Medicare Reimbursement for CPT 21047

This page covers a specific CPT procedure code (the AMA-licensed descriptor is not reproduced here). It shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount nationally and, where available, by locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1076.51	$1076.51
ALASKA* (AK)	$1386.02	$1386.02
ALABAMA (AL)	$996.72	$996.72
ARKANSAS (AR)	$986.90	$986.90
ARIZONA (AZ)	$1053.55	$1053.55
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1226.11	$1226.11
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1244.22	$1244.22
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1123.04	$1123.04
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1135.45	$1135.45
NAPA (CA)	$1181.55	$1181.55
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1229.07	$1229.07
VALLEJO (CA)	$1177.27	$1177.27
BAKERSFIELD (CA)	$1087.07	$1087.07
CHICO (CA)	$1079.40	$1079.40
FRESNO (CA)	$1079.40	$1079.40
HANFORD-CORCORAN (CA)	$1079.40	$1079.40
MADERA (CA)	$1079.40	$1079.40
MERCED (CA)	$1079.40	$1079.40
MODESTO (CA)	$1079.40	$1079.40
REDDING (CA)	$1079.40	$1079.40
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1107.69	$1107.69
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1114.31	$1114.31
SALINAS (CA)	$1109.70	$1109.70
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1256.33	$1256.33
SANTA CRUZ-WATSONVILLE (CA)	$1121.96	$1121.96
SANTA ROSA-PETALUMA (CA)	$1132.21	$1132.21
STOCKTON (CA)	$1079.40	$1079.40
VISALIA (CA)	$1079.40	$1079.40
YUBA CITY (CA)	$1079.40	$1079.40
EL CENTRO (CA)	$1079.83	$1079.83
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1121.99	$1121.99
SAN LUIS OBISPO-PASO ROBLES (CA)	$1093.83	$1093.83
SANTA MARIA-SANTA BARBARA (CA)	$1110.09	$1110.09
REST OF CALIFORNIA (CA)	$1079.40	$1079.40
COLORADO (CO)	$1086.75	$1086.75
CONNECTICUT (CT)	$1133.74	$1133.74
DC + MD/VA SUBURBS (DC)	$1181.41	$1181.41
DELAWARE (DE)	$1066.95	$1066.95
FORT LAUDERDALE (FL)	$1151.31	$1151.31
MIAMI (FL)	$1223.57	$1223.57
REST OF FLORIDA (FL)	$1105.59	$1105.59
ATLANTA (GA)	$1101.37	$1101.37
REST OF GEORGIA (GA)	$1057.00	$1057.00
HAWAII, GUAM (HI)	$1085.80	$1085.80
IOWA (IA)	$995.41	$995.41
IDAHO (ID)	$1003.71	$1003.71
EAST ST. LOUIS (IL)	$1138.05	$1138.05
SUBURBAN CHICAGO (IL)	$1157.45	$1157.45
CHICAGO (IL)	$1195.66	$1195.66
REST OF ILLINOIS (IL)	$1096.39	$1096.39
INDIANA (IN)	$1007.20	$1007.20
KANSAS (KS)	$1001.05	$1001.05
KENTUCKY (KY)	$1031.84	$1031.84
NEW ORLEANS (LA)	$1068.56	$1068.56
REST OF LOUISIANA (LA)	$1034.25	$1034.25
METROPOLITAN BOSTON (MA)	$1158.84	$1158.84
REST OF MASSACHUSETTS (MA)	$1087.06	$1087.06
BALTIMORE/SURR. CNTYS (MD)	$1132.13	$1132.13
REST OF MARYLAND (MD)	$1079.93	$1079.93
SOUTHERN MAINE (ME)	$1041.32	$1041.32
REST OF MAINE (ME)	$1016.70	$1016.70
DETROIT (MI)	$1124.57	$1124.57
REST OF MICHIGAN (MI)	$1058.55	$1058.55
MINNESOTA (MN)	$1024.87	$1024.87
METROPOLITAN ST. LOUIS (MO)	$1060.57	$1060.57
METROPOLITAN KANSAS CITY (MO)	$1054.03	$1054.03
REST OF MISSOURI (MO)	$1027.92	$1027.92
MISSISSIPPI (MS)	$1007.10	$1007.10
MONTANA** (MT)	$1076.34	$1076.34
NORTH CAROLINA (NC)	$1022.55	$1022.55
NORTH DAKOTA** (ND)	$1024.73	$1024.73
NEBRASKA (NE)	$996.44	$996.44
NEW HAMPSHIRE (NH)	$1079.38	$1079.38
NORTHERN NJ (NJ)	$1177.33	$1177.33
REST OF NEW JERSEY (NJ)	$1142.00	$1142.00
NEW MEXICO (NM)	$1066.17	$1066.17
NEVADA** (NV)	$1062.29	$1062.29
MANHATTAN (NY)	$1223.81	$1223.81
NYC SUBURBS/LONG ISLAND (NY)	$1256.50	$1256.50
POUGHKPSIE/N NYC SUBURBS (NY)	$1156.12	$1156.12
QUEENS (NY)	$1217.97	$1217.97
REST OF NEW YORK (NY)	$1033.84	$1033.84
OHIO (OH)	$1048.00	$1048.00
OKLAHOMA (OK)	$1021.15	$1021.15
PORTLAND (OR)	$1101.91	$1101.91
REST OF OREGON (OR)	$1049.28	$1049.28
METROPOLITAN PHILADELPHIA (PA)	$1118.86	$1118.86
REST OF PENNSYLVANIA (PA)	$1044.19	$1044.19
PUERTO RICO (PR)	$1078.90	$1078.90
RHODE ISLAND (RI)	$1090.59	$1090.59
SOUTH CAROLINA (SC)	$1037.92	$1037.92
SOUTH DAKOTA** (SD)	$1018.63	$1018.63
TENNESSEE (TN)	$1005.60	$1005.60
BRAZORIA (TX)	$1059.54	$1059.54
DALLAS (TX)	$1068.67	$1068.67
GALVESTON (TX)	$1064.40	$1064.40
HOUSTON (TX)	$1112.17	$1112.17
BEAUMONT (TX)	$1040.11	$1040.11
FORT WORTH (TX)	$1066.45	$1066.45
AUSTIN (TX)	$1087.35	$1087.35
REST OF TEXAS (TX)	$1050.94	$1050.94
UTAH (UT)	$1047.48	$1047.48
VIRGINIA (VA)	$1045.17	$1045.17
VIRGIN ISLANDS (VI)	$1078.90	$1078.90
VERMONT (VT)	$1030.09	$1030.09
SEATTLE (KING CNTY) (WA)	$1169.44	$1169.44
REST OF WASHINGTON (WA)	$1081.96	$1081.96
WISCONSIN (WI)	$1002.09	$1002.09
WEST VIRGINIA (WV)	$1070.11	$1070.11
WYOMING** (WY)	$1053.85	$1053.85

Look up another code or locality →

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 PFS amounts are 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. The adjusted RVUs are summed and multiplied by the annual Conversion Factor to produce the dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, which is why two amounts are often shown; for this code, those practice-expense values are the same, so the non-facility and facility estimates match. Updates to RVUs, GPCIs, and the Conversion Factor occur annually and can shift amounts year to year.

RVUs — work 19.57, practice expense 10.05 (non-facility) / 10.05 (facility), malpractice 2.61 — × 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 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 can alter the amount from one year to the next.
Always verify current rates and coverage rules with your specific Medicare Administrative Contractor (MAC) or payer.

Frequently asked

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

Because the practice-expense RVU used in this calculation is identical for both settings, the resulting non-facility and facility PFS estimates come out equal. This isn't the case for every code.

Is this the amount my practice will actually be paid?

No. It's a national estimate based on standard RVUs, GPCIs, and the conversion factor. Your actual payment depends on your locality, any modifiers applied, and Medicare adjustments like sequestration.

Why don't you show the CPT code's description?

CPT descriptors are copyrighted by the American Medical Association, so we reference the code generically rather than reproducing the official language.

Does this amount reflect what the patient owes?

Not directly. Medicare generally pays 80% of the allowed amount after the deductible; the patient's share depends on their deductible status, secondary coverage, and any applicable copay or coinsurance rules.

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.