Medicare Reimbursement for CPT 21330

CPT 21330 is a physician procedure code; because it is a CPT code, the official AMA descriptor cannot be reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and adjusted for your locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$490.33	$490.33
ALASKA* (AK)	$590.04	$590.04
ALABAMA (AL)	$444.06	$444.06
ARKANSAS (AR)	$438.26	$438.26
ARIZONA (AZ)	$477.84	$477.84
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$604.61	$604.61
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$615.43	$615.43
OXNARD-THOUSAND OAKS-VENTURA (CA)	$535.01	$535.01
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$538.87	$538.87
NAPA (CA)	$575.67	$575.67
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$605.55	$605.55
VALLEJO (CA)	$574.31	$574.31
BAKERSFIELD (CA)	$509.36	$509.36
CHICO (CA)	$506.96	$506.96
FRESNO (CA)	$506.96	$506.96
HANFORD-CORCORAN (CA)	$506.96	$506.96
MADERA (CA)	$506.96	$506.96
MERCED (CA)	$506.96	$506.96
MODESTO (CA)	$506.96	$506.96
REDDING (CA)	$506.96	$506.96
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$515.94	$515.94
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$528.90	$528.90
SALINAS (CA)	$526.86	$526.86
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$619.28	$619.28
SANTA CRUZ-WATSONVILLE (CA)	$540.31	$540.31
SANTA ROSA-PETALUMA (CA)	$545.57	$545.57
STOCKTON (CA)	$506.96	$506.96
VISALIA (CA)	$506.96	$506.96
YUBA CITY (CA)	$506.96	$506.96
EL CENTRO (CA)	$507.10	$507.10
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$536.97	$536.97
SAN LUIS OBISPO-PASO ROBLES (CA)	$518.74	$518.74
SANTA MARIA-SANTA BARBARA (CA)	$528.21	$528.21
REST OF CALIFORNIA (CA)	$506.96	$506.96
COLORADO (CO)	$504.05	$504.05
CONNECTICUT (CT)	$521.01	$521.01
DC + MD/VA SUBURBS (DC)	$552.40	$552.40
DELAWARE (DE)	$485.18	$485.18
FORT LAUDERDALE (FL)	$516.29	$516.29
MIAMI (FL)	$543.94	$543.94
REST OF FLORIDA (FL)	$492.22	$492.22
ATLANTA (GA)	$500.85	$500.85
REST OF GEORGIA (GA)	$466.07	$466.07
HAWAII, GUAM (HI)	$516.18	$516.18
IOWA (IA)	$450.33	$450.33
IDAHO (ID)	$453.80	$453.80
EAST ST. LOUIS (IL)	$496.53	$496.53
SUBURBAN CHICAGO (IL)	$520.44	$520.44
CHICAGO (IL)	$528.92	$528.92
REST OF ILLINOIS (IL)	$482.10	$482.10
INDIANA (IN)	$456.08	$456.08
KANSAS (KS)	$450.28	$450.28
KENTUCKY (KY)	$457.57	$457.57
NEW ORLEANS (LA)	$477.94	$477.94
REST OF LOUISIANA (LA)	$457.66	$457.66
METROPOLITAN BOSTON (MA)	$548.15	$548.15
REST OF MASSACHUSETTS (MA)	$502.23	$502.23
BALTIMORE/SURR. CNTYS (MD)	$519.91	$519.91
REST OF MARYLAND (MD)	$493.23	$493.23
SOUTHERN MAINE (ME)	$477.63	$477.63
REST OF MAINE (ME)	$457.94	$457.94
DETROIT (MI)	$499.76	$499.76
REST OF MICHIGAN (MI)	$470.07	$470.07
MINNESOTA (MN)	$478.75	$478.75
METROPOLITAN ST. LOUIS (MO)	$477.23	$477.23
METROPOLITAN KANSAS CITY (MO)	$472.98	$472.98
REST OF MISSOURI (MO)	$451.81	$451.81
MISSISSIPPI (MS)	$445.02	$445.02
MONTANA** (MT)	$490.27	$490.27
NORTH CAROLINA (NC)	$461.97	$461.97
NORTH DAKOTA** (ND)	$473.86	$473.86
NEBRASKA (NE)	$451.99	$451.99
NEW HAMPSHIRE (NH)	$498.09	$498.09
NORTHERN NJ (NJ)	$547.92	$547.92
REST OF NEW JERSEY (NJ)	$525.76	$525.76
NEW MEXICO (NM)	$473.16	$473.16
NEVADA** (NV)	$485.97	$485.97
MANHATTAN (NY)	$563.02	$563.02
NYC SUBURBS/LONG ISLAND (NY)	$577.93	$577.93
POUGHKPSIE/N NYC SUBURBS (NY)	$530.66	$530.66
QUEENS (NY)	$564.50	$564.50
REST OF NEW YORK (NY)	$468.40	$468.40
OHIO (OH)	$466.72	$466.72
OKLAHOMA (OK)	$454.84	$454.84
PORTLAND (OR)	$516.65	$516.65
REST OF OREGON (OR)	$481.00	$481.00
METROPOLITAN PHILADELPHIA (PA)	$510.30	$510.30
REST OF PENNSYLVANIA (PA)	$466.34	$466.34
PUERTO RICO (PR)	$492.92	$492.92
RHODE ISLAND (RI)	$499.96	$499.96
SOUTH CAROLINA (SC)	$465.35	$465.35
SOUTH DAKOTA** (SD)	$471.92	$471.92
TENNESSEE (TN)	$452.57	$452.57
BRAZORIA (TX)	$483.27	$483.27
DALLAS (TX)	$486.99	$486.99
GALVESTON (TX)	$485.15	$485.15
HOUSTON (TX)	$500.34	$500.34
BEAUMONT (TX)	$463.71	$463.71
FORT WORTH (TX)	$484.61	$484.61
AUSTIN (TX)	$503.43	$503.43
REST OF TEXAS (TX)	$473.67	$473.67
UTAH (UT)	$471.06	$471.06
VIRGINIA (VA)	$477.52	$477.52
VIRGIN ISLANDS (VI)	$492.92	$492.92
VERMONT (VT)	$473.89	$473.89
SEATTLE (KING CNTY) (WA)	$556.86	$556.86
REST OF WASHINGTON (WA)	$500.67	$500.67
WISCONSIN (WI)	$459.64	$459.64
WEST VIRGINIA (WV)	$466.39	$466.39
WYOMING** (WY)	$483.12	$483.12

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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 pricing starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting local cost differences. The locality-adjusted RVUs are summed and then multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs — and therefore the final amount — can differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings; for this code those practice-expense RVUs are the same in both settings, so the non-facility and facility amounts shown are equal.

RVUs — work 5.65, practice expense 8.2 (non-facility) / 8.2 (facility), malpractice 0.83 — × 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 beneficiary or secondary payer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, multiple-procedure or bilateral adjustments, sequestration, and annual budget-neutrality adjustments to RVUs or the conversion factor.
Always confirm the current fee with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the amount differ by locality?

Each locality has its own Geographic Practice Cost Index (GPCI) values for work, practice expense, and malpractice, which adjust the national RVUs to reflect local cost-of-living and practice-cost differences before the conversion factor is applied.

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

The payment difference between settings comes from the practice-expense RVU. When the practice-expense RVU is identical in both facility and non-facility settings, as it is here, the resulting allowed amounts are also the same.

Does this amount reflect what the practice will actually collect?

No. This is the Medicare-allowed amount before the standard 80/20 split, deductible status, modifiers, and any sequestration or secondary payer adjustments are applied.

Can this amount change during the year?

Yes. CMS can issue mid-year corrections, and RVUs or the conversion factor are subject to annual rulemaking, so amounts can change from one calendar year to the next.

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.