Medicare Reimbursement for CPT 21083

This page covers CPT code 21083, a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). It shows the estimated Medicare-allowed amount nationally and adjusted for your locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings. Because CPT descriptors are proprietary to the AMA, this page refers to the code generically rather than reproducing its official description.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1411.52	$915.85
ALASKA* (AK)	$1739.54	$1211.65
ALABAMA (AL)	$1291.45	$857.73
ARKANSAS (AR)	$1276.40	$850.62
ARIZONA (AZ)	$1379.14	$898.84
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1722.15	$1023.25
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1752.36	$1037.60
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1531.81	$945.93
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1543.61	$957.24
NAPA (CA)	$1642.45	$989.16
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1724.58	$1025.68
VALLEJO (CA)	$1638.95	$985.66
BAKERSFIELD (CA)	$1463.89	$920.64
CHICO (CA)	$1457.42	$914.17
FRESNO (CA)	$1457.42	$914.17
HANFORD-CORCORAN (CA)	$1457.42	$914.17
MADERA (CA)	$1457.42	$914.17
MERCED (CA)	$1457.42	$914.17
MODESTO (CA)	$1457.42	$914.17
REDDING (CA)	$1457.42	$914.17
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1480.71	$937.45
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1517.08	$940.61
SALINAS (CA)	$1511.09	$936.61
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1762.29	$1047.54
SANTA CRUZ-WATSONVILLE (CA)	$1544.71	$942.47
SANTA ROSA-PETALUMA (CA)	$1559.62	$950.94
STOCKTON (CA)	$1457.42	$914.17
VISALIA (CA)	$1457.42	$914.17
YUBA CITY (CA)	$1457.42	$914.17
EL CENTRO (CA)	$1457.78	$914.52
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1537.25	$944.43
SAN LUIS OBISPO-PASO ROBLES (CA)	$1488.05	$923.49
SANTA MARIA-SANTA BARBARA (CA)	$1514.19	$936.24
REST OF CALIFORNIA (CA)	$1457.42	$914.17
COLORADO (CO)	$1449.00	$921.60
CONNECTICUT (CT)	$1493.94	$960.11
DC + MD/VA SUBURBS (DC)	$1580.30	$996.41
DELAWARE (DE)	$1398.89	$909.17
FORT LAUDERDALE (FL)	$1478.54	$976.42
MIAMI (FL)	$1550.02	$1034.03
REST OF FLORIDA (FL)	$1416.13	$942.27
ATLANTA (GA)	$1439.17	$935.57
REST OF GEORGIA (GA)	$1348.30	$906.17
HAWAII, GUAM (HI)	$1479.03	$915.46
IOWA (IA)	$1307.86	$854.33
IDAHO (ID)	$1316.86	$860.84
EAST ST. LOUIS (IL)	$1427.01	$970.99
SUBURBAN CHICAGO (IL)	$1490.33	$981.28
CHICAGO (IL)	$1512.04	$1013.89
REST OF ILLINOIS (IL)	$1389.78	$937.24
INDIANA (IN)	$1322.77	$863.29
KANSAS (KS)	$1307.67	$859.59
KENTUCKY (KY)	$1326.37	$885.72
NEW ORLEANS (LA)	$1379.21	$912.78
REST OF LOUISIANA (LA)	$1326.59	$887.92
METROPOLITAN BOSTON (MA)	$1567.60	$975.78
REST OF MASSACHUSETTS (MA)	$1444.81	$922.87
BALTIMORE/SURR. CNTYS (MD)	$1490.51	$958.66
REST OF MARYLAND (MD)	$1420.49	$918.87
SOUTHERN MAINE (ME)	$1378.73	$887.53
REST OF MAINE (ME)	$1327.51	$871.49
DETROIT (MI)	$1435.62	$957.30
REST OF MICHIGAN (MI)	$1358.76	$906.21
MINNESOTA (MN)	$1381.86	$871.82
METROPOLITAN ST. LOUIS (MO)	$1377.47	$905.59
METROPOLITAN KANSAS CITY (MO)	$1366.42	$900.99
REST OF MISSOURI (MO)	$1311.35	$884.08
MISSISSIPPI (MS)	$1293.84	$867.07
MONTANA** (MT)	$1411.38	$915.71
NORTH CAROLINA (NC)	$1337.98	$875.53
NORTH DAKOTA** (ND)	$1369.06	$873.39
NEBRASKA (NE)	$1312.20	$854.70
NEW HAMPSHIRE (NH)	$1431.80	$915.81
NORTHERN NJ (NJ)	$1569.91	$994.94
REST OF NEW JERSEY (NJ)	$1509.10	$967.83
NEW MEXICO (NM)	$1366.76	$912.23
NEVADA** (NV)	$1400.30	$904.13
MANHATTAN (NY)	$1608.99	$1033.02
NYC SUBURBS/LONG ISLAND (NY)	$1647.60	$1058.25
POUGHKPSIE/N NYC SUBURBS (NY)	$1522.46	$979.70
QUEENS (NY)	$1612.95	$1027.06
REST OF NEW YORK (NY)	$1354.67	$883.79
OHIO (OH)	$1350.11	$897.57
OKLAHOMA (OK)	$1319.35	$876.72
PORTLAND (OR)	$1482.35	$931.66
REST OF OREGON (OR)	$1387.44	$893.76
METROPOLITAN PHILADELPHIA (PA)	$1465.82	$949.83
REST OF PENNSYLVANIA (PA)	$1349.17	$894.15
PUERTO RICO (PR)	$1418.29	$917.16
RHODE ISLAND (RI)	$1439.24	$927.21
SOUTH CAROLINA (SC)	$1346.65	$888.66
SOUTH DAKOTA** (SD)	$1364.06	$868.39
TENNESSEE (TN)	$1313.60	$863.03
BRAZORIA (TX)	$1394.41	$903.20
DALLAS (TX)	$1404.17	$910.48
GALVESTON (TX)	$1399.26	$907.06
HOUSTON (TX)	$1438.43	$946.23
BEAUMONT (TX)	$1342.33	$891.27
FORT WORTH (TX)	$1397.98	$909.25
AUSTIN (TX)	$1445.95	$921.53
REST OF TEXAS (TX)	$1368.25	$897.86
UTAH (UT)	$1361.48	$895.56
VIRGINIA (VA)	$1378.40	$891.15
VIRGIN ISLANDS (VI)	$1418.29	$917.16
VERMONT (VT)	$1369.09	$878.37
SEATTLE (KING CNTY) (WA)	$1591.55	$983.36
REST OF WASHINGTON (WA)	$1440.36	$918.42
WISCONSIN (WI)	$1332.14	$857.29
WEST VIRGINIA (WV)	$1349.00	$918.26
WYOMING** (WY)	$1392.94	$897.27

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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 PFS amounts are built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility and facility rates differ mainly because practice-expense RVUs are lower in facility settings, since the facility (not the billing physician) absorbs certain overhead costs. The resulting figure is the Medicare-allowed amount before any deductible, coinsurance, or adjustment is applied.

RVUs — work 18.79, practice expense 21.33 (non-facility) / 6.49 (facility), malpractice 2.14 — × 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's deductible is met; the patient or secondary payer is responsible for the rest.
Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Rates vary by locality based on GPCI values, so the national figures shown are reference points, not what every region will see.
Always confirm the actual allowed amount and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

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

In facility settings, the facility itself bears many overhead costs (equipment, supplies, staff), so the practice-expense RVU component used in the formula is lower than when the same service is performed in a non-facility setting like an office.

Will my locality's payment match the national figure shown here?

Not exactly. The national amount uses a national average; your actual payment is adjusted by locality-specific GPCI values for work, practice expense, and malpractice, which can raise or lower the final amount.

Does this amount reflect what Medicare will actually pay?

It reflects the Medicare-allowed amount under current PFS rules. Medicare generally pays 80% of that amount after the deductible is met, and the final payment can be further affected by modifiers, sequestration, or claim-specific adjustments.

Why isn't the CPT code description shown on this page?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page refers to the code generically rather than reproducing the official descriptor text.

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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.