38 | $335.07 |
| REST OF PENNSYLVANIA (PA) | $3216.53 | $314.98 |
| PUERTO RICO (PR) | $3517.23 | $321.74 |
| RHODE ISLAND (RI) | $3589.01 | $323.98 |
| SOUTH CAROLINA (SC) | $3232.41 | $311.90 |
| SOUTH DAKOTA** (SD) | $3458.43 | $297.70 |
| TENNESSEE (TN) | $3172.85 | $299.75 |
| BRAZORIA (TX) | $3447.31 | $315.03 |
| DALLAS (TX) | $3466.44 | $318.36 |
| GALVESTON (TX) | $3455.48 | $316.87 |
| HOUSTON (TX) | $3475.24 | $336.64 |
| BEAUMONT (TX) | $3190.21 | $313.95 |
| FORT WORTH (TX) | $3434.73 | $318.25 |
| AUSTIN (TX) | $3665.36 | $321.31 |
| REST OF TEXAS (TX) | $3314.77 | $315.24 |
| UTAH (UT) | $3285.63 | $314.54 |
| VIRGINIA (VA) | $3417.07 | $310.07 |
| VIRGIN ISLANDS (VI) | $3517.23 | $321.74 |
| VERMONT (VT) | $3432.38 | $303.26 |
| SEATTLE (KING CNTY) (WA) | $4217.65 | $339.44 |
| REST OF WASHINGTON (WA) | $3647.27 | $319.03 |
| WISCONSIN (WI) | $3322.27 | $294.29 |
| WEST VIRGINIA (WV) | $3076.39 | $329.72 |
| WYOMING** (WY) | $3473.00 | $312.27 |
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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: Policy. 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 pricing starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted using the Geographic Practice Cost Index (GPCI) values for the specific locality, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice expense RVUs differ between non-facility and facility settings because facilities absorb certain overhead costs, which is why the two allowed amounts differ.
RVUs — work 6.84, practice expense 96.34 (non-facility) / 1.71 (facility), malpractice 1.08 — × 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 deductible is met; the patient or secondary payer is responsible for the remainder.
- Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
- 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?
In a facility setting, the hospital or facility bears certain overhead costs, so the practice expense RVU used for this code is lower than when the service is performed in a non-facility setting like a physician's office.
Does this amount reflect what Medicare will actually pay?
No. This is an estimated allowed amount. Actual payment depends on the patient's deductible status, applicable modifiers, secondary insurance, and MAC-specific adjustments.
Why does the allowed amount vary by locality?
Medicare adjusts RVUs using locality-specific Geographic Practice Cost Indices (GPCIs) to account for regional differences in wages, rent, and malpractice costs.
What is the conversion factor used for?
The conversion factor is a dollar multiplier set annually by CMS that converts the geographically adjusted total RVUs into a payment amount.
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.
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