Medicare Reimbursement for CPT Code 21335

This page covers a physician procedure code (CPT descriptors are proprietary to the AMA and not reproduced here). It shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for locality, with non-facility and facility rates shown separately.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$648.98	$648.98
ALASKA* (AK)	$796.04	$796.04
ALABAMA (AL)	$590.83	$590.83
ARKANSAS (AR)	$583.59	$583.59
ARIZONA (AZ)	$632.94	$632.94
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$778.82	$778.82
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$791.93	$791.93
OXNARD-THOUSAND OAKS-VENTURA (CA)	$697.05	$697.05
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$703.00	$703.00
NAPA (CA)	$744.51	$744.51
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$780.33	$780.33
VALLEJO (CA)	$742.33	$742.33
BAKERSFIELD (CA)	$667.04	$667.04
CHICO (CA)	$663.21	$663.21
FRESNO (CA)	$663.21	$663.21
HANFORD-CORCORAN (CA)	$663.21	$663.21
MADERA (CA)	$663.21	$663.21
MERCED (CA)	$663.21	$663.21
MODESTO (CA)	$663.21	$663.21
REDDING (CA)	$663.21	$663.21
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$677.59	$677.59
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$689.62	$689.62
SALINAS (CA)	$686.91	$686.91
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$798.11	$798.11
SANTA CRUZ-WATSONVILLE (CA)	$701.39	$701.39
SANTA ROSA-PETALUMA (CA)	$708.07	$708.07
STOCKTON (CA)	$663.21	$663.21
VISALIA (CA)	$663.21	$663.21
YUBA CITY (CA)	$663.21	$663.21
EL CENTRO (CA)	$663.43	$663.43
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$698.39	$698.39
SAN LUIS OBISPO-PASO ROBLES (CA)	$676.58	$676.58
SANTA MARIA-SANTA BARBARA (CA)	$688.21	$688.21
REST OF CALIFORNIA (CA)	$663.21	$663.21
COLORADO (CO)	$662.68	$662.68
CONNECTICUT (CT)	$688.12	$688.12
DC + MD/VA SUBURBS (DC)	$725.20	$725.20
DELAWARE (DE)	$642.23	$642.23
FORT LAUDERDALE (FL)	$688.92	$688.92
MIAMI (FL)	$729.65	$729.65
REST OF FLORIDA (FL)	$657.64	$657.64
ATLANTA (GA)	$663.76	$663.76
REST OF GEORGIA (GA)	$623.92	$623.92
HAWAII, GUAM (HI)	$672.88	$672.88
IOWA (IA)	$595.76	$595.76
IDAHO (ID)	$600.69	$600.69
EAST ST. LOUIS (IL)	$669.15	$669.15
SUBURBAN CHICAGO (IL)	$693.73	$693.73
CHICAGO (IL)	$710.12	$710.12
REST OF ILLINOIS (IL)	$646.94	$646.94
INDIANA (IN)	$603.45	$603.45
KANSAS (KS)	$597.09	$597.09
KENTUCKY (KY)	$610.69	$610.69
NEW ORLEANS (LA)	$636.67	$636.67
REST OF LOUISIANA (LA)	$611.35	$611.35
METROPOLITAN BOSTON (MA)	$716.46	$716.46
REST OF MASSACHUSETTS (MA)	$661.14	$661.14
BALTIMORE/SURR. CNTYS (MD)	$686.91	$686.91
REST OF MARYLAND (MD)	$652.00	$652.00
SOUTHERN MAINE (ME)	$629.79	$629.79
REST OF MAINE (ME)	$607.31	$607.31
DETROIT (MI)	$668.57	$668.57
REST OF MICHIGAN (MI)	$627.66	$627.66
MINNESOTA (MN)	$626.72	$626.72
METROPOLITAN ST. LOUIS (MO)	$634.14	$634.14
METROPOLITAN KANSAS CITY (MO)	$628.99	$628.99
REST OF MISSOURI (MO)	$604.91	$604.91
MISSISSIPPI (MS)	$594.16	$594.16
MONTANA** (MT)	$648.89	$648.89
NORTH CAROLINA (NC)	$612.11	$612.11
NORTH DAKOTA** (ND)	$622.59	$622.59
NEBRASKA (NE)	$597.40	$597.40
NEW HAMPSHIRE (NH)	$656.18	$656.18
NORTHERN NJ (NJ)	$720.25	$720.25
REST OF NEW JERSEY (NJ)	$693.64	$693.64
NEW MEXICO (NM)	$632.10	$632.10
NEVADA** (NV)	$641.87	$641.87
MANHATTAN (NY)	$744.18	$744.18
NYC SUBURBS/LONG ISLAND (NY)	$764.61	$764.61
POUGHKPSIE/N NYC SUBURBS (NY)	$701.06	$701.06
QUEENS (NY)	$744.00	$744.00
REST OF NEW YORK (NY)	$620.24	$620.24
OHIO (OH)	$622.28	$622.28
OKLAHOMA (OK)	$605.80	$605.80
PORTLAND (OR)	$676.82	$676.82
REST OF OREGON (OR)	$634.54	$634.54
METROPOLITAN PHILADELPHIA (PA)	$675.59	$675.59
REST OF PENNSYLVANIA (PA)	$621.04	$621.04
PUERTO RICO (PR)	$651.73	$651.73
RHODE ISLAND (RI)	$660.02	$660.02
SOUTH CAROLINA (SC)	$618.68	$618.68
SOUTH DAKOTA** (SD)	$619.48	$619.48
TENNESSEE (TN)	$600.11	$600.11
BRAZORIA (TX)	$638.76	$638.76
DALLAS (TX)	$644.07	$644.07
GALVESTON (TX)	$641.51	$641.51
HOUSTON (TX)	$665.85	$665.85
BEAUMONT (TX)	$617.84	$617.84
FORT WORTH (TX)	$641.54	$641.54
AUSTIN (TX)	$662.54	$662.54
REST OF TEXAS (TX)	$628.81	$628.81
UTAH (UT)	$625.79	$625.79
VIRGINIA (VA)	$630.63	$630.63
VIRGIN ISLANDS (VI)	$651.73	$651.73
VERMONT (VT)	$623.92	$623.92
SEATTLE (KING CNTY) (WA)	$726.12	$726.12
REST OF WASHINGTON (WA)	$658.66	$658.66
WISCONSIN (WI)	$605.18	$605.18
WEST VIRGINIA (WV)	$627.39	$627.39
WYOMING** (WY)	$637.43	$637.43

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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) — work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished. The geographically adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar allowed amount. Practice expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts can diverge, while work and malpractice RVUs generally stay the same across settings. The resulting figure represents the total allowed amount before patient cost-sharing is applied.

RVUs — work 8.79, practice expense 9.31 (non-facility) / 9.31 (facility), malpractice 1.33 — × 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 responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the actual paid amount.
Locality-specific GPCIs mean the national figures shown may not match what a specific Medicare Administrative Contractor (MAC) pays in your area.
Always verify final payment policy and amounts with your local MAC before billing or appealing a claim.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The two settings use different practice expense RVUs, reflecting the fact that overhead costs (equipment, supplies, staff time) are typically lower when a service is performed in a facility like a hospital versus a physician's own office.

Does this amount reflect what Medicare will actually pay my practice?

No. The figure shown is the standard PFS allowed amount calculated with national RVUs and the conversion factor; actual payment depends on your specific locality GPCIs, any applicable modifiers, and current sequestration or budget-neutrality adjustments.

Why isn't the CPT code description shown on this page?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this site cannot reproduce the official language. The code is referenced generically instead.

How is the conversion factor determined each year?

The conversion factor is set annually by CMS through federal rulemaking and is subject to legislative adjustments, so the dollar value multiplied against RVUs can change from year to year.

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.