Medicare Reimbursement for CPT Code 21244

This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code, both at the national level and adjusted for your specific locality. Amounts are shown for non-facility (e.g., office) and facility (e.g., hospital) settings, since practice expense inputs differ between the two.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$897.48	$897.48
ALASKA* (AK)	$1115.46	$1115.46
ALABAMA (AL)	$820.72	$820.72
ARKANSAS (AR)	$811.19	$811.19
ARIZONA (AZ)	$876.09	$876.09
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1061.90	$1061.90
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1079.19	$1079.19
OXNARD-THOUSAND OAKS-VENTURA (CA)	$956.29	$956.29
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$965.11	$965.11
NAPA (CA)	$1017.29	$1017.29
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1064.10	$1064.10
VALLEJO (CA)	$1014.11	$1014.11
BAKERSFIELD (CA)	$917.93	$917.93
CHICO (CA)	$912.31	$912.31
FRESNO (CA)	$912.31	$912.31
HANFORD-CORCORAN (CA)	$912.31	$912.31
MADERA (CA)	$912.31	$912.31
MERCED (CA)	$912.31	$912.31
MODESTO (CA)	$912.31	$912.31
REDDING (CA)	$912.31	$912.31
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$933.30	$933.30
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$946.81	$946.81
SALINAS (CA)	$943.04	$943.04
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1088.20	$1088.20
SANTA CRUZ-WATSONVILLE (CA)	$960.39	$960.39
SANTA ROSA-PETALUMA (CA)	$969.44	$969.44
STOCKTON (CA)	$912.31	$912.31
VISALIA (CA)	$912.31	$912.31
YUBA CITY (CA)	$912.31	$912.31
EL CENTRO (CA)	$912.64	$912.64
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$957.38	$957.38
SAN LUIS OBISPO-PASO ROBLES (CA)	$929.04	$929.04
SANTA MARIA-SANTA BARBARA (CA)	$944.43	$944.43
REST OF CALIFORNIA (CA)	$912.31	$912.31
COLORADO (CO)	$913.52	$913.52
CONNECTICUT (CT)	$949.92	$949.92
DC + MD/VA SUBURBS (DC)	$998.02	$998.02
DELAWARE (DE)	$888.49	$888.49
FORT LAUDERDALE (FL)	$954.90	$954.90
MIAMI (FL)	$1012.51	$1012.51
REST OF FLORIDA (FL)	$912.95	$912.95
ATLANTA (GA)	$918.06	$918.06
REST OF GEORGIA (GA)	$867.90	$867.90
HAWAII, GUAM (HI)	$923.51	$923.51
IOWA (IA)	$825.33	$825.33
IDAHO (ID)	$832.20	$832.20
EAST ST. LOUIS (IL)	$932.06	$932.06
SUBURBAN CHICAGO (IL)	$961.12	$961.12
CHICAGO (IL)	$986.45	$986.45
REST OF ILLINOIS (IL)	$900.11	$900.11
INDIANA (IN)	$835.77	$835.77
KANSAS (KS)	$827.99	$827.99
KENTUCKY (KY)	$848.78	$848.78
NEW ORLEANS (LA)	$883.34	$883.34
REST OF LOUISIANA (LA)	$850.01	$850.01
METROPOLITAN BOSTON (MA)	$984.03	$984.03
REST OF MASSACHUSETTS (MA)	$912.05	$912.05
BALTIMORE/SURR. CNTYS (MD)	$948.34	$948.34
REST OF MARYLAND (MD)	$901.27	$901.27
SOUTHERN MAINE (ME)	$870.07	$870.07
REST OF MAINE (ME)	$841.86	$841.86
DETROIT (MI)	$928.31	$928.31
REST OF MICHIGAN (MI)	$871.99	$871.99
MINNESOTA (MN)	$863.15	$863.15
METROPOLITAN ST. LOUIS (MO)	$878.93	$878.93
METROPOLITAN KANSAS CITY (MO)	$872.26	$872.26
REST OF MISSOURI (MO)	$842.10	$842.10
MISSISSIPPI (MS)	$826.48	$826.48
MONTANA** (MT)	$897.35	$897.35
NORTH CAROLINA (NC)	$848.02	$848.02
NORTH DAKOTA** (ND)	$858.99	$858.99
NEBRASKA (NE)	$827.22	$827.22
NEW HAMPSHIRE (NH)	$905.34	$905.34
NORTHERN NJ (NJ)	$992.09	$992.09
REST OF NEW JERSEY (NJ)	$957.31	$957.31
NEW MEXICO (NM)	$878.21	$878.21
NEVADA** (NV)	$887.05	$887.05
MANHATTAN (NY)	$1026.88	$1026.88
NYC SUBURBS/LONG ISLAND (NY)	$1054.95	$1054.95
POUGHKPSIE/N NYC SUBURBS (NY)	$968.02	$968.02
QUEENS (NY)	$1025.33	$1025.33
REST OF NEW YORK (NY)	$858.78	$858.78
OHIO (OH)	$864.15	$864.15
OKLAHOMA (OK)	$841.40	$841.40
PORTLAND (OR)	$931.18	$931.18
REST OF OREGON (OR)	$876.68	$876.68
METROPOLITAN PHILADELPHIA (PA)	$933.93	$933.93
REST OF PENNSYLVANIA (PA)	$862.01	$862.01
PUERTO RICO (PR)	$900.79	$900.79
RHODE ISLAND (RI)	$911.75	$911.75
SOUTH CAROLINA (SC)	$858.19	$858.19
SOUTH DAKOTA** (SD)	$854.46	$854.46
TENNESSEE (TN)	$832.07	$832.07
BRAZORIA (TX)	$883.27	$883.27
DALLAS (TX)	$890.72	$890.72
GALVESTON (TX)	$887.16	$887.16
HOUSTON (TX)	$922.67	$922.67
BEAUMONT (TX)	$857.86	$857.86
FORT WORTH (TX)	$887.67	$887.67
AUSTIN (TX)	$913.55	$913.55
REST OF TEXAS (TX)	$871.35	$871.35
UTAH (UT)	$867.53	$867.53
VIRGINIA (VA)	$871.82	$871.82
VIRGIN ISLANDS (VI)	$900.79	$900.79
VERMONT (VT)	$861.58	$861.58
SEATTLE (KING CNTY) (WA)	$996.13	$996.13
REST OF WASHINGTON (WA)	$908.39	$908.39
WISCONSIN (WI)	$836.30	$836.30
WEST VIRGINIA (WV)	$874.44	$874.44
WYOMING** (WY)	$880.63	$880.63

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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

Each CPT code is assigned three Relative Value Units (RVUs): physician work, practice expense, and malpractice. These RVUs are each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice expense RVUs — and therefore the final allowed amount — typically differ between non-facility and facility settings because facilities bear some overhead costs separately (e.g., through hospital payment). For this code, the non-facility and facility amounts shown reflect that calculation using current-year RVUs, GPCIs, and conversion factor.

RVUs — work 13.28, practice expense 11.65 (non-facility) / 11.65 (facility), malpractice 1.94 — × 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 patient or secondary payer is generally responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and mid-year rule changes can shift RVUs and the conversion factor from what is shown.
Always verify final allowed amounts and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the allowed amount differ by locality?

Medicare adjusts each RVU component (work, practice expense, malpractice) using locality-specific GPCIs to account for regional differences in costs like wages and rent, so the same code can pay differently depending on where the service is performed.

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

When a code's practice expense RVUs are identical in both settings, the resulting allowed amounts will match; this can happen when the code's overhead costs are treated the same way regardless of where it is performed.

Does this amount include what the patient owes?

No. The figure shown is the total Medicare-allowed amount. Medicare generally pays 80% of this after the deductible, with the remaining portion owed by the patient or a secondary payer.

Will this amount change during the year?

It can. CMS may issue corrections, and factors like sequestration or local coverage determinations can affect what is actually paid, even though the published RVUs and conversion factor are typically set annually.

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.