Medicare Reimbursement for CPT 21267

CPT 21267 is a surgical procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, with non-facility and facility rates shown separately.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1466.63	$1466.63
ALASKA* (AK)	$1790.64	$1790.64
ALABAMA (AL)	$1328.81	$1328.81
ARKANSAS (AR)	$1311.74	$1311.74
ARIZONA (AZ)	$1427.90	$1427.90
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1732.36	$1732.36
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1760.33	$1760.33
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1559.79	$1559.79
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1574.36	$1574.36
NAPA (CA)	$1659.78	$1659.78
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1736.62	$1736.62
VALLEJO (CA)	$1653.64	$1653.64
BAKERSFIELD (CA)	$1494.56	$1494.56
CHICO (CA)	$1484.07	$1484.07
FRESNO (CA)	$1484.07	$1484.07
HANFORD-CORCORAN (CA)	$1484.07	$1484.07
MADERA (CA)	$1484.07	$1484.07
MERCED (CA)	$1484.07	$1484.07
MODESTO (CA)	$1484.07	$1484.07
REDDING (CA)	$1484.07	$1484.07
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1524.45	$1524.45
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1541.60	$1541.60
SALINAS (CA)	$1535.56	$1535.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1777.74	$1777.74
SANTA CRUZ-WATSONVILLE (CA)	$1566.22	$1566.22
SANTA ROSA-PETALUMA (CA)	$1580.96	$1580.96
STOCKTON (CA)	$1484.07	$1484.07
VISALIA (CA)	$1484.07	$1484.07
YUBA CITY (CA)	$1484.07	$1484.07
EL CENTRO (CA)	$1484.69	$1484.69
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1560.34	$1560.34
SAN LUIS OBISPO-PASO ROBLES (CA)	$1512.78	$1512.78
SANTA MARIA-SANTA BARBARA (CA)	$1538.21	$1538.21
REST OF CALIFORNIA (CA)	$1484.07	$1484.07
COLORADO (CO)	$1490.02	$1490.02
CONNECTICUT (CT)	$1557.82	$1557.82
DC + MD/VA SUBURBS (DC)	$1636.01	$1636.01
DELAWARE (DE)	$1449.34	$1449.34
FORT LAUDERDALE (FL)	$1576.52	$1576.52
MIAMI (FL)	$1685.52	$1685.52
REST OF FLORIDA (FL)	$1500.26	$1500.26
ATLANTA (GA)	$1504.51	$1504.51
REST OF GEORGIA (GA)	$1418.57	$1418.57
HAWAII, GUAM (HI)	$1505.37	$1505.37
IOWA (IA)	$1334.35	$1334.35
IDAHO (ID)	$1347.21	$1347.21
EAST ST. LOUIS (IL)	$1540.23	$1540.23
SUBURBAN CHICAGO (IL)	$1586.07	$1586.07
CHICAGO (IL)	$1636.89	$1636.89
REST OF ILLINOIS (IL)	$1479.06	$1479.06
INDIANA (IN)	$1353.51	$1353.51
KANSAS (KS)	$1340.41	$1340.41
KENTUCKY (KY)	$1381.87	$1381.87
NEW ORLEANS (LA)	$1444.27	$1444.27
REST OF LOUISIANA (LA)	$1384.59	$1384.59
METROPOLITAN BOSTON (MA)	$1610.01	$1610.01
REST OF MASSACHUSETTS (MA)	$1487.37	$1487.37
BALTIMORE/SURR. CNTYS (MD)	$1555.84	$1555.84
REST OF MARYLAND (MD)	$1471.11	$1471.11
SOUTHERN MAINE (ME)	$1414.41	$1414.41
REST OF MAINE (ME)	$1365.87	$1365.87
DETROIT (MI)	$1529.19	$1529.19
REST OF MICHIGAN (MI)	$1424.70	$1424.70
MINNESOTA (MN)	$1397.82	$1397.82
METROPOLITAN ST. LOUIS (MO)	$1434.84	$1434.84
METROPOLITAN KANSAS CITY (MO)	$1423.02	$1423.02
REST OF MISSOURI (MO)	$1371.24	$1371.24
MISSISSIPPI (MS)	$1341.13	$1341.13
MONTANA** (MT)	$1466.38	$1466.38
NORTH CAROLINA (NC)	$1376.68	$1376.68
NORTH DAKOTA** (ND)	$1392.23	$1392.23
NEBRASKA (NE)	$1337.31	$1337.31
NEW HAMPSHIRE (NH)	$1478.35	$1478.35
NORTHERN NJ (NJ)	$1624.42	$1624.42
REST OF NEW JERSEY (NJ)	$1567.16	$1567.16
NEW MEXICO (NM)	$1436.39	$1436.39
NEVADA** (NV)	$1446.38	$1446.38
MANHATTAN (NY)	$1691.31	$1691.31
NYC SUBURBS/LONG ISLAND (NY)	$1743.28	$1743.28
POUGHKPSIE/N NYC SUBURBS (NY)	$1586.68	$1586.68
QUEENS (NY)	$1686.63	$1686.63
REST OF NEW YORK (NY)	$1396.05	$1396.05
OHIO (OH)	$1409.55	$1409.55
OKLAHOMA (OK)	$1367.26	$1367.26
PORTLAND (OR)	$1519.46	$1519.46
REST OF OREGON (OR)	$1426.76	$1426.76
METROPOLITAN PHILADELPHIA (PA)	$1530.31	$1530.31
REST OF PENNSYLVANIA (PA)	$1404.99	$1404.99
PUERTO RICO (PR)	$1472.10	$1472.10
RHODE ISLAND (RI)	$1487.94	$1487.94
SOUTH CAROLINA (SC)	$1397.10	$1397.10
SOUTH DAKOTA** (SD)	$1383.47	$1383.47
TENNESSEE (TN)	$1347.88	$1347.88
BRAZORIA (TX)	$1438.46	$1438.46
DALLAS (TX)	$1452.24	$1452.24
GALVESTON (TX)	$1445.81	$1445.81
HOUSTON (TX)	$1514.44	$1514.44
BEAUMONT (TX)	$1397.65	$1397.65
FORT WORTH (TX)	$1447.19	$1447.19
AUSTIN (TX)	$1492.43	$1492.43
REST OF TEXAS (TX)	$1420.43	$1420.43
UTAH (UT)	$1413.80	$1413.80
VIRGINIA (VA)	$1418.46	$1418.46
VIRGIN ISLANDS (VI)	$1472.10	$1472.10
VERMONT (VT)	$1398.08	$1398.08
SEATTLE (KING CNTY) (WA)	$1628.96	$1628.96
REST OF WASHINGTON (WA)	$1480.84	$1480.84
WISCONSIN (WI)	$1351.92	$1351.92
WEST VIRGINIA (WV)	$1433.15	$1433.15
WYOMING** (WY)	$1434.07	$1434.07

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. The adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Practice-expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts may not match. For this code, the non-facility and facility practice-expense RVUs are the same, so the national allowed amounts are identical in both settings, though locality-adjusted amounts can still vary due to GPCI differences.

RVUs — work 20.17, practice expense 19.99 (non-facility) / 19.99 (facility), malpractice 3.75 — × 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 responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs may shift the amount up or down from the national figure shown here.
Always verify the current fee with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why does the facility amount equal the non-facility amount for this code?

Because the practice-expense RVU is the same in both settings for this code, the national allowed amounts calculate to the same figure. Locality adjustments could still cause small differences in some areas.

Will my actual payment match the national amount shown?

Not necessarily. The national figure uses a standard GPCI baseline; your actual payment depends on your specific locality's GPCIs, any applicable modifiers, and Medicare's 80% payment rate after the deductible.

Does this amount reflect what the patient will owe?

No. This figure is the total Medicare-allowed amount. Patient responsibility depends on deductible status, coinsurance, and any secondary coverage.

Can this fee change during the year?

The conversion factor and RVUs are typically set annually, but budget-neutrality adjustments, legislation, or coding changes can affect the fee mid-year or in future years.

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.