Medicare Reimbursement for CPT 21184

CPT 21184 is a physician procedure code reported to Medicare for payment under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$2154.36	$2154.36
ALASKA* (AK)	$2721.07	$2721.07
ALABAMA (AL)	$1969.91	$1969.91
ARKANSAS (AR)	$1947.36	$1947.36
ARIZONA (AZ)	$2100.10	$2100.10
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2410.89	$2410.89
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2444.40	$2444.40
OXNARD-THOUSAND OAKS-VENTURA (CA)	$2221.91	$2221.91
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$2248.52	$2248.52
NAPA (CA)	$2329.12	$2329.12
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2418.85	$2418.85
VALLEJO (CA)	$2317.64	$2317.64
BAKERSFIELD (CA)	$2150.32	$2150.32
CHICO (CA)	$2130.71	$2130.71
FRESNO (CA)	$2130.71	$2130.71
HANFORD-CORCORAN (CA)	$2130.71	$2130.71
MADERA (CA)	$2130.71	$2130.71
MERCED (CA)	$2130.71	$2130.71
MODESTO (CA)	$2130.71	$2130.71
REDDING (CA)	$2130.71	$2130.71
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$2206.19	$2206.19
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$2199.00	$2199.00
SALINAS (CA)	$2190.07	$2190.07
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2476.95	$2476.95
SANTA CRUZ-WATSONVILLE (CA)	$2214.60	$2214.60
SANTA ROSA-PETALUMA (CA)	$2234.53	$2234.53
STOCKTON (CA)	$2130.71	$2130.71
VISALIA (CA)	$2130.71	$2130.71
YUBA CITY (CA)	$2130.71	$2130.71
EL CENTRO (CA)	$2131.88	$2131.88
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$2214.73	$2214.73
SAN LUIS OBISPO-PASO ROBLES (CA)	$2159.21	$2159.21
SANTA MARIA-SANTA BARBARA (CA)	$2190.93	$2190.93
REST OF CALIFORNIA (CA)	$2130.71	$2130.71
COLORADO (CO)	$2160.58	$2160.58
CONNECTICUT (CT)	$2279.70	$2279.70
DC + MD/VA SUBURBS (DC)	$2366.68	$2366.68
DELAWARE (DE)	$2129.05	$2129.05
FORT LAUDERDALE (FL)	$2352.16	$2352.16
MIAMI (FL)	$2539.53	$2539.53
REST OF FLORIDA (FL)	$2242.97	$2242.97
ATLANTA (GA)	$2215.80	$2215.80
REST OF GEORGIA (GA)	$2127.74	$2127.74
HAWAII, GUAM (HI)	$2146.57	$2146.57
IOWA (IA)	$1956.84	$1956.84
IDAHO (ID)	$1977.95	$1977.95
EAST ST. LOUIS (IL)	$2338.76	$2338.76
SUBURBAN CHICAGO (IL)	$2361.81	$2361.81
CHICAGO (IL)	$2469.69	$2469.69
REST OF ILLINOIS (IL)	$2228.53	$2228.53
INDIANA (IN)	$1985.63	$1985.63
KANSAS (KS)	$1974.61	$1974.61
KENTUCKY (KY)	$2060.90	$2060.90
NEW ORLEANS (LA)	$2147.10	$2147.10
REST OF LOUISIANA (LA)	$2068.32	$2068.32
METROPOLITAN BOSTON (MA)	$2308.72	$2308.72
REST OF MASSACHUSETTS (MA)	$2162.07	$2162.07
BALTIMORE/SURR. CNTYS (MD)	$2278.35	$2278.35
REST OF MARYLAND (MD)	$2155.69	$2155.69
SOUTHERN MAINE (ME)	$2062.00	$2062.00
REST OF MAINE (ME)	$2012.84	$2012.84
DETROIT (MI)	$2291.78	$2291.78
REST OF MICHIGAN (MI)	$2126.91	$2126.91
MINNESOTA (MN)	$2008.74	$2008.74
METROPOLITAN ST. LOUIS (MO)	$2123.02	$2123.02
METROPOLITAN KANSAS CITY (MO)	$2108.55	$2108.55
REST OF MISSOURI (MO)	$2056.82	$2056.82
MISSISSIPPI (MS)	$2001.14	$2001.14
MONTANA** (MT)	$2153.89	$2153.89
NORTH CAROLINA (NC)	$2025.43	$2025.43
NORTH DAKOTA** (ND)	$2015.28	$2015.28
NEBRASKA (NE)	$1957.70	$1957.70
NEW HAMPSHIRE (NH)	$2152.26	$2152.26
NORTHERN NJ (NJ)	$2355.53	$2355.53
REST OF NEW JERSEY (NJ)	$2288.34	$2288.34
NEW MEXICO (NM)	$2146.42	$2146.42
NEVADA** (NV)	$2115.92	$2115.92
MANHATTAN (NY)	$2479.40	$2479.40
NYC SUBURBS/LONG ISLAND (NY)	$2560.74	$2560.74
POUGHKPSIE/N NYC SUBURBS (NY)	$2323.07	$2323.07
QUEENS (NY)	$2458.94	$2458.94
REST OF NEW YORK (NY)	$2051.68	$2051.68
OHIO (OH)	$2098.58	$2098.58
OKLAHOMA (OK)	$2031.24	$2031.24
PORTLAND (OR)	$2188.10	$2188.10
REST OF OREGON (OR)	$2082.17	$2082.17
METROPOLITAN PHILADELPHIA (PA)	$2249.35	$2249.35
REST OF PENNSYLVANIA (PA)	$2087.14	$2087.14
PUERTO RICO (PR)	$2158.14	$2158.14
RHODE ISLAND (RI)	$2174.83	$2174.83
SOUTH CAROLINA (SC)	$2068.87	$2068.87
SOUTH DAKOTA** (SD)	$1998.89	$1998.89
TENNESSEE (TN)	$1985.65	$1985.65
BRAZORIA (TX)	$2106.94	$2106.94
DALLAS (TX)	$2129.78	$2129.78
GALVESTON (TX)	$2119.51	$2119.51
HOUSTON (TX)	$2247.82	$2247.82
BEAUMONT (TX)	$2078.09	$2078.09
FORT WORTH (TX)	$2126.19	$2126.19
AUSTIN (TX)	$2168.62	$2168.62
REST OF TEXAS (TX)	$2097.85	$2097.85
UTAH (UT)	$2090.72	$2090.72
VIRGINIA (VA)	$2074.26	$2074.26
VIRGIN ISLANDS (VI)	$2158.14	$2158.14
VERMONT (VT)	$2032.07	$2032.07
SEATTLE (KING CNTY) (WA)	$2324.81	$2324.81
REST OF WASHINGTON (WA)	$2149.87	$2149.87
WISCONSIN (WI)	$1964.50	$1964.50
WEST VIRGINIA (WV)	$2168.46	$2168.46
WYOMING** (WY)	$2093.48	$2093.48

Look up another code or locality →

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 performed. These locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs because the practice-expense inputs differ depending on who bears the overhead costs. The conversion factor is set annually by CMS and can change due to legislation or budget-neutrality adjustments.

RVUs — work 37.65, practice expense 19.84 (non-facility) / 19.84 (facility), malpractice 7.01 — × 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 patient or secondary insurer is generally responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Allowed amounts vary by Medicare Administrative Contractor (MAC) locality and can change each calendar year.
Always confirm current rates and applicable modifiers with your MAC or the official CMS PFS lookup tool before billing.

Frequently asked

Why does the amount differ between non-facility and facility settings?

The practice-expense RVU component changes based on setting because overhead costs (staff, supplies, equipment) are borne differently when a service is performed in a physician office versus a hospital or facility.

Why does the reimbursement amount change by locality?

CMS applies Geographic Practice Cost Indices (GPCIs) to the work, practice-expense, and malpractice RVUs to reflect regional differences in wages, rent, and other costs before multiplying by the conversion factor.

Does this page tell me what the patient will owe?

No. This page shows the estimated Medicare-allowed amount. Patient responsibility depends on deductible status, coinsurance, and any secondary coverage.

Can modifiers change this amount?

Yes. Modifiers such as bilateral, assistant-at-surgery, or reduced-service modifiers can increase or decrease the final allowed amount relative to the base PFS rate shown here.

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.