Medicare Reimbursement for CPT 21077

CPT 21077 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code at the national level and by locality, broken out for non-facility and facility settings. Actual payment depends on where and how the service is performed.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$2193.77	$1528.43
ALASKA* (AK)	$2749.42	$2040.83
ALABAMA (AL)	$2018.04	$1435.86
ARKANSAS (AR)	$1996.12	$1424.59
ARIZONA (AZ)	$2145.63	$1500.91
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2624.11	$1685.98
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2668.14	$1708.71
OXNARD-THOUSAND OAKS-VENTURA (CA)	$2354.00	$1567.56
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$2374.37	$1587.27
NAPA (CA)	$2510.06	$1633.13
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2628.37	$1690.23
VALLEJO (CA)	$2503.92	$1627.00
BAKERSFIELD (CA)	$2258.86	$1529.64
CHICO (CA)	$2247.52	$1518.31
FRESNO (CA)	$2247.52	$1518.31
HANFORD-CORCORAN (CA)	$2247.52	$1518.31
MADERA (CA)	$2247.52	$1518.31
MERCED (CA)	$2247.52	$1518.31
MODESTO (CA)	$2247.52	$1518.31
REDDING (CA)	$2247.52	$1518.31
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$2288.33	$1559.11
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$2333.43	$1559.64
SALINAS (CA)	$2324.06	$1552.93
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2685.55	$1726.12
SANTA CRUZ-WATSONVILLE (CA)	$2367.46	$1559.06
SANTA ROSA-PETALUMA (CA)	$2389.96	$1572.92
STOCKTON (CA)	$2247.52	$1518.31
VISALIA (CA)	$2247.52	$1518.31
YUBA CITY (CA)	$2247.52	$1518.31
EL CENTRO (CA)	$2248.15	$1518.93
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$2359.64	$1563.89
SAN LUIS OBISPO-PASO ROBLES (CA)	$2289.28	$1531.45
SANTA MARIA-SANTA BARBARA (CA)	$2327.57	$1551.77
REST OF CALIFORNIA (CA)	$2247.52	$1518.31
COLORADO (CO)	$2241.65	$1533.72
CONNECTICUT (CT)	$2316.79	$1600.21
DC + MD/VA SUBURBS (DC)	$2440.02	$1656.25
DELAWARE (DE)	$2174.96	$1517.59
FORT LAUDERDALE (FL)	$2307.60	$1633.60
MIAMI (FL)	$2425.09	$1732.47
REST OF FLORIDA (FL)	$2214.05	$1577.98
ATLANTA (GA)	$2237.78	$1561.78
REST OF GEORGIA (GA)	$2112.96	$1519.47
HAWAII, GUAM (HI)	$2274.06	$1517.56
IOWA (IA)	$2035.71	$1426.92
IDAHO (ID)	$2050.09	$1437.97
EAST ST. LOUIS (IL)	$2243.10	$1630.98
SUBURBAN CHICAGO (IL)	$2324.37	$1641.06
CHICAGO (IL)	$2368.51	$1699.84
REST OF ILLINOIS (IL)	$2179.81	$1572.35
INDIANA (IN)	$2058.51	$1441.73
KANSAS (KS)	$2038.43	$1436.96
KENTUCKY (KY)	$2075.35	$1483.86
NEW ORLEANS (LA)	$2153.52	$1527.43
REST OF LOUISIANA (LA)	$2076.85	$1488.02
METROPOLITAN BOSTON (MA)	$2413.36	$1618.94
REST OF MASSACHUSETTS (MA)	$2237.37	$1536.76
BALTIMORE/SURR. CNTYS (MD)	$2311.90	$1597.98
REST OF MARYLAND (MD)	$2206.13	$1532.80
SOUTHERN MAINE (ME)	$2138.81	$1479.46
REST OF MAINE (ME)	$2068.75	$1456.63
DETROIT (MI)	$2245.71	$1603.65
REST OF MICHIGAN (MI)	$2125.45	$1517.99
MINNESOTA (MN)	$2133.75	$1449.11
METROPOLITAN ST. LOUIS (MO)	$2147.42	$1514.01
METROPOLITAN KANSAS CITY (MO)	$2131.66	$1506.90
REST OF MISSOURI (MO)	$2056.52	$1482.99
MISSISSIPPI (MS)	$2026.12	$1453.25
MONTANA** (MT)	$2193.52	$1528.17
NORTH CAROLINA (NC)	$2083.50	$1462.73
NORTH DAKOTA** (ND)	$2119.37	$1454.02
NEBRASKA (NE)	$2041.10	$1426.98
NEW HAMPSHIRE (NH)	$2217.92	$1525.30
NORTHERN NJ (NJ)	$2426.79	$1654.99
REST OF NEW JERSEY (NJ)	$2339.15	$1612.59
NEW MEXICO (NM)	$2138.36	$1528.23
NEVADA** (NV)	$2173.82	$1507.81
MANHATTAN (NY)	$2494.71	$1721.58
NYC SUBURBS/LONG ISLAND (NY)	$2554.87	$1763.77
POUGHKPSIE/N NYC SUBURBS (NY)	$2361.71	$1633.15
QUEENS (NY)	$2496.09	$1709.65
REST OF NEW YORK (NY)	$2108.02	$1475.94
OHIO (OH)	$2110.30	$1502.84
OKLAHOMA (OK)	$2061.95	$1467.79
PORTLAND (OR)	$2287.04	$1547.84
REST OF OREGON (OR)	$2152.69	$1490.00
METROPOLITAN PHILADELPHIA (PA)	$2277.51	$1584.89
REST OF PENNSYLVANIA (PA)	$2107.26	$1496.48
PUERTO RICO (PR)	$2202.57	$1529.91
RHODE ISLAND (RI)	$2233.14	$1545.84
SOUTH CAROLINA (SC)	$2101.19	$1486.41
SOUTH DAKOTA** (SD)	$2110.60	$1445.26
TENNESSEE (TN)	$2047.42	$1442.62
BRAZORIA (TX)	$2166.26	$1506.90
DALLAS (TX)	$2181.98	$1519.29
GALVESTON (TX)	$2174.21	$1513.52
HOUSTON (TX)	$2242.85	$1582.16
BEAUMONT (TX)	$2097.49	$1492.03
FORT WORTH (TX)	$2173.90	$1517.87
AUSTIN (TX)	$2238.00	$1534.07
REST OF TEXAS (TX)	$2132.10	$1500.69
UTAH (UT)	$2122.74	$1497.31
VIRGINIA (VA)	$2140.44	$1486.41
VIRGIN ISLANDS (VI)	$2202.57	$1529.91
VERMONT (VT)	$2122.19	$1463.49
SEATTLE (KING CNTY) (WA)	$2446.14	$1629.76
REST OF WASHINGTON (WA)	$2229.56	$1528.96
WISCONSIN (WI)	$2066.32	$1428.91
WEST VIRGINIA (WV)	$2120.56	$1542.37
WYOMING** (WY)	$2161.21	$1495.86

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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) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is furnished, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility settings use different practice-expense RVUs, since overhead costs differ when a service is performed in a physician's office versus a hospital or facility setting, which is why the two allowed amounts differ.

RVUs — work 32.86, practice expense 29.07 (non-facility) / 9.15 (facility), malpractice 3.75 — × 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 insurer is responsible for the remainder.
Modifiers, place of service, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs mean the actual allowed amount can vary meaningfully from the national figure.
Always confirm current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why is the non-facility amount higher than the facility amount for this code?

The non-facility rate includes higher practice-expense RVUs because the billing provider is assumed to bear the overhead costs (staff, supplies, equipment) typically covered by the facility when the service is performed in a hospital or other facility setting.

Why does the allowed amount differ by locality?

Each locality has its own Geographic Practice Cost Index values for work, practice expense, and malpractice, which adjust the RVUs to reflect local labor, rent, and liability cost differences before the conversion factor is applied.

Will the patient's Medicare coinsurance equal 20% of this estimated amount?

Generally yes, once the deductible is met, but modifiers, secondary payers, and claim-specific adjustments can change the patient's actual responsibility.

Does this amount change every year?

Yes. The conversion factor, RVUs, and GPCIs can all be updated annually through CMS rulemaking, and budget-neutrality adjustments may shift amounts even if RVUs stay the same.

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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.