Medicare Reimbursement for CPT 21141

CPT 21141 is a physician procedure code reported to Medicare for payment purposes; the specific clinical description is omitted here because CPT descriptors are licensed by the AMA. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjustable by locality, and compares non-facility versus facility payment settings. All figures are derived from published RVUs, geographic adjustments, and the annual conversion factor.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1208.44	$1208.44
ALASKA* (AK)	$1516.83	$1516.83
ALABAMA (AL)	$1108.56	$1108.56
ARKANSAS (AR)	$1096.20	$1096.20
ARIZONA (AZ)	$1180.32	$1180.32
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1412.36	$1412.36
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1434.66	$1434.66
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1278.71	$1278.71
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1291.25	$1291.25
NAPA (CA)	$1355.55	$1355.55
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1415.49	$1415.49
VALLEJO (CA)	$1351.03	$1351.03
BAKERSFIELD (CA)	$1230.49	$1230.49
CHICO (CA)	$1222.48	$1222.48
FRESNO (CA)	$1222.48	$1222.48
HANFORD-CORCORAN (CA)	$1222.48	$1222.48
MADERA (CA)	$1222.48	$1222.48
MERCED (CA)	$1222.48	$1222.48
MODESTO (CA)	$1222.48	$1222.48
REDDING (CA)	$1222.48	$1222.48
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1252.35	$1252.35
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1266.68	$1266.68
SALINAS (CA)	$1261.58	$1261.58
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1447.48	$1447.48
SANTA CRUZ-WATSONVILLE (CA)	$1282.03	$1282.03
SANTA ROSA-PETALUMA (CA)	$1293.99	$1293.99
STOCKTON (CA)	$1222.48	$1222.48
VISALIA (CA)	$1222.48	$1222.48
YUBA CITY (CA)	$1222.48	$1222.48
EL CENTRO (CA)	$1222.95	$1222.95
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1279.22	$1279.22
SAN LUIS OBISPO-PASO ROBLES (CA)	$1243.08	$1243.08
SANTA MARIA-SANTA BARBARA (CA)	$1263.02	$1263.02
REST OF CALIFORNIA (CA)	$1222.48	$1222.48
COLORADO (CO)	$1226.56	$1226.56
CONNECTICUT (CT)	$1277.43	$1277.43
DC + MD/VA SUBURBS (DC)	$1338.53	$1338.53
DELAWARE (DE)	$1196.57	$1196.57
FORT LAUDERDALE (FL)	$1289.16	$1289.16
MIAMI (FL)	$1369.04	$1369.04
REST OF FLORIDA (FL)	$1233.74	$1233.74
ATLANTA (GA)	$1236.55	$1236.55
REST OF GEORGIA (GA)	$1174.42	$1174.42
HAWAII, GUAM (HI)	$1235.25	$1235.25
IOWA (IA)	$1112.14	$1112.14
IDAHO (ID)	$1121.54	$1121.54
EAST ST. LOUIS (IL)	$1263.60	$1263.60
SUBURBAN CHICAGO (IL)	$1297.01	$1297.01
CHICAGO (IL)	$1334.68	$1334.68
REST OF ILLINOIS (IL)	$1218.68	$1218.68
INDIANA (IN)	$1126.10	$1126.10
KANSAS (KS)	$1116.74	$1116.74
KENTUCKY (KY)	$1147.44	$1147.44
NEW ORLEANS (LA)	$1192.72	$1192.72
REST OF LOUISIANA (LA)	$1149.49	$1149.49
METROPOLITAN BOSTON (MA)	$1317.35	$1317.35
REST OF MASSACHUSETTS (MA)	$1225.31	$1225.31
BALTIMORE/SURR. CNTYS (MD)	$1275.45	$1275.45
REST OF MARYLAND (MD)	$1213.01	$1213.01
SOUTHERN MAINE (ME)	$1170.12	$1170.12
REST OF MAINE (ME)	$1135.28	$1135.28
DETROIT (MI)	$1254.92	$1254.92
REST OF MICHIGAN (MI)	$1178.67	$1178.67
MINNESOTA (MN)	$1157.44	$1157.44
METROPOLITAN ST. LOUIS (MO)	$1185.64	$1185.64
METROPOLITAN KANSAS CITY (MO)	$1177.11	$1177.11
REST OF MISSOURI (MO)	$1139.95	$1139.95
MISSISSIPPI (MS)	$1117.81	$1117.81
MONTANA** (MT)	$1208.26	$1208.26
NORTH CAROLINA (NC)	$1143.07	$1143.07
NORTH DAKOTA** (ND)	$1153.69	$1153.69
NEBRASKA (NE)	$1114.22	$1114.22
NEW HAMPSHIRE (NH)	$1216.56	$1216.56
NORTHERN NJ (NJ)	$1331.50	$1331.50
REST OF NEW JERSEY (NJ)	$1286.94	$1286.94
NEW MEXICO (NM)	$1187.22	$1187.22
NEVADA** (NV)	$1193.53	$1193.53
MANHATTAN (NY)	$1380.85	$1380.85
NYC SUBURBS/LONG ISLAND (NY)	$1418.76	$1418.76
POUGHKPSIE/N NYC SUBURBS (NY)	$1301.98	$1301.98
QUEENS (NY)	$1377.15	$1377.15
REST OF NEW YORK (NY)	$1157.12	$1157.12
OHIO (OH)	$1167.51	$1167.51
OKLAHOMA (OK)	$1136.64	$1136.64
PORTLAND (OR)	$1248.21	$1248.21
REST OF OREGON (OR)	$1179.15	$1179.15
METROPOLITAN PHILADELPHIA (PA)	$1257.35	$1257.35
REST OF PENNSYLVANIA (PA)	$1164.10	$1164.10
PUERTO RICO (PR)	$1212.33	$1212.33
RHODE ISLAND (RI)	$1226.40	$1226.40
SOUTH CAROLINA (SC)	$1158.21	$1158.21
SOUTH DAKOTA** (SD)	$1147.23	$1147.23
TENNESSEE (TN)	$1122.18	$1122.18
BRAZORIA (TX)	$1188.95	$1188.95
DALLAS (TX)	$1199.17	$1199.17
GALVESTON (TX)	$1194.33	$1194.33
HOUSTON (TX)	$1244.85	$1244.85
BEAUMONT (TX)	$1158.79	$1158.79
FORT WORTH (TX)	$1195.58	$1195.58
AUSTIN (TX)	$1226.99	$1226.99
REST OF TEXAS (TX)	$1175.08	$1175.08
UTAH (UT)	$1170.30	$1170.30
VIRGINIA (VA)	$1173.20	$1173.20
VIRGIN ISLANDS (VI)	$1212.33	$1212.33
VERMONT (VT)	$1158.11	$1158.11
SEATTLE (KING CNTY) (WA)	$1332.16	$1332.16
REST OF WASHINGTON (WA)	$1220.08	$1220.08
WISCONSIN (WI)	$1124.53	$1124.53
WEST VIRGINIA (WV)	$1185.43	$1185.43
WYOMING** (WY)	$1184.48	$1184.48

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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) assigned to a code: physician work, practice expense (PE), and malpractice (MP). Each RVU component is adjusted by a locality-specific Geographic Practice Cost Index (GPCI) to reflect regional cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice expense RVUs typically differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings, which is why the same code can have two different allowed amounts depending on place of service. Work and malpractice RVUs generally stay constant across settings, while PE RVUs shift to account for where overhead costs are incurred.

RVUs — work 19.08, practice expense 14.34 (non-facility) / 14.34 (facility), malpractice 2.76 — × 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 the annual Part B deductible; the remaining 20% is patient or secondary-payer responsibility.
Actual payment varies by locality GPCI values, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments to RVUs or the conversion factor.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The practice expense RVU component is calculated differently depending on whether the service is performed in a non-facility setting (like a physician's office, which bears more overhead) versus a facility setting (like a hospital, where the facility bills separately for overhead). This often results in different allowed amounts for the same code.

Is the national amount what I'll actually be paid?

No. The national amount uses a GPCI value of 1.0 as a baseline. Actual payment in your locality will be higher or lower depending on that area's wage, rent, and malpractice cost indices.

Does this amount include the patient's deductible and coinsurance?

No. The figure shown is the full Medicare-allowed amount before cost-sharing. Medicare generally reimburses 80% of this amount after the deductible is met, with the remaining 20% owed by the patient or secondary insurer.

Why might my actual remittance differ from this estimate?

Differences can arise from modifiers (e.g., bilateral, reduced services), sequestration cuts, multiple-procedure payment reductions, or mid-year/annual updates to RVUs and the conversion factor that aren't reflected in a static estimate.

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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.