Medicare Reimbursement for CPT 21182

CPT 21182 is a procedure code used for billing purposes; 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, both nationally and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1849.07	$1849.07
ALASKA* (AK)	$2329.57	$2329.57
ALABAMA (AL)	$1689.69	$1689.69
ARKANSAS (AR)	$1670.19	$1670.19
ARIZONA (AZ)	$1802.38	$1802.38
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2078.82	$2078.82
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2108.13	$2108.13
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1912.03	$1912.03
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1934.49	$1934.49
NAPA (CA)	$2006.86	$2006.86
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2085.52	$2085.52
VALLEJO (CA)	$1997.21	$1997.21
BAKERSFIELD (CA)	$1848.91	$1848.91
CHICO (CA)	$1832.40	$1832.40
FRESNO (CA)	$1832.40	$1832.40
HANFORD-CORCORAN (CA)	$1832.40	$1832.40
MADERA (CA)	$1832.40	$1832.40
MERCED (CA)	$1832.40	$1832.40
MODESTO (CA)	$1832.40	$1832.40
REDDING (CA)	$1832.40	$1832.40
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1895.93	$1895.93
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1892.15	$1892.15
SALINAS (CA)	$1884.48	$1884.48
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2135.52	$2135.52
SANTA CRUZ-WATSONVILLE (CA)	$1906.95	$1906.95
SANTA ROSA-PETALUMA (CA)	$1924.19	$1924.19
STOCKTON (CA)	$1832.40	$1832.40
VISALIA (CA)	$1832.40	$1832.40
YUBA CITY (CA)	$1832.40	$1832.40
EL CENTRO (CA)	$1833.38	$1833.38
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1906.46	$1906.46
SAN LUIS OBISPO-PASO ROBLES (CA)	$1857.80	$1857.80
SANTA MARIA-SANTA BARBARA (CA)	$1885.43	$1885.43
REST OF CALIFORNIA (CA)	$1832.40	$1832.40
COLORADO (CO)	$1856.47	$1856.47
CONNECTICUT (CT)	$1957.18	$1957.18
DC + MD/VA SUBURBS (DC)	$2033.82	$2033.82
DELAWARE (DE)	$1827.39	$1827.39
FORT LAUDERDALE (FL)	$2015.98	$2015.98
MIAMI (FL)	$2174.61	$2174.61
REST OF FLORIDA (FL)	$1922.20	$1922.20
ATLANTA (GA)	$1901.32	$1901.32
REST OF GEORGIA (GA)	$1823.10	$1823.10
HAWAII, GUAM (HI)	$1847.06	$1847.06
IOWA (IA)	$1680.02	$1680.02
IDAHO (ID)	$1697.95	$1697.95
EAST ST. LOUIS (IL)	$2001.63	$2001.63
SUBURBAN CHICAGO (IL)	$2024.59	$2024.59
CHICAGO (IL)	$2114.66	$2114.66
REST OF ILLINOIS (IL)	$1908.62	$1908.62
INDIANA (IN)	$1704.65	$1704.65
KANSAS (KS)	$1694.61	$1694.61
KENTUCKY (KY)	$1766.74	$1766.74
NEW ORLEANS (LA)	$1841.01	$1841.01
REST OF LOUISIANA (LA)	$1772.85	$1772.85
METROPOLITAN BOSTON (MA)	$1985.53	$1985.53
REST OF MASSACHUSETTS (MA)	$1857.36	$1857.36
BALTIMORE/SURR. CNTYS (MD)	$1955.89	$1955.89
REST OF MARYLAND (MD)	$1850.62	$1850.62
SOUTHERN MAINE (ME)	$1771.04	$1771.04
REST OF MAINE (ME)	$1727.31	$1727.31
DETROIT (MI)	$1963.58	$1963.58
REST OF MICHIGAN (MI)	$1823.09	$1823.09
MINNESOTA (MN)	$1727.47	$1727.47
METROPOLITAN ST. LOUIS (MO)	$1821.11	$1821.11
METROPOLITAN KANSAS CITY (MO)	$1808.50	$1808.50
REST OF MISSOURI (MO)	$1762.41	$1762.41
MISSISSIPPI (MS)	$1715.51	$1715.51
MONTANA** (MT)	$1848.68	$1848.68
NORTH CAROLINA (NC)	$1738.35	$1738.35
NORTH DAKOTA** (ND)	$1732.02	$1732.02
NEBRASKA (NE)	$1681.00	$1681.00
NEW HAMPSHIRE (NH)	$1848.67	$1848.67
NORTHERN NJ (NJ)	$2023.86	$2023.86
REST OF NEW JERSEY (NJ)	$1964.99	$1964.99
NEW MEXICO (NM)	$1839.64	$1839.64
NEVADA** (NV)	$1816.75	$1816.75
MANHATTAN (NY)	$2128.19	$2128.19
NYC SUBURBS/LONG ISLAND (NY)	$2197.55	$2197.55
POUGHKPSIE/N NYC SUBURBS (NY)	$1994.34	$1994.34
QUEENS (NY)	$2111.63	$2111.63
REST OF NEW YORK (NY)	$1761.00	$1761.00
OHIO (OH)	$1799.25	$1799.25
OKLAHOMA (OK)	$1741.91	$1741.91
PORTLAND (OR)	$1881.19	$1881.19
REST OF OREGON (OR)	$1788.18	$1788.18
METROPOLITAN PHILADELPHIA (PA)	$1930.43	$1930.43
REST OF PENNSYLVANIA (PA)	$1789.78	$1789.78
PUERTO RICO (PR)	$1852.62	$1852.62
RHODE ISLAND (RI)	$1867.45	$1867.45
SOUTH CAROLINA (SC)	$1774.61	$1774.61
SOUTH DAKOTA** (SD)	$1718.22	$1718.22
TENNESSEE (TN)	$1704.06	$1704.06
BRAZORIA (TX)	$1808.89	$1808.89
DALLAS (TX)	$1828.28	$1828.28
GALVESTON (TX)	$1819.53	$1819.53
HOUSTON (TX)	$1927.52	$1927.52
BEAUMONT (TX)	$1781.90	$1781.90
FORT WORTH (TX)	$1824.93	$1824.93
AUSTIN (TX)	$1863.00	$1863.00
REST OF TEXAS (TX)	$1799.82	$1799.82
UTAH (UT)	$1793.52	$1793.52
VIRGINIA (VA)	$1781.09	$1781.09
VIRGIN ISLANDS (VI)	$1852.62	$1852.62
VERMONT (VT)	$1745.81	$1745.81
SEATTLE (KING CNTY) (WA)	$2000.19	$2000.19
REST OF WASHINGTON (WA)	$1847.09	$1847.09
WISCONSIN (WI)	$1687.89	$1687.89
WEST VIRGINIA (WV)	$1856.61	$1856.61
WYOMING** (WY)	$1797.84	$1797.84

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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 a 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 performed, reflecting local cost-of-living and practice cost differences. The adjusted RVUs are summed and multiplied by the annual national Conversion Factor (CF) to produce a dollar allowed amount. Practice expense RVUs often differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings, which is why the two amounts can diverge, though for some codes — including this one — they may be identical.

RVUs — work 31.77, practice expense 17.69 (non-facility) / 17.69 (facility), malpractice 5.9 — × 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 annual deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claim-specific circumstances, and federal sequestration adjustments.
The Conversion Factor and RVUs are updated annually and may be revised mid-year due to budget-neutrality adjustments or legislation.
Always verify the current allowed amount and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the amount for CPT 21182 differ by locality?

The national RVUs are adjusted by locality-specific GPCIs, which account for differences in local wages, rents, and malpractice costs. This produces different allowed amounts across geographic areas even though the underlying RVUs stay the same.

Why are the non-facility and facility amounts the same for this code?

When the practice expense RVU is identical in both settings, the non-facility and facility allowed amounts will match. This is common for codes where site-of-service does not significantly change the resources used.

Is this the amount Medicare will actually pay?

No. This figure represents the Medicare-allowed amount before the patient's deductible and coinsurance are applied, and before any modifier, sequestration, or claim-specific adjustments are factored in.

Where can I find the official descriptor for CPT 21182?

CPT code descriptors are copyrighted by the American Medical Association. Refer to your licensed CPT codebook or practice management software for the official language.

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.