Medicare Reimbursement for CPT 21044

This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for procedure code 21044, both at the national level and adjusted for local cost differences. Amounts are shown for non-facility and facility settings, since Medicare pays practice expense differently depending on where the service is performed.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$764.88	$764.88
ALASKA* (AK)	$964.16	$964.16
ALABAMA (AL)	$702.28	$702.28
ARKANSAS (AR)	$694.55	$694.55
ARIZONA (AZ)	$747.11	$747.11
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$886.31	$886.31
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$899.99	$899.99
OXNARD-THOUSAND OAKS-VENTURA (CA)	$805.35	$805.35
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$813.59	$813.59
NAPA (CA)	$851.77	$851.77
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$888.41	$888.41
VALLEJO (CA)	$848.74	$848.74
BAKERSFIELD (CA)	$776.12	$776.12
CHICO (CA)	$770.78	$770.78
FRESNO (CA)	$770.78	$770.78
HANFORD-CORCORAN (CA)	$770.78	$770.78
MADERA (CA)	$770.78	$770.78
MERCED (CA)	$770.78	$770.78
MODESTO (CA)	$770.78	$770.78
REDDING (CA)	$770.78	$770.78
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$790.78	$790.78
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$797.87	$797.87
SALINAS (CA)	$794.64	$794.64
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$908.58	$908.58
SANTA CRUZ-WATSONVILLE (CA)	$806.51	$806.51
SANTA ROSA-PETALUMA (CA)	$813.98	$813.98
STOCKTON (CA)	$770.78	$770.78
VISALIA (CA)	$770.78	$770.78
YUBA CITY (CA)	$770.78	$770.78
EL CENTRO (CA)	$771.08	$771.08
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$805.19	$805.19
SAN LUIS OBISPO-PASO ROBLES (CA)	$783.08	$783.08
SANTA MARIA-SANTA BARBARA (CA)	$795.40	$795.40
REST OF CALIFORNIA (CA)	$770.78	$770.78
COLORADO (CO)	$774.67	$774.67
CONNECTICUT (CT)	$808.23	$808.23
DC + MD/VA SUBURBS (DC)	$845.32	$845.32
DELAWARE (DE)	$757.29	$757.29
FORT LAUDERDALE (FL)	$818.53	$818.53
MIAMI (FL)	$871.10	$871.10
REST OF FLORIDA (FL)	$783.37	$783.37
ATLANTA (GA)	$783.13	$783.13
REST OF GEORGIA (GA)	$745.83	$745.83
HAWAII, GUAM (HI)	$778.08	$778.08
IOWA (IA)	$703.29	$703.29
IDAHO (ID)	$709.42	$709.42
EAST ST. LOUIS (IL)	$804.64	$804.64
SUBURBAN CHICAGO (IL)	$823.23	$823.23
CHICAGO (IL)	$849.25	$849.25
REST OF ILLINOIS (IL)	$774.77	$774.77
INDIANA (IN)	$712.22	$712.22
KANSAS (KS)	$706.75	$706.75
KENTUCKY (KY)	$727.86	$727.86
NEW ORLEANS (LA)	$756.40	$756.40
REST OF LOUISIANA (LA)	$729.37	$729.37
METROPOLITAN BOSTON (MA)	$830.71	$830.71
REST OF MASSACHUSETTS (MA)	$774.18	$774.18
BALTIMORE/SURR. CNTYS (MD)	$807.09	$807.09
REST OF MARYLAND (MD)	$767.42	$767.42
SOUTHERN MAINE (ME)	$739.50	$739.50
REST OF MAINE (ME)	$718.62	$718.62
DETROIT (MI)	$797.25	$797.25
REST OF MICHIGAN (MI)	$747.95	$747.95
MINNESOTA (MN)	$729.68	$729.68
METROPOLITAN ST. LOUIS (MO)	$751.26	$751.26
METROPOLITAN KANSAS CITY (MO)	$746.00	$746.00
REST OF MISSOURI (MO)	$723.77	$723.77
MISSISSIPPI (MS)	$708.96	$708.96
MONTANA** (MT)	$764.76	$764.76
NORTH CAROLINA (NC)	$723.40	$723.40
NORTH DAKOTA** (ND)	$728.18	$728.18
NEBRASKA (NE)	$704.41	$704.41
NEW HAMPSHIRE (NH)	$768.89	$768.89
NORTHERN NJ (NJ)	$841.14	$841.14
REST OF NEW JERSEY (NJ)	$813.88	$813.88
NEW MEXICO (NM)	$753.54	$753.54
NEVADA** (NV)	$754.85	$754.85
MANHATTAN (NY)	$874.14	$874.14
NYC SUBURBS/LONG ISLAND (NY)	$898.61	$898.61
POUGHKPSIE/N NYC SUBURBS (NY)	$823.81	$823.81
QUEENS (NY)	$870.97	$870.97
REST OF NEW YORK (NY)	$732.22	$732.22
OHIO (OH)	$740.47	$740.47
OKLAHOMA (OK)	$720.47	$720.47
PORTLAND (OR)	$787.50	$787.50
REST OF OREGON (OR)	$745.38	$745.38
METROPOLITAN PHILADELPHIA (PA)	$796.05	$796.05
REST OF PENNSYLVANIA (PA)	$738.01	$738.01
PUERTO RICO (PR)	$767.10	$767.10
RHODE ISLAND (RI)	$775.57	$775.57
SOUTH CAROLINA (SC)	$733.86	$733.86
SOUTH DAKOTA** (SD)	$723.85	$723.85
TENNESSEE (TN)	$710.22	$710.22
BRAZORIA (TX)	$752.04	$752.04
DALLAS (TX)	$758.71	$758.71
GALVESTON (TX)	$755.58	$755.58
HOUSTON (TX)	$789.45	$789.45
BEAUMONT (TX)	$734.73	$734.73
FORT WORTH (TX)	$756.65	$756.65
AUSTIN (TX)	$775.27	$775.27
REST OF TEXAS (TX)	$744.29	$744.29
UTAH (UT)	$741.40	$741.40
VIRGINIA (VA)	$741.85	$741.85
VIRGIN ISLANDS (VI)	$767.10	$767.10
VERMONT (VT)	$731.49	$731.49
SEATTLE (KING CNTY) (WA)	$839.39	$839.39
REST OF WASHINGTON (WA)	$770.70	$770.70
WISCONSIN (WI)	$710.10	$710.10
WEST VIRGINIA (WV)	$754.01	$754.01
WYOMING** (WY)	$748.81	$748.81

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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's fee for a procedure is built from 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 billed, to reflect regional differences in cost of living and practice costs. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the dollar allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs, since the physician's overhead differs depending on who bears the facility costs.

RVUs — work 12.48, practice expense 8.57 (non-facility) / 8.57 (facility), malpractice 1.85 — × 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 their annual Part B deductible; the patient or secondary payer is responsible for the remainder.
Actual payment can vary based on the specific locality, applicable modifiers, claims-processing adjustments like sequestration, and annual budget-neutrality changes to RVUs or the conversion factor.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility and non-facility amount differ for some codes?

When a procedure is performed in a facility (like a hospital), the facility bears certain overhead costs, so the physician's practice-expense RVU is typically lower than when the same service is performed in a non-facility setting like an office. For some codes, including this one, those RVUs may be the same, resulting in equal allowed amounts.

Does this amount reflect what the patient will actually owe?

No. This figure is the Medicare-allowed amount before cost-sharing. The patient's actual out-of-pocket cost depends on their deductible status, coinsurance, and any secondary insurance.

Will this amount be the same in every state?

No. The national amount is adjusted by locality-specific GPCIs, so the actual allowed amount can be higher or lower depending on where the service is billed.

Why might the amount I'm paid differ from this estimate?

Modifiers, multiple-procedure payment reductions, sequestration, and annual updates to RVUs or the conversion factor can all change the final payment from the estimate shown here.

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.