Medicare Reimbursement for CPT 21060
This page covers CPT code 21060, a physician procedure code valued under the Medicare Physician Fee Schedule (PFS). It shows the estimated Medicare-allowed amount nationally and lets you compare non-facility and facility rates. Actual payment depends on your specific locality and claim details.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $717.45 | $717.45 |
| ALASKA* (AK) | $894.08 | $894.08 |
| ALABAMA (AL) | $656.72 | $656.72 |
| ARKANSAS (AR) | $649.18 | $649.18 |
| ARIZONA (AZ) | $700.49 | $700.49 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $846.76 | $846.76 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $860.46 | $860.46 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $763.40 | $763.40 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $770.53 | $770.53 |
| NAPA (CA) | $811.49 | $811.49 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $848.53 | $848.53 |
| VALLEJO (CA) | $808.94 | $808.94 |
| BAKERSFIELD (CA) | $733.20 | $733.20 |
| CHICO (CA) | $728.68 | $728.68 |
| FRESNO (CA) | $728.68 | $728.68 |
| HANFORD-CORCORAN (CA) | $728.68 | $728.68 |
| MADERA (CA) | $728.68 | $728.68 |
| MERCED (CA) | $728.68 | $728.68 |
| MODESTO (CA) | $728.68 | $728.68 |
| REDDING (CA) | $728.68 | $728.68 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $745.55 | $745.55 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $755.96 | $755.96 |
| SALINAS (CA) | $752.93 | $752.93 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $867.71 | $867.71 |
| SANTA CRUZ-WATSONVILLE (CA) | $766.41 | $766.41 |
| SANTA ROSA-PETALUMA (CA) | $773.61 | $773.61 |
| STOCKTON (CA) | $728.68 | $728.68 |
| VISALIA (CA) | $728.68 | $728.68 |
| YUBA CITY (CA) | $728.68 | $728.68 |
| EL CENTRO (CA) | $728.94 | $728.94 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $764.17 | $764.17 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $741.79 | $741.79 |
| SANTA MARIA-SANTA BARBARA (CA) | $753.99 | $753.99 |
| REST OF CALIFORNIA (CA) | $728.68 | $728.68 |
| COLORADO (CO) | $729.88 | $729.88 |
| CONNECTICUT (CT) | $759.08 | $759.08 |
| DC + MD/VA SUBURBS (DC) | $797.08 | $797.08 |
| DELAWARE (DE) | $710.33 | $710.33 |
| FORT LAUDERDALE (FL) | $763.52 | $763.52 |
| MIAMI (FL) | $809.62 | $809.62 |
| REST OF FLORIDA (FL) | $730.24 | $730.24 |
| ATLANTA (GA) | $733.88 | $733.88 |
| REST OF GEORGIA (GA) | $694.52 | $694.52 |
| HAWAII, GUAM (HI) | $737.29 | $737.29 |
| IOWA (IA) | $660.11 | $660.11 |
| IDAHO (ID) | $665.60 | $665.60 |
| EAST ST. LOUIS (IL) | $745.89 | $745.89 |
| SUBURBAN CHICAGO (IL) | $768.43 | $768.43 |
| CHICAGO (IL) | $788.98 | $788.98 |
| REST OF ILLINOIS (IL) | $720.26 | $720.26 |
| INDIANA (IN) | $668.41 | $668.41 |
| KANSAS (KS) | $662.33 | $662.33 |
| KENTUCKY (KY) | $679.17 | $679.17 |
| NEW ORLEANS (LA) | $706.55 | $706.55 |
| REST OF LOUISIANA (LA) | $680.19 | $680.19 |
| METROPOLITAN BOSTON (MA) | $785.66 | $785.66 |
| REST OF MASSACHUSETTS (MA) | $728.80 | $728.80 |
| BALTIMORE/SURR. CNTYS (MD) | $757.83 | $757.83 |
| REST OF MARYLAND (MD) | $720.44 | $720.44 |
| SOUTHERN MAINE (ME) | $695.48 | $695.48 |
| REST OF MAINE (ME) | $673.36 | $673.36 |
| DETROIT (MI) | $742.52 | $742.52 |
| REST OF MICHIGAN (MI) | $697.64 | $697.64 |
| MINNESOTA (MN) | $689.61 | $689.61 |
| METROPOLITAN ST. LOUIS (MO) | $702.92 | $702.92 |
| METROPOLITAN KANSAS CITY (MO) | $697.65 | $697.65 |
| REST OF MISSOURI (MO) | $674.01 | $674.01 |
| MISSISSIPPI (MS) | $661.46 | $661.46 |
| MONTANA** (MT) | $717.35 | $717.35 |
| NORTH CAROLINA (NC) | $678.21 | $678.21 |
| NORTH DAKOTA** (ND) | $686.50 | $686.50 |
| NEBRASKA (NE) | $661.56 | $661.56 |
| NEW HAMPSHIRE (NH) | $723.44 | $723.44 |
| NORTHERN NJ (NJ) | $792.49 | $792.49 |
| REST OF NEW JERSEY (NJ) | $764.98 | $764.98 |
| NEW MEXICO (NM) | $702.61 | $702.61 |
| NEVADA** (NV) | $709.05 | $709.05 |
| MANHATTAN (NY) | $820.45 | $820.45 |
| NYC SUBURBS/LONG ISLAND (NY) | $842.81 | $842.81 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $773.58 | $773.58 |
| QUEENS (NY) | $819.05 | $819.05 |
| REST OF NEW YORK (NY) | $686.73 | $686.73 |
| OHIO (OH) | $691.34 | $691.34 |
| OKLAHOMA (OK) | $673.20 | $673.20 |
| PORTLAND (OR) | $743.73 | $743.73 |
| REST OF OREGON (OR) | $700.76 | $700.76 |
| METROPOLITAN PHILADELPHIA (PA) | $746.50 | $746.50 |
| REST OF PENNSYLVANIA (PA) | $689.58 | $689.58 |
| PUERTO RICO (PR) | $720.02 | $720.02 |
| RHODE ISLAND (RI) | $728.73 | $728.73 |
| SOUTH CAROLINA (SC) | $686.46 | $686.46 |
| SOUTH DAKOTA** (SD) | $682.85 | $682.85 |
| TENNESSEE (TN) | $665.58 | $665.58 |
| BRAZORIA (TX) | $706.13 | $706.13 |
| DALLAS (TX) | $712.08 | $712.08 |
| GALVESTON (TX) | $709.24 | $709.24 |
| HOUSTON (TX) | $737.79 | $737.79 |
| BEAUMONT (TX) | $686.31 | $686.31 |
| FORT WORTH (TX) | $709.70 | $709.70 |
| AUSTIN (TX) | $729.92 | $729.92 |
| REST OF TEXAS (TX) | $696.84 | $696.84 |
| UTAH (UT) | $693.84 | $693.84 |
| VIRGINIA (VA) | $696.95 | $696.95 |
| VIRGIN ISLANDS (VI) | $720.02 | $720.02 |
| VERMONT (VT) | $688.66 | $688.66 |
| SEATTLE (KING CNTY) (WA) | $795.16 | $795.16 |
| REST OF WASHINGTON (WA) | $725.85 | $725.85 |
| WISCONSIN (WI) | $668.59 | $668.59 |
| WEST VIRGINIA (WV) | $699.96 | $699.96 |
| WYOMING** (WY) | $703.90 | $703.90 |
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: 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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility settings can have different practice-expense RVUs because overhead costs differ; for this code, those values are the same, so the resulting non-facility and facility amounts match.
RVUs — work 10.79, practice expense 9.13 (non-facility) / 9.13 (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 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.
- Rates vary by Medicare Administrative Contractor (MAC) locality — confirm the exact figure with your MAC or current fee schedule file.
Frequently asked
Why do non-facility and facility amounts sometimes differ for other codes?
They can differ because practice-expense RVUs account for overhead; non-facility (e.g., office) settings often include more overhead than facility (e.g., hospital) settings where the facility bills separately for overhead.
Why is CPT 21060's descriptor not shown here?
CPT code descriptors are licensed by the American Medical Association, so this page refers to the code generically rather than reproducing the official language.
Will my locality's payment match the national amount shown?
Not necessarily. The national figure uses average GPCIs; your locality's specific GPCI values may raise or lower the actual allowed amount.
Does this amount include sequestration or other federal adjustments?
Not automatically. Federal sequestration and other claim-level adjustments can reduce the amount actually paid, separate from the base PFS calculation.
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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