Medicare Reimbursement for CPT Code 21010

This page covers a Medicare-recognized procedure code billed under the Physician Fee Schedule (PFS). It shows the estimated Medicare allowed amount nationally and adjusted for your locality, broken out by non-facility and facility settings. Because CPT descriptors are licensed by the AMA, this page refers to it generically as 'this procedure code' rather than reproducing its official description.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$672.69	$672.69
ALASKA* (AK)	$845.97	$845.97
ALABAMA (AL)	$617.43	$617.43
ARKANSAS (AR)	$610.59	$610.59
ARIZONA (AZ)	$657.09	$657.09
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$783.97	$783.97
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$796.26	$796.26
OXNARD-THOUSAND OAKS-VENTURA (CA)	$710.65	$710.65
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$717.72	$717.72
NAPA (CA)	$752.76	$752.76
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$785.74	$785.74
VALLEJO (CA)	$750.21	$750.21
BAKERSFIELD (CA)	$684.22	$684.22
CHICO (CA)	$679.70	$679.70
FRESNO (CA)	$679.70	$679.70
HANFORD-CORCORAN (CA)	$679.70	$679.70
MADERA (CA)	$679.70	$679.70
MERCED (CA)	$679.70	$679.70
MODESTO (CA)	$679.70	$679.70
REDDING (CA)	$679.70	$679.70
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$696.58	$696.58
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$704.03	$704.03
SALINAS (CA)	$701.19	$701.19
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$803.50	$803.50
SANTA CRUZ-WATSONVILLE (CA)	$712.22	$712.22
SANTA ROSA-PETALUMA (CA)	$718.85	$718.85
STOCKTON (CA)	$679.70	$679.70
VISALIA (CA)	$679.70	$679.70
YUBA CITY (CA)	$679.70	$679.70
EL CENTRO (CA)	$679.96	$679.96
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$710.81	$710.81
SAN LUIS OBISPO-PASO ROBLES (CA)	$690.93	$690.93
SANTA MARIA-SANTA BARBARA (CA)	$701.94	$701.94
REST OF CALIFORNIA (CA)	$679.70	$679.70
COLORADO (CO)	$682.31	$682.31
CONNECTICUT (CT)	$710.94	$710.94
DC + MD/VA SUBURBS (DC)	$744.48	$744.48
DELAWARE (DE)	$666.09	$666.09
FORT LAUDERDALE (FL)	$718.19	$718.19
MIAMI (FL)	$763.07	$763.07
REST OF FLORIDA (FL)	$687.41	$687.41
ATLANTA (GA)	$688.42	$688.42
REST OF GEORGIA (GA)	$654.49	$654.49
HAWAII, GUAM (HI)	$686.54	$686.54
IOWA (IA)	$619.07	$619.07
IDAHO (ID)	$624.34	$624.34
EAST ST. LOUIS (IL)	$704.63	$704.63
SUBURBAN CHICAGO (IL)	$722.49	$722.49
CHICAGO (IL)	$743.99	$743.99
REST OF ILLINOIS (IL)	$679.31	$679.31
INDIANA (IN)	$626.84	$626.84
KANSAS (KS)	$621.78	$621.78
KENTUCKY (KY)	$639.27	$639.27
NEW ORLEANS (LA)	$664.37	$664.37
REST OF LOUISIANA (LA)	$640.47	$640.47
METROPOLITAN BOSTON (MA)	$732.37	$732.37
REST OF MASSACHUSETTS (MA)	$681.71	$681.71
BALTIMORE/SURR. CNTYS (MD)	$709.86	$709.86
REST OF MARYLAND (MD)	$675.15	$675.15
SOUTHERN MAINE (ME)	$651.12	$651.12
REST OF MAINE (ME)	$632.10	$632.10
DETROIT (MI)	$699.30	$699.30
REST OF MICHIGAN (MI)	$656.69	$656.69
MINNESOTA (MN)	$643.59	$643.59
METROPOLITAN ST. LOUIS (MO)	$660.26	$660.26
METROPOLITAN KANSAS CITY (MO)	$655.56	$655.56
REST OF MISSOURI (MO)	$635.29	$635.29
MISSISSIPPI (MS)	$622.79	$622.79
MONTANA** (MT)	$672.59	$672.59
NORTH CAROLINA (NC)	$636.38	$636.38
NORTH DAKOTA** (ND)	$641.74	$641.74
NEBRASKA (NE)	$620.17	$620.17
NEW HAMPSHIRE (NH)	$676.89	$676.89
NORTHERN NJ (NJ)	$740.67	$740.67
REST OF NEW JERSEY (NJ)	$716.15	$716.15
NEW MEXICO (NM)	$661.49	$661.49
NEVADA** (NV)	$664.25	$664.25
MANHATTAN (NY)	$768.54	$768.54
NYC SUBURBS/LONG ISLAND (NY)	$789.72	$789.72
POUGHKPSIE/N NYC SUBURBS (NY)	$724.62	$724.62
QUEENS (NY)	$766.26	$766.26
REST OF NEW YORK (NY)	$644.16	$644.16
OHIO (OH)	$650.39	$650.39
OKLAHOMA (OK)	$633.13	$633.13
PORTLAND (OR)	$694.10	$694.10
REST OF OREGON (OR)	$656.17	$656.17
METROPOLITAN PHILADELPHIA (PA)	$699.93	$699.93
REST OF PENNSYLVANIA (PA)	$648.41	$648.41
PUERTO RICO (PR)	$674.79	$674.79
RHODE ISLAND (RI)	$682.51	$682.51
SOUTH CAROLINA (SC)	$645.03	$645.03
SOUTH DAKOTA** (SD)	$638.10	$638.10
TENNESSEE (TN)	$624.80	$624.80
BRAZORIA (TX)	$661.76	$661.76
DALLAS (TX)	$667.48	$667.48
GALVESTON (TX)	$664.78	$664.78
HOUSTON (TX)	$693.33	$693.33
BEAUMONT (TX)	$645.49	$645.49
FORT WORTH (TX)	$665.55	$665.55
AUSTIN (TX)	$682.62	$682.62
REST OF TEXAS (TX)	$654.32	$654.32
UTAH (UT)	$651.71	$651.71
VIRGINIA (VA)	$652.93	$652.93
VIRGIN ISLANDS (VI)	$674.79	$674.79
VERMONT (VT)	$644.34	$644.34
SEATTLE (KING CNTY) (WA)	$740.42	$740.42
REST OF WASHINGTON (WA)	$678.76	$678.76
WISCONSIN (WI)	$625.67	$625.67
WEST VIRGINIA (WV)	$660.94	$660.94
WYOMING** (WY)	$659.15	$659.15

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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's Physician Fee Schedule amount is built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by a Geographic Practice Cost Index (GPCI) specific to the locality where the service is performed, reflecting regional cost differences. The geographically adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, since overhead costs differ depending on where the service is rendered; for this code, work and malpractice RVUs are the same in both settings, so any difference between the two totals stems from practice-expense RVU variation.

RVUs — work 10.76, practice expense 7.82 (non-facility) / 7.82 (facility), malpractice 1.56 — × 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 patient meets the annual deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates mean amounts can change year to year.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the amount differ by locality?

Medicare applies locality-specific Geographic Practice Cost Indices (GPCIs) to the work, practice expense, and malpractice RVUs to account for regional differences in cost of living and practice costs, which changes the final allowed amount even though the RVUs themselves are national.

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

The two settings use separate practice-expense RVUs to reflect different overhead costs, but when those values are equal (as shown here), the calculated allowed amount comes out the same for both settings.

Is this the amount my practice will actually be paid?

No. This figure is an estimate based on standard PFS inputs. Actual payment can be affected by the patient's deductible status, applicable modifiers, secondary payer rules, and annual Medicare adjustments such as sequestration.

Where can I find the official CPT descriptor for this code?

CPT code descriptors are copyrighted by the American Medical Association. Check your CPT codebook, practice management software, or AMA resources for the official language.

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.