Medicare Reimbursement for CPT 21183

CPT 21183 is a surgical procedure code; the full descriptor is maintained by the AMA and is not reproduced here. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$2006.73	$2006.73
ALASKA* (AK)	$2532.03	$2532.03
ALABAMA (AL)	$1834.55	$1834.55
ARKANSAS (AR)	$1813.49	$1813.49
ARIZONA (AZ)	$1956.18	$1956.18
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2250.70	$2250.70
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2282.21	$2282.21
OXNARD-THOUSAND OAKS-VENTURA (CA)	$2072.28	$2072.28
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$2096.87	$2096.87
NAPA (CA)	$2173.61	$2173.61
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2258.04	$2258.04
VALLEJO (CA)	$2163.03	$2163.03
BAKERSFIELD (CA)	$2004.77	$2004.77
CHICO (CA)	$1986.69	$1986.69
FRESNO (CA)	$1986.69	$1986.69
HANFORD-CORCORAN (CA)	$1986.69	$1986.69
MADERA (CA)	$1986.69	$1986.69
MERCED (CA)	$1986.69	$1986.69
MODESTO (CA)	$1986.69	$1986.69
REDDING (CA)	$1986.69	$1986.69
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$2056.25	$2056.25
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$2050.87	$2050.87
SALINAS (CA)	$2042.55	$2042.55
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2312.20	$2312.20
SANTA CRUZ-WATSONVILLE (CA)	$2066.10	$2066.10
SANTA ROSA-PETALUMA (CA)	$2084.74	$2084.74
STOCKTON (CA)	$1986.69	$1986.69
VISALIA (CA)	$1986.69	$1986.69
YUBA CITY (CA)	$1986.69	$1986.69
EL CENTRO (CA)	$1987.77	$1987.77
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$2065.93	$2065.93
SAN LUIS OBISPO-PASO ROBLES (CA)	$2013.70	$2013.70
SANTA MARIA-SANTA BARBARA (CA)	$2043.46	$2043.46
REST OF CALIFORNIA (CA)	$1986.69	$1986.69
COLORADO (CO)	$2013.63	$2013.63
CONNECTICUT (CT)	$2123.67	$2123.67
DC + MD/VA SUBURBS (DC)	$2205.73	$2205.73
DELAWARE (DE)	$1983.21	$1983.21
FORT LAUDERDALE (FL)	$2189.24	$2189.24
MIAMI (FL)	$2362.40	$2362.40
REST OF FLORIDA (FL)	$2087.61	$2087.61
ATLANTA (GA)	$2063.64	$2063.64
REST OF GEORGIA (GA)	$1980.30	$1980.30
HAWAII, GUAM (HI)	$2001.96	$2001.96
IOWA (IA)	$1823.21	$1823.21
IDAHO (ID)	$1842.75	$1842.75
EAST ST. LOUIS (IL)	$2175.25	$2175.25
SUBURBAN CHICAGO (IL)	$2198.40	$2198.40
CHICAGO (IL)	$2297.43	$2297.43
REST OF ILLINOIS (IL)	$2073.54	$2073.54
INDIANA (IN)	$1849.96	$1849.96
KANSAS (KS)	$1839.39	$1839.39
KENTUCKY (KY)	$1918.65	$1918.65
NEW ORLEANS (LA)	$1999.00	$1999.00
REST OF LOUISIANA (LA)	$1925.41	$1925.41
METROPOLITAN BOSTON (MA)	$2152.55	$2152.55
REST OF MASSACHUSETTS (MA)	$2014.83	$2014.83
BALTIMORE/SURR. CNTYS (MD)	$2122.33	$2122.33
REST OF MARYLAND (MD)	$2008.20	$2008.20
SOUTHERN MAINE (ME)	$1921.45	$1921.45
REST OF MAINE (ME)	$1874.90	$1874.90
DETROIT (MI)	$2132.75	$2132.75
REST OF MICHIGAN (MI)	$1979.90	$1979.90
MINNESOTA (MN)	$1873.04	$1873.04
METROPOLITAN ST. LOUIS (MO)	$1977.00	$1977.00
METROPOLITAN KANSAS CITY (MO)	$1963.44	$1963.44
REST OF MISSOURI (MO)	$1914.41	$1914.41
MISSISSIPPI (MS)	$1863.08	$1863.08
MONTANA** (MT)	$2006.29	$2006.29
NORTH CAROLINA (NC)	$1886.74	$1886.74
NORTH DAKOTA** (ND)	$1878.56	$1878.56
NEBRASKA (NE)	$1824.14	$1824.14
NEW HAMPSHIRE (NH)	$2005.51	$2005.51
NORTHERN NJ (NJ)	$2195.17	$2195.17
REST OF NEW JERSEY (NJ)	$2131.96	$2131.96
NEW MEXICO (NM)	$1997.95	$1997.95
NEVADA** (NV)	$1971.32	$1971.32
MANHATTAN (NY)	$2309.36	$2309.36
NYC SUBURBS/LONG ISLAND (NY)	$2384.80	$2384.80
POUGHKPSIE/N NYC SUBURBS (NY)	$2164.04	$2164.04
QUEENS (NY)	$2290.85	$2290.85
REST OF NEW YORK (NY)	$1911.23	$1911.23
OHIO (OH)	$1953.79	$1953.79
OKLAHOMA (OK)	$1891.38	$1891.38
PORTLAND (OR)	$2039.83	$2039.83
REST OF OREGON (OR)	$1940.13	$1940.13
METROPOLITAN PHILADELPHIA (PA)	$2095.06	$2095.06
REST OF PENNSYLVANIA (PA)	$1943.34	$1943.34
PUERTO RICO (PR)	$2010.40	$2010.40
RHODE ISLAND (RI)	$2026.25	$2026.25
SOUTH CAROLINA (SC)	$1926.61	$1926.61
SOUTH DAKOTA** (SD)	$1863.45	$1863.45
TENNESSEE (TN)	$1849.65	$1849.65
BRAZORIA (TX)	$1962.90	$1962.90
DALLAS (TX)	$1984.04	$1984.04
GALVESTON (TX)	$1974.52	$1974.52
HOUSTON (TX)	$2092.76	$2092.76
BEAUMONT (TX)	$1934.86	$1934.86
FORT WORTH (TX)	$1980.56	$1980.56
AUSTIN (TX)	$2020.89	$2020.89
REST OF TEXAS (TX)	$1953.75	$1953.75
UTAH (UT)	$1947.02	$1947.02
VIRGINIA (VA)	$1932.61	$1932.61
VIRGIN ISLANDS (VI)	$2010.40	$2010.40
VERMONT (VT)	$1893.85	$1893.85
SEATTLE (KING CNTY) (WA)	$2167.99	$2167.99
REST OF WASHINGTON (WA)	$2003.57	$2003.57
WISCONSIN (WI)	$1831.03	$1831.03
WEST VIRGINIA (WV)	$2017.42	$2017.42
WYOMING** (WY)	$1950.63	$1950.63

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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) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is billed. These locality-adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Non-facility and facility settings can differ because the practice-expense RVU component reflects whether overhead costs (like staff, supplies, and equipment) are borne by the physician's office or by a facility such as a hospital. For this code, the non-facility and facility PE RVUs are the same, so the national allowed amount shown is identical for both settings before locality adjustment.

RVUs — work 34.81, practice expense 18.81 (non-facility) / 18.81 (facility), malpractice 6.46 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

All figures are estimates based on the national PFS formula and may not reflect your actual payment.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final payment.
Locality-specific GPCIs can shift the amount up or down from the national figure shown here.
Always confirm final pricing and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

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

Because the practice-expense RVU is identical for both settings for CPT 21183, the calculated national amounts match. This is not true for all codes — many show a lower facility rate because practice-expense costs are assumed to be covered by the facility.

Will I actually be paid this exact amount?

No. The amount shown is a national or locality-level estimate. Actual payment depends on your specific Medicare Administrative Contractor, any applicable modifiers, sequestration, and the patient's deductible status.

What's the difference between the conversion factor and the RVUs?

RVUs measure the relative resources (work, practice expense, malpractice risk) required for a service. The conversion factor is a dollar multiplier, updated annually, that converts the total adjusted RVUs into a payment amount.

Does this page tell me if CPT 21183 is covered by Medicare?

No. This page only estimates the fee schedule amount if the service is covered and billed. Coverage determinations depend on medical necessity, LCDs/NCDs, and other payer policies — check with your MAC.

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.