Medicare Reimbursement for CPT 21347
This page explains the Medicare Physician Fee Schedule (PFS) allowed amount for CPT code 21347, a procedure code whose official description is proprietary to the AMA and not reproduced here. It shows the national estimated payment as well as amounts adjusted for non-facility and facility settings, which may vary by locality.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $939.23 | $939.23 |
| ALASKA* (AK) | $1158.96 | $1158.96 |
| ALABAMA (AL) | $857.08 | $857.08 |
| ARKANSAS (AR) | $846.86 | $846.86 |
| ARIZONA (AZ) | $916.53 | $916.53 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $1122.38 | $1122.38 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $1141.09 | $1141.09 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $1006.48 | $1006.48 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $1015.27 | $1015.27 |
| NAPA (CA) | $1073.62 | $1073.62 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $1124.56 | $1124.56 |
| VALLEJO (CA) | $1070.48 | $1070.48 |
| BAKERSFIELD (CA) | $964.25 | $964.25 |
| CHICO (CA) | $958.68 | $958.68 |
| FRESNO (CA) | $958.68 | $958.68 |
| HANFORD-CORCORAN (CA) | $958.68 | $958.68 |
| MADERA (CA) | $958.68 | $958.68 |
| MERCED (CA) | $958.68 | $958.68 |
| MODESTO (CA) | $958.68 | $958.68 |
| REDDING (CA) | $958.68 | $958.68 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $979.45 | $979.45 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $996.17 | $996.17 |
| SALINAS (CA) | $992.23 | $992.23 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $1150.01 | $1150.01 |
| SANTA CRUZ-WATSONVILLE (CA) | $1012.16 | $1012.16 |
| SANTA ROSA-PETALUMA (CA) | $1021.77 | $1021.77 |
| STOCKTON (CA) | $958.68 | $958.68 |
| VISALIA (CA) | $958.68 | $958.68 |
| YUBA CITY (CA) | $958.68 | $958.68 |
| EL CENTRO (CA) | $959.00 | $959.00 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $1008.25 | $1008.25 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $977.37 | $977.37 |
| SANTA MARIA-SANTA BARBARA (CA) | $993.95 | $993.95 |
| REST OF CALIFORNIA (CA) | $958.68 | $958.68 |
| COLORADO (CO) | $958.29 | $958.29 |
| CONNECTICUT (CT) | $994.97 | $994.97 |
| DC + MD/VA SUBURBS (DC) | $1047.62 | $1047.62 |
| DELAWARE (DE) | $929.74 | $929.74 |
| FORT LAUDERDALE (FL) | $996.70 | $996.70 |
| MIAMI (FL) | $1055.10 | $1055.10 |
| REST OF FLORIDA (FL) | $952.37 | $952.37 |
| ATLANTA (GA) | $960.40 | $960.40 |
| REST OF GEORGIA (GA) | $904.62 | $904.62 |
| HAWAII, GUAM (HI) | $971.77 | $971.77 |
| IOWA (IA) | $863.63 | $863.63 |
| IDAHO (ID) | $870.67 | $870.67 |
| EAST ST. LOUIS (IL) | $969.50 | $969.50 |
| SUBURBAN CHICAGO (IL) | $1003.56 | $1003.56 |
| CHICAGO (IL) | $1027.54 | $1027.54 |
| REST OF ILLINOIS (IL) | $937.53 | $937.53 |
| INDIANA (IN) | $874.55 | $874.55 |
| KANSAS (KS) | $865.71 | $865.71 |
| KENTUCKY (KY) | $885.55 | $885.55 |
| NEW ORLEANS (LA) | $922.32 | $922.32 |
| REST OF LOUISIANA (LA) | $886.57 | $886.57 |
| METROPOLITAN BOSTON (MA) | $1034.54 | $1034.54 |
| REST OF MASSACHUSETTS (MA) | $956.29 | $956.29 |
| BALTIMORE/SURR. CNTYS (MD) | $993.20 | $993.20 |
| REST OF MARYLAND (MD) | $943.59 | $943.59 |
| SOUTHERN MAINE (ME) | $911.66 | $911.66 |
| REST OF MAINE (ME) | $880.23 | $880.23 |
| DETROIT (MI) | $968.02 | $968.02 |
| REST OF MICHIGAN (MI) | $909.70 | $909.70 |
| MINNESOTA (MN) | $906.69 | $906.69 |
| METROPOLITAN ST. LOUIS (MO) | $918.50 | $918.50 |
| METROPOLITAN KANSAS CITY (MO) | $911.25 | $911.25 |
| REST OF MISSOURI (MO) | $877.60 | $877.60 |
| MISSISSIPPI (MS) | $862.09 | $862.09 |
| MONTANA** (MT) | $939.11 | $939.11 |
| NORTH CAROLINA (NC) | $886.97 | $886.97 |
| NORTH DAKOTA** (ND) | $901.14 | $901.14 |
| NEBRASKA (NE) | $865.88 | $865.88 |
| NEW HAMPSHIRE (NH) | $949.03 | $949.03 |
| NORTHERN NJ (NJ) | $1040.88 | $1040.88 |
| REST OF NEW JERSEY (NJ) | $1003.05 | $1003.05 |
| NEW MEXICO (NM) | $916.06 | $916.06 |
| NEVADA** (NV) | $928.96 | $928.96 |
| MANHATTAN (NY) | $1075.41 | $1075.41 |
| NYC SUBURBS/LONG ISLAND (NY) | $1104.52 | $1104.52 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $1013.81 | $1013.81 |
| QUEENS (NY) | $1074.86 | $1074.86 |
| REST OF NEW YORK (NY) | $898.46 | $898.46 |
| OHIO (OH) | $901.94 | $901.94 |
| OKLAHOMA (OK) | $878.44 | $878.44 |
| PORTLAND (OR) | $978.10 | $978.10 |
| REST OF OREGON (OR) | $918.45 | $918.45 |
| METROPOLITAN PHILADELPHIA (PA) | $977.36 | $977.36 |
| REST OF PENNSYLVANIA (PA) | $900.07 | $900.07 |
| PUERTO RICO (PR) | $943.05 | $943.05 |
| RHODE ISLAND (RI) | $955.02 | $955.02 |
| SOUTH CAROLINA (SC) | $896.59 | $896.59 |
| SOUTH DAKOTA** (SD) | $896.65 | $896.65 |
| TENNESSEE (TN) | $870.00 | $870.00 |
| BRAZORIA (TX) | $924.74 | $924.74 |
| DALLAS (TX) | $932.35 | $932.35 |
| GALVESTON (TX) | $928.69 | $928.69 |
| HOUSTON (TX) | $963.83 | $963.83 |
| BEAUMONT (TX) | $895.57 | $895.57 |
| FORT WORTH (TX) | $928.84 | $928.84 |
| AUSTIN (TX) | $958.01 | $958.01 |
| REST OF TEXAS (TX) | $910.85 | $910.85 |
| UTAH (UT) | $906.62 | $906.62 |
| VIRGINIA (VA) | $912.99 | $912.99 |
| VIRGIN ISLANDS (VI) | $943.05 | $943.05 |
| VERMONT (VT) | $903.21 | $903.21 |
| SEATTLE (KING CNTY) (WA) | $1048.17 | $1048.17 |
| REST OF WASHINGTON (WA) | $952.66 | $952.66 |
| WISCONSIN (WI) | $876.60 | $876.60 |
| WEST VIRGINIA (WV) | $909.95 | $909.95 |
| WYOMING** (WY) | $922.56 | $922.56 |
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 — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, though for some codes these values are the same.
RVUs — work 13.19, practice expense 13.01 (non-facility) / 13.01 (facility), malpractice 1.92 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- This is an estimate only, not a guarantee of payment or coverage.
- Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary payer is responsible for the remainder.
- Modifiers, place-of-service codes, multiple-procedure reductions, and sequestration can change the actual paid amount.
- Annual updates to RVUs, GPCIs, and the conversion factor, as well as budget-neutrality adjustments, can change fees from year to year.
- Always confirm final payment amounts and coverage policies with your Medicare Administrative Contractor (MAC).
Frequently asked
Why don't you show the CPT code description?
CPT code descriptors are copyrighted by the American Medical Association (AMA) and cannot be reproduced without a license. We reference the code generically instead.
Why do non-facility and facility amounts sometimes differ?
The practice-expense RVU component can vary depending on whether the service is performed in a physician office (non-facility) versus a hospital or ambulatory surgical center (facility), since overhead costs differ between these settings.
Why might my actual payment differ from the amount shown?
Actual payment depends on your specific locality's GPCIs, any applicable modifiers, secondary payer coordination, sequestration, and whether multiple procedures were billed together.
Is this the amount the patient will pay?
No. Medicare generally pays 80% of the allowed amount after the deductible is met; the patient or a supplemental insurer typically covers the remaining 20% plus any unmet deductible.
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.
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