Medicare Reimbursement for CPT Code 21336

This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code, both at the national level and adjusted by locality. Because CPT code descriptors are proprietary to the AMA, this page refers to the procedure generically rather than reproducing the official description. Amounts are shown separately for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$583.18	$583.18
ALASKA* (AK)	$700.16	$700.16
ALABAMA (AL)	$527.72	$527.72
ARKANSAS (AR)	$520.77	$520.77
ARIZONA (AZ)	$568.24	$568.24
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$720.60	$720.60
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$733.55	$733.55
OXNARD-THOUSAND OAKS-VENTURA (CA)	$637.07	$637.07
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$641.61	$641.61
NAPA (CA)	$685.90	$685.90
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$721.71	$721.71
VALLEJO (CA)	$684.30	$684.30
BAKERSFIELD (CA)	$606.25	$606.25
CHICO (CA)	$603.42	$603.42
FRESNO (CA)	$603.42	$603.42
HANFORD-CORCORAN (CA)	$603.42	$603.42
MADERA (CA)	$603.42	$603.42
MERCED (CA)	$603.42	$603.42
MODESTO (CA)	$603.42	$603.42
REDDING (CA)	$603.42	$603.42
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$614.02	$614.02
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$629.72	$629.72
SALINAS (CA)	$627.30	$627.30
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$738.10	$738.10
SANTA CRUZ-WATSONVILLE (CA)	$643.57	$643.57
SANTA ROSA-PETALUMA (CA)	$649.85	$649.85
STOCKTON (CA)	$603.42	$603.42
VISALIA (CA)	$603.42	$603.42
YUBA CITY (CA)	$603.42	$603.42
EL CENTRO (CA)	$603.58	$603.58
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$639.48	$639.48
SAN LUIS OBISPO-PASO ROBLES (CA)	$617.61	$617.61
SANTA MARIA-SANTA BARBARA (CA)	$628.94	$628.94
REST OF CALIFORNIA (CA)	$603.42	$603.42
COLORADO (CO)	$599.78	$599.78
CONNECTICUT (CT)	$619.87	$619.87
DC + MD/VA SUBURBS (DC)	$657.52	$657.52
DELAWARE (DE)	$577.02	$577.02
FORT LAUDERDALE (FL)	$613.92	$613.92
MIAMI (FL)	$646.76	$646.76
REST OF FLORIDA (FL)	$585.12	$585.12
ATLANTA (GA)	$595.70	$595.70
REST OF GEORGIA (GA)	$553.82	$553.82
HAWAII, GUAM (HI)	$614.61	$614.61
IOWA (IA)	$535.39	$535.39
IDAHO (ID)	$539.53	$539.53
EAST ST. LOUIS (IL)	$589.97	$589.97
SUBURBAN CHICAGO (IL)	$618.90	$618.90
CHICAGO (IL)	$628.76	$628.76
REST OF ILLINOIS (IL)	$572.90	$572.90
INDIANA (IN)	$542.26	$542.26
KANSAS (KS)	$535.26	$535.26
KENTUCKY (KY)	$543.77	$543.77
NEW ORLEANS (LA)	$568.16	$568.16
REST OF LOUISIANA (LA)	$543.85	$543.85
METROPOLITAN BOSTON (MA)	$652.64	$652.64
REST OF MASSACHUSETTS (MA)	$597.55	$597.55
BALTIMORE/SURR. CNTYS (MD)	$618.55	$618.55
REST OF MARYLAND (MD)	$586.66	$586.66
SOUTHERN MAINE (ME)	$568.13	$568.13
REST OF MAINE (ME)	$544.41	$544.41
DETROIT (MI)	$594.08	$594.08
REST OF MICHIGAN (MI)	$558.69	$558.69
MINNESOTA (MN)	$569.71	$569.71
METROPOLITAN ST. LOUIS (MO)	$567.41	$567.41
METROPOLITAN KANSAS CITY (MO)	$562.30	$562.30
REST OF MISSOURI (MO)	$536.79	$536.79
MISSISSIPPI (MS)	$528.77	$528.77
MONTANA** (MT)	$583.11	$583.11
NORTH CAROLINA (NC)	$549.25	$549.25
NORTH DAKOTA** (ND)	$563.74	$563.74
NEBRASKA (NE)	$537.41	$537.41
NEW HAMPSHIRE (NH)	$592.62	$592.62
NORTHERN NJ (NJ)	$652.09	$652.09
REST OF NEW JERSEY (NJ)	$625.53	$625.53
NEW MEXICO (NM)	$562.37	$562.37
NEVADA** (NV)	$578.04	$578.04
MANHATTAN (NY)	$669.93	$669.93
NYC SUBURBS/LONG ISLAND (NY)	$687.71	$687.71
POUGHKPSIE/N NYC SUBURBS (NY)	$631.32	$631.32
QUEENS (NY)	$671.82	$671.82
REST OF NEW YORK (NY)	$556.96	$556.96
OHIO (OH)	$554.73	$554.73
OKLAHOMA (OK)	$540.57	$540.57
PORTLAND (OR)	$614.96	$614.96
REST OF OREGON (OR)	$572.14	$572.14
METROPOLITAN PHILADELPHIA (PA)	$607.00	$607.00
REST OF PENNSYLVANIA (PA)	$554.32	$554.32
PUERTO RICO (PR)	$586.32	$586.32
RHODE ISLAND (RI)	$594.72	$594.72
SOUTH CAROLINA (SC)	$553.19	$553.19
SOUTH DAKOTA** (SD)	$561.45	$561.45
TENNESSEE (TN)	$537.99	$537.99
BRAZORIA (TX)	$574.77	$574.77
DALLAS (TX)	$579.20	$579.20
GALVESTON (TX)	$577.00	$577.00
HOUSTON (TX)	$594.94	$594.94
BEAUMONT (TX)	$551.16	$551.16
FORT WORTH (TX)	$576.32	$576.32
AUSTIN (TX)	$599.03	$599.03
REST OF TEXAS (TX)	$563.17	$563.17
UTAH (UT)	$560.04	$560.04
VIRGINIA (VA)	$567.95	$567.95
VIRGIN ISLANDS (VI)	$586.32	$586.32
VERMONT (VT)	$563.71	$563.71
SEATTLE (KING CNTY) (WA)	$663.12	$663.12
REST OF WASHINGTON (WA)	$595.71	$595.71
WISCONSIN (WI)	$546.67	$546.67
WEST VIRGINIA (WV)	$554.06	$554.06
WYOMING** (WY)	$574.67	$574.67

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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 calculates the PFS allowed amount using three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by the Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, to reflect local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility settings can have different practice-expense RVUs, since facility settings often shift certain overhead costs to the facility itself; for some codes, including this one, those values are the same, resulting in equal non-facility and facility amounts.

RVUs — work 6.6, practice expense 9.88 (non-facility) / 9.88 (facility), malpractice 0.98 — × 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, place of service, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Locality-specific GPCIs mean the national amount shown may differ from what is actually paid in your area.
Always confirm final allowed amounts with your Medicare Administrative Contractor (MAC).

Frequently asked

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

When the practice-expense RVU is identical for both settings, the calculated allowed amount is the same regardless of place of service.

Why might my local payment differ from the national amount shown?

The national amount uses an average GPCI of 1.0 for all components, while actual payments are adjusted using the GPCI values specific to the provider's locality.

Does this amount include the patient's share?

No. The figure represents the total Medicare-allowed amount; Medicare generally pays 80% after the deductible, with the patient or secondary insurance responsible for the rest.

Will this amount stay the same next year?

No. RVUs, GPCIs, and the conversion factor are updated annually and can change the allowed amount from year to year.

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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.