Medicare Reimbursement for CPT 21084

CPT 21084 is a physician procedure code; the specific clinical descriptor is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1610.59	$1056.80
ALASKA* (AK)	$1990.84	$1401.06
ALABAMA (AL)	$1474.98	$990.42
ARKANSAS (AR)	$1458.01	$982.30
ARIZONA (AZ)	$1573.92	$1037.30
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1958.06	$1177.22
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1992.14	$1193.58
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1744.29	$1089.71
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1758.03	$1102.90
NAPA (CA)	$1868.42	$1138.53
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1960.90	$1180.06
VALLEJO (CA)	$1864.33	$1134.44
BAKERSFIELD (CA)	$1668.17	$1061.22
CHICO (CA)	$1660.61	$1053.66
FRESNO (CA)	$1660.61	$1053.66
HANFORD-CORCORAN (CA)	$1660.61	$1053.66
MADERA (CA)	$1660.61	$1053.66
MERCED (CA)	$1660.61	$1053.66
MODESTO (CA)	$1660.61	$1053.66
REDDING (CA)	$1660.61	$1053.66
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1687.81	$1080.86
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1727.78	$1083.72
SALINAS (CA)	$1720.94	$1079.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2003.75	$1205.19
SANTA CRUZ-WATSONVILLE (CA)	$1758.13	$1085.28
SANTA ROSA-PETALUMA (CA)	$1775.06	$1095.01
STOCKTON (CA)	$1660.61	$1053.66
VISALIA (CA)	$1660.61	$1053.66
YUBA CITY (CA)	$1660.61	$1053.66
EL CENTRO (CA)	$1661.02	$1054.07
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1750.12	$1087.79
SAN LUIS OBISPO-PASO ROBLES (CA)	$1694.79	$1064.03
SANTA MARIA-SANTA BARBARA (CA)	$1724.31	$1078.59
REST OF CALIFORNIA (CA)	$1660.61	$1053.66
COLORADO (CO)	$1651.97	$1062.74
CONNECTICUT (CT)	$1703.98	$1107.55
DC + MD/VA SUBURBS (DC)	$1801.06	$1148.70
DELAWARE (DE)	$1596.28	$1049.14
FORT LAUDERDALE (FL)	$1688.40	$1127.41
MIAMI (FL)	$1770.86	$1194.37
REST OF FLORIDA (FL)	$1617.62	$1088.20
ATLANTA (GA)	$1642.29	$1079.64
REST OF GEORGIA (GA)	$1540.77	$1046.79
HAWAII, GUAM (HI)	$1684.34	$1054.69
IOWA (IA)	$1492.67	$985.95
IDAHO (ID)	$1502.99	$993.51
EAST ST. LOUIS (IL)	$1631.67	$1122.18
SUBURBAN CHICAGO (IL)	$1701.64	$1132.90
CHICAGO (IL)	$1727.83	$1171.27
REST OF ILLINOIS (IL)	$1588.44	$1082.84
INDIANA (IN)	$1509.64	$996.28
KANSAS (KS)	$1492.86	$992.24
KENTUCKY (KY)	$1515.26	$1022.94
NEW ORLEANS (LA)	$1575.05	$1053.93
REST OF LOUISIANA (LA)	$1515.67	$1025.56
METROPOLITAN BOSTON (MA)	$1785.64	$1124.42
REST OF MASSACHUSETTS (MA)	$1647.49	$1064.35
BALTIMORE/SURR. CNTYS (MD)	$1700.13	$1105.91
REST OF MARYLAND (MD)	$1620.60	$1060.17
SOUTHERN MAINE (ME)	$1572.62	$1023.82
REST OF MAINE (ME)	$1515.43	$1005.95
DETROIT (MI)	$1640.05	$1105.65
REST OF MICHIGAN (MI)	$1552.20	$1046.60
MINNESOTA (MN)	$1574.86	$1005.01
METROPOLITAN ST. LOUIS (MO)	$1572.60	$1045.40
METROPOLITAN KANSAS CITY (MO)	$1560.18	$1040.17
REST OF MISSOURI (MO)	$1498.72	$1021.35
MISSISSIPPI (MS)	$1478.30	$1001.49
MONTANA** (MT)	$1610.42	$1056.64
NORTH CAROLINA (NC)	$1527.19	$1010.50
NORTH DAKOTA** (ND)	$1560.99	$1007.20
NEBRASKA (NE)	$1497.44	$986.30
NEW HAMPSHIRE (NH)	$1632.75	$1056.25
NORTHERN NJ (NJ)	$1789.59	$1147.19
REST OF NEW JERSEY (NJ)	$1721.11	$1116.38
NEW MEXICO (NM)	$1561.40	$1053.57
NEVADA** (NV)	$1597.44	$1043.10
MANHATTAN (NY)	$1835.16	$1191.66
NYC SUBURBS/LONG ISLAND (NY)	$1879.25	$1220.80
POUGHKPSIE/N NYC SUBURBS (NY)	$1736.59	$1130.20
QUEENS (NY)	$1839.04	$1184.46
REST OF NEW YORK (NY)	$1546.04	$1019.95
OHIO (OH)	$1542.10	$1036.49
OKLAHOMA (OK)	$1506.91	$1012.38
PORTLAND (OR)	$1689.17	$1073.91
REST OF OREGON (OR)	$1582.61	$1031.04
METROPOLITAN PHILADELPHIA (PA)	$1672.48	$1095.99
REST OF PENNSYLVANIA (PA)	$1540.81	$1032.44
PUERTO RICO (PR)	$1618.08	$1058.20
RHODE ISLAND (RI)	$1641.72	$1069.66
SOUTH CAROLINA (SC)	$1537.65	$1025.95
SOUTH DAKOTA** (SD)	$1555.15	$1001.36
TENNESSEE (TN)	$1499.59	$996.20
BRAZORIA (TX)	$1590.92	$1042.12
DALLAS (TX)	$1602.14	$1050.57
GALVESTON (TX)	$1596.52	$1046.61
HOUSTON (TX)	$1642.28	$1092.37
BEAUMONT (TX)	$1533.12	$1029.17
FORT WORTH (TX)	$1595.28	$1049.25
AUSTIN (TX)	$1648.64	$1062.74
REST OF TEXAS (TX)	$1561.95	$1036.41
UTAH (UT)	$1554.38	$1033.82
VIRGINIA (VA)	$1572.53	$1028.16
VIRGIN ISLANDS (VI)	$1618.08	$1058.20
VERMONT (VT)	$1561.39	$1013.14
SEATTLE (KING CNTY) (WA)	$1812.37	$1132.87
REST OF WASHINGTON (WA)	$1642.28	$1059.15
WISCONSIN (WI)	$1519.42	$988.89
WEST VIRGINIA (WV)	$1542.44	$1061.20
WYOMING** (WY)	$1588.88	$1035.09

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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) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, then the 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 use different practice-expense RVUs because overhead costs differ, which is why the two allowed amounts for this code are not the same. These calculations are updated annually and can change due to RVU revaluation, GPCI updates, or conversion factor changes.

RVUs — work 21.92, practice expense 23.8 (non-facility) / 7.22 (facility), malpractice 2.5 — × 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 beneficiary or secondary payer is responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the actual paid amount.
Locality-specific GPCIs mean the amount for your practice location may differ from the national figure shown.
Always confirm the current, locality-specific allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

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

The facility rate uses a lower practice-expense RVU because Medicare assumes the facility (e.g., hospital) is absorbing some of the overhead costs, such as equipment and staff, that a physician's office would otherwise bear.

Does this amount represent what Medicare will actually pay?

No. It's the Medicare-allowed amount before the standard 80/20 split and before any deductible, modifier, or sequestration adjustments are applied.

Why might my locality's amount differ from the national figure?

Medicare adjusts the RVU components using Geographic Practice Cost Indices (GPCIs) that reflect local costs for labor, rent, and malpractice insurance, so the same code can price differently in different areas.

Will this amount stay the same next year?

Not necessarily. The conversion factor, RVUs, and GPCIs are all subject to annual updates and budget-neutrality adjustments from CMS, which can raise or lower the allowed amount.

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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.