Medicare Reimbursement for CPT 21070

CPT 21070 is a procedure code defined by the American Medical Association; the specific clinical description is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for a specific locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$540.09	$540.09
ALASKA* (AK)	$676.13	$676.13
ALABAMA (AL)	$494.96	$494.96
ARKANSAS (AR)	$489.37	$489.37
ARIZONA (AZ)	$527.40	$527.40
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$632.68	$632.68
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$642.73	$642.73
OXNARD-THOUSAND OAKS-VENTURA (CA)	$572.22	$572.22
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$577.77	$577.77
NAPA (CA)	$607.02	$607.02
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$634.08	$634.08
VALLEJO (CA)	$605.01	$605.01
BAKERSFIELD (CA)	$550.33	$550.33
CHICO (CA)	$546.77	$546.77
FRESNO (CA)	$546.77	$546.77
HANFORD-CORCORAN (CA)	$546.77	$546.77
MADERA (CA)	$546.77	$546.77
MERCED (CA)	$546.77	$546.77
MODESTO (CA)	$546.77	$546.77
REDDING (CA)	$546.77	$546.77
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$560.07	$560.07
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$566.74	$566.74
SALINAS (CA)	$564.46	$564.46
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$648.44	$648.44
SANTA CRUZ-WATSONVILLE (CA)	$573.89	$573.89
SANTA ROSA-PETALUMA (CA)	$579.25	$579.25
STOCKTON (CA)	$546.77	$546.77
VISALIA (CA)	$546.77	$546.77
YUBA CITY (CA)	$546.77	$546.77
EL CENTRO (CA)	$546.98	$546.98
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$572.51	$572.51
SAN LUIS OBISPO-PASO ROBLES (CA)	$556.16	$556.16
SANTA MARIA-SANTA BARBARA (CA)	$565.15	$565.15
REST OF CALIFORNIA (CA)	$546.77	$546.77
COLORADO (CO)	$548.44	$548.44
CONNECTICUT (CT)	$571.15	$571.15
DC + MD/VA SUBURBS (DC)	$598.77	$598.77
DELAWARE (DE)	$534.72	$534.72
FORT LAUDERDALE (FL)	$576.13	$576.13
MIAMI (FL)	$611.86	$611.86
REST OF FLORIDA (FL)	$551.15	$551.15
ATLANTA (GA)	$552.69	$552.69
REST OF GEORGIA (GA)	$524.39	$524.39
HAWAII, GUAM (HI)	$552.72	$552.72
IOWA (IA)	$496.75	$496.75
IDAHO (ID)	$500.97	$500.97
EAST ST. LOUIS (IL)	$564.28	$564.28
SUBURBAN CHICAGO (IL)	$579.67	$579.67
CHICAGO (IL)	$596.35	$596.35
REST OF ILLINOIS (IL)	$544.22	$544.22
INDIANA (IN)	$503.03	$503.03
KANSAS (KS)	$498.74	$498.74
KENTUCKY (KY)	$512.35	$512.35
NEW ORLEANS (LA)	$532.79	$532.79
REST OF LOUISIANA (LA)	$513.25	$513.25
METROPOLITAN BOSTON (MA)	$589.45	$589.45
REST OF MASSACHUSETTS (MA)	$547.82	$547.82
BALTIMORE/SURR. CNTYS (MD)	$570.26	$570.26
REST OF MARYLAND (MD)	$542.15	$542.15
SOUTHERN MAINE (ME)	$522.97	$522.97
REST OF MAINE (ME)	$507.09	$507.09
DETROIT (MI)	$560.63	$560.63
REST OF MICHIGAN (MI)	$526.39	$526.39
MINNESOTA (MN)	$517.50	$517.50
METROPOLITAN ST. LOUIS (MO)	$529.69	$529.69
METROPOLITAN KANSAS CITY (MO)	$525.82	$525.82
REST OF MISSOURI (MO)	$508.88	$508.88
MISSISSIPPI (MS)	$499.01	$499.01
MONTANA** (MT)	$540.01	$540.01
NORTH CAROLINA (NC)	$510.63	$510.63
NORTH DAKOTA** (ND)	$515.69	$515.69
NEBRASKA (NE)	$497.72	$497.72
NEW HAMPSHIRE (NH)	$543.91	$543.91
NORTHERN NJ (NJ)	$595.51	$595.51
REST OF NEW JERSEY (NJ)	$575.40	$575.40
NEW MEXICO (NM)	$530.22	$530.22
NEVADA** (NV)	$533.45	$533.45
MANHATTAN (NY)	$617.51	$617.51
NYC SUBURBS/LONG ISLAND (NY)	$634.54	$634.54
POUGHKPSIE/N NYC SUBURBS (NY)	$582.10	$582.10
QUEENS (NY)	$615.96	$615.96
REST OF NEW YORK (NY)	$516.97	$516.97
OHIO (OH)	$521.42	$521.42
OKLAHOMA (OK)	$507.56	$507.56
PORTLAND (OR)	$558.31	$558.31
REST OF OREGON (OR)	$527.02	$527.02
METROPOLITAN PHILADELPHIA (PA)	$562.03	$562.03
REST OF PENNSYLVANIA (PA)	$519.92	$519.92
PUERTO RICO (PR)	$541.88	$541.88
RHODE ISLAND (RI)	$548.19	$548.19
SOUTH CAROLINA (SC)	$517.33	$517.33
SOUTH DAKOTA** (SD)	$512.81	$512.81
TENNESSEE (TN)	$501.19	$501.19
BRAZORIA (TX)	$531.33	$531.33
DALLAS (TX)	$535.91	$535.91
GALVESTON (TX)	$533.74	$533.74
HOUSTON (TX)	$556.26	$556.26
BEAUMONT (TX)	$517.52	$517.52
FORT WORTH (TX)	$534.26	$534.26
AUSTIN (TX)	$548.64	$548.64
REST OF TEXAS (TX)	$524.97	$524.97
UTAH (UT)	$522.80	$522.80
VIRGINIA (VA)	$524.30	$524.30
VIRGIN ISLANDS (VI)	$541.88	$541.88
VERMONT (VT)	$517.61	$517.61
SEATTLE (KING CNTY) (WA)	$596.19	$596.19
REST OF WASHINGTON (WA)	$545.50	$545.50
WISCONSIN (WI)	$502.49	$502.49
WEST VIRGINIA (WV)	$529.18	$529.18
WYOMING** (WY)	$529.41	$529.41

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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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs because the resources the physician practice bears differ by site of service; for this code, the practice-expense RVU happens to be the same in both settings, so the national amounts shown are identical.

RVUs — work 8.4, practice expense 6.54 (non-facility) / 6.54 (facility), malpractice 1.23 — × 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 deductible; the beneficiary or secondary payer is generally responsible for the remainder.
Actual payment can vary based on locality, applied modifiers, claim-specific adjustments, sequestration, and annual budget-neutrality adjustments to RVUs or the conversion factor.
Always confirm final allowed amounts and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why do non-facility and facility amounts sometimes differ?

They can differ because the practice-expense RVU component reflects different overhead costs depending on whether the service is performed in a physician office (non-facility) or a facility such as a hospital. For some codes, like this one, the practice-expense RVU is the same in both settings, so the amounts match.

Is this the amount my practice will actually be paid?

No. This figure is the Medicare PFS allowed amount estimate before patient cost-sharing, secondary payer adjustments, modifiers, or claim-specific factors are applied.

Why can this amount change year to year?

The conversion factor, RVUs, and GPCIs are updated annually by CMS, and budget-neutrality adjustments can shift relative values even when the conversion factor itself is stable.

Does this code's description appear on this page?

No. CPT code descriptors are copyrighted by the American Medical Association and are not reproduced here; only the numeric code and its Medicare pricing inputs are shown.

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.