Medicare Reimbursement for CPT 21348

CPT 21348 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and, where available, by locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$947.92	$947.92
ALASKA* (AK)	$1214.95	$1214.95
ALABAMA (AL)	$875.04	$875.04
ARKANSAS (AR)	$866.09	$866.09
ARIZONA (AZ)	$926.82	$926.82
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1074.94	$1074.94
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1090.58	$1090.58
OXNARD-THOUSAND OAKS-VENTURA (CA)	$986.09	$986.09
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$997.21	$997.21
NAPA (CA)	$1036.51	$1036.51
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1077.77	$1077.77
VALLEJO (CA)	$1032.44	$1032.44
BAKERSFIELD (CA)	$954.49	$954.49
CHICO (CA)	$947.27	$947.27
FRESNO (CA)	$947.27	$947.27
HANFORD-CORCORAN (CA)	$947.27	$947.27
MADERA (CA)	$947.27	$947.27
MERCED (CA)	$947.27	$947.27
MODESTO (CA)	$947.27	$947.27
REDDING (CA)	$947.27	$947.27
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$974.21	$974.21
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$977.83	$977.83
SALINAS (CA)	$973.80	$973.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1102.14	$1102.14
SANTA CRUZ-WATSONVILLE (CA)	$984.57	$984.57
SANTA ROSA-PETALUMA (CA)	$993.53	$993.53
STOCKTON (CA)	$947.27	$947.27
VISALIA (CA)	$947.27	$947.27
YUBA CITY (CA)	$947.27	$947.27
EL CENTRO (CA)	$947.69	$947.69
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$984.62	$984.62
SAN LUIS OBISPO-PASO ROBLES (CA)	$959.93	$959.93
SANTA MARIA-SANTA BARBARA (CA)	$974.15	$974.15
REST OF CALIFORNIA (CA)	$947.27	$947.27
COLORADO (CO)	$955.38	$955.38
CONNECTICUT (CT)	$999.45	$999.45
DC + MD/VA SUBURBS (DC)	$1040.50	$1040.50
DELAWARE (DE)	$938.84	$938.84
FORT LAUDERDALE (FL)	$1018.94	$1018.94
MIAMI (FL)	$1087.15	$1087.15
REST OF FLORIDA (FL)	$976.80	$976.80
ATLANTA (GA)	$971.05	$971.05
REST OF GEORGIA (GA)	$932.11	$932.11
HAWAII, GUAM (HI)	$953.22	$953.22
IOWA (IA)	$872.75	$872.75
IDAHO (ID)	$880.55	$880.55
EAST ST. LOUIS (IL)	$1008.71	$1008.71
SUBURBAN CHICAGO (IL)	$1024.06	$1024.06
CHICAGO (IL)	$1061.09	$1061.09
REST OF ILLINOIS (IL)	$969.14	$969.14
INDIANA (IN)	$883.69	$883.69
KANSAS (KS)	$878.42	$878.42
KENTUCKY (KY)	$908.19	$908.19
NEW ORLEANS (LA)	$941.87	$941.87
REST OF LOUISIANA (LA)	$910.58	$910.58
METROPOLITAN BOSTON (MA)	$1019.25	$1019.25
REST OF MASSACHUSETTS (MA)	$955.76	$955.76
BALTIMORE/SURR. CNTYS (MD)	$998.24	$998.24
REST OF MARYLAND (MD)	$950.33	$950.33
SOUTHERN MAINE (ME)	$914.58	$914.58
REST OF MAINE (ME)	$892.94	$892.94
DETROIT (MI)	$994.67	$994.67
REST OF MICHIGAN (MI)	$933.05	$933.05
MINNESOTA (MN)	$897.90	$897.90
METROPOLITAN ST. LOUIS (MO)	$933.96	$933.96
METROPOLITAN KANSAS CITY (MO)	$928.05	$928.05
REST OF MISSOURI (MO)	$905.15	$905.15
MISSISSIPPI (MS)	$885.31	$885.31
MONTANA** (MT)	$947.75	$947.75
NORTH CAROLINA (NC)	$898.18	$898.18
NORTH DAKOTA** (ND)	$898.52	$898.52
NEBRASKA (NE)	$873.53	$873.53
NEW HAMPSHIRE (NH)	$949.59	$949.59
NORTHERN NJ (NJ)	$1036.60	$1036.60
REST OF NEW JERSEY (NJ)	$1005.88	$1005.88
NEW MEXICO (NM)	$940.21	$940.21
NEVADA** (NV)	$934.32	$934.32
MANHATTAN (NY)	$1080.84	$1080.84
NYC SUBURBS/LONG ISLAND (NY)	$1111.32	$1111.32
POUGHKPSIE/N NYC SUBURBS (NY)	$1019.01	$1019.01
QUEENS (NY)	$1074.74	$1074.74
REST OF NEW YORK (NY)	$908.50	$908.50
OHIO (OH)	$922.98	$922.98
OKLAHOMA (OK)	$897.88	$897.88
PORTLAND (OR)	$968.42	$968.42
REST OF OREGON (OR)	$922.04	$922.04
METROPOLITAN PHILADELPHIA (PA)	$986.30	$986.30
REST OF PENNSYLVANIA (PA)	$919.21	$919.21
PUERTO RICO (PR)	$949.91	$949.91
RHODE ISLAND (RI)	$959.49	$959.49
SOUTH CAROLINA (SC)	$913.08	$913.08
SOUTH DAKOTA** (SD)	$892.69	$892.69
TENNESSEE (TN)	$882.63	$882.63
BRAZORIA (TX)	$931.54	$931.54
DALLAS (TX)	$940.06	$940.06
GALVESTON (TX)	$936.12	$936.12
HOUSTON (TX)	$981.69	$981.69
BEAUMONT (TX)	$915.53	$915.53
FORT WORTH (TX)	$938.20	$938.20
AUSTIN (TX)	$956.64	$956.64
REST OF TEXAS (TX)	$924.84	$924.84
UTAH (UT)	$921.78	$921.78
VIRGINIA (VA)	$918.46	$918.46
VIRGIN ISLANDS (VI)	$949.91	$949.91
VERMONT (VT)	$903.89	$903.89
SEATTLE (KING CNTY) (WA)	$1028.02	$1028.02
REST OF WASHINGTON (WA)	$951.05	$951.05
WISCONSIN (WI)	$878.01	$878.01
WEST VIRGINIA (WV)	$945.21	$945.21
WYOMING** (WY)	$926.29	$926.29

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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 Physician Fee Schedule amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is performed, reflecting local cost differences. The locality-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility allowed amounts can differ because the practice-expense RVU is typically higher in non-facility settings (e.g., a physician's office) where the provider bears more overhead, versus facility settings (e.g., hospital) where the facility is paid separately for overhead costs.

RVUs — work 17.08, practice expense 8.81 (non-facility) / 8.81 (facility), malpractice 2.49 — × 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 their annual deductible; the patient or secondary insurer is generally responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claim-specific circumstances, and federal budget sequestration.
Annual updates to RVUs, GPCIs, and the conversion factor, along with budget-neutrality adjustments, can change this amount year to year.
Always verify the current, locality-specific amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the allowed amount differ between facility and non-facility settings?

The practice-expense RVU component differs because non-facility settings (like a physician's office) include overhead costs borne by the provider, while in facility settings the facility bills separately for overhead, so the physician's practice-expense RVU is typically lower there.

Does this amount reflect what Medicare will actually pay?

No — it's an estimate based on standard PFS formulas. Actual payment depends on the specific locality, any modifiers applied, sequestration reductions, and other claim-specific factors determined by your MAC.

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

CPT code descriptors are copyrighted and licensed by the American Medical Association (AMA), so this page refers to the code generically rather than reproducing the official descriptor.

How much will the patient owe for this code?

Generally, Medicare pays 80% of the allowed amount after the annual Part B deductible is met, leaving the patient (or supplemental insurance) responsible for the remaining 20%, subject to any applicable secondary coverage.

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.