Medicare Reimbursement for CPT 21387

CPT 21387 is a surgical procedure code; the exact service it describes is defined by the AMA's CPT manual. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both at the national level and adjusted for your locality, separately for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$702.09	$702.09
ALASKA* (AK)	$859.56	$859.56
ALABAMA (AL)	$636.61	$636.61
ARKANSAS (AR)	$628.50	$628.50
ARIZONA (AZ)	$683.62	$683.62
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$826.00	$826.00
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$839.20	$839.20
OXNARD-THOUSAND OAKS-VENTURA (CA)	$744.98	$744.98
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$752.08	$752.08
NAPA (CA)	$791.86	$791.86
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$828.07	$828.07
VALLEJO (CA)	$788.87	$788.87
BAKERSFIELD (CA)	$714.36	$714.36
CHICO (CA)	$709.24	$709.24
FRESNO (CA)	$709.24	$709.24
HANFORD-CORCORAN (CA)	$709.24	$709.24
MADERA (CA)	$709.24	$709.24
MERCED (CA)	$709.24	$709.24
MODESTO (CA)	$709.24	$709.24
REDDING (CA)	$709.24	$709.24
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$728.95	$728.95
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$736.38	$736.38
SALINAS (CA)	$733.48	$733.48
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$847.69	$847.69
SANTA CRUZ-WATSONVILLE (CA)	$747.64	$747.64
SANTA ROSA-PETALUMA (CA)	$754.66	$754.66
STOCKTON (CA)	$709.24	$709.24
VISALIA (CA)	$709.24	$709.24
YUBA CITY (CA)	$709.24	$709.24
EL CENTRO (CA)	$709.55	$709.55
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$745.05	$745.05
SAN LUIS OBISPO-PASO ROBLES (CA)	$722.64	$722.64
SANTA MARIA-SANTA BARBARA (CA)	$734.68	$734.68
REST OF CALIFORNIA (CA)	$709.24	$709.24
COLORADO (CO)	$712.60	$712.60
CONNECTICUT (CT)	$745.51	$745.51
DC + MD/VA SUBURBS (DC)	$782.25	$782.25
DELAWARE (DE)	$693.82	$693.82
FORT LAUDERDALE (FL)	$755.53	$755.53
MIAMI (FL)	$808.32	$808.32
REST OF FLORIDA (FL)	$719.12	$719.12
ATLANTA (GA)	$720.35	$720.35
REST OF GEORGIA (GA)	$680.17	$680.17
HAWAII, GUAM (HI)	$719.05	$719.05
IOWA (IA)	$638.74	$638.74
IDAHO (ID)	$644.94	$644.94
EAST ST. LOUIS (IL)	$739.14	$739.14
SUBURBAN CHICAGO (IL)	$759.99	$759.99
CHICAGO (IL)	$785.11	$785.11
REST OF ILLINOIS (IL)	$709.39	$709.39
INDIANA (IN)	$647.92	$647.92
KANSAS (KS)	$641.85	$641.85
KENTUCKY (KY)	$662.30	$662.30
NEW ORLEANS (LA)	$692.01	$692.01
REST OF LOUISIANA (LA)	$663.68	$663.68
METROPOLITAN BOSTON (MA)	$769.32	$769.32
REST OF MASSACHUSETTS (MA)	$711.46	$711.46
BALTIMORE/SURR. CNTYS (MD)	$744.59	$744.59
REST OF MARYLAND (MD)	$704.11	$704.11
SOUTHERN MAINE (ME)	$676.73	$676.73
REST OF MAINE (ME)	$654.05	$654.05
DETROIT (MI)	$733.11	$733.11
REST OF MICHIGAN (MI)	$682.86	$682.86
MINNESOTA (MN)	$668.09	$668.09
METROPOLITAN ST. LOUIS (MO)	$687.25	$687.25
METROPOLITAN KANSAS CITY (MO)	$681.67	$681.67
REST OF MISSOURI (MO)	$657.49	$657.49
MISSISSIPPI (MS)	$642.82	$642.82
MONTANA** (MT)	$701.96	$701.96
NORTH CAROLINA (NC)	$659.14	$659.14
NORTH DAKOTA** (ND)	$665.78	$665.78
NEBRASKA (NE)	$640.07	$640.07
NEW HAMPSHIRE (NH)	$707.22	$707.22
NORTHERN NJ (NJ)	$776.85	$776.85
REST OF NEW JERSEY (NJ)	$749.86	$749.86
NEW MEXICO (NM)	$688.51	$688.51
NEVADA** (NV)	$692.19	$692.19
MANHATTAN (NY)	$809.47	$809.47
NYC SUBURBS/LONG ISLAND (NY)	$834.45	$834.45
POUGHKPSIE/N NYC SUBURBS (NY)	$759.35	$759.35
QUEENS (NY)	$806.90	$806.90
REST OF NEW YORK (NY)	$668.35	$668.35
OHIO (OH)	$675.46	$675.46
OKLAHOMA (OK)	$655.11	$655.11
PORTLAND (OR)	$726.30	$726.30
REST OF OREGON (OR)	$682.69	$682.69
METROPOLITAN PHILADELPHIA (PA)	$732.59	$732.59
REST OF PENNSYLVANIA (PA)	$673.17	$673.17
PUERTO RICO (PR)	$704.60	$704.60
RHODE ISLAND (RI)	$712.03	$712.03
SOUTH CAROLINA (SC)	$669.23	$669.23
SOUTH DAKOTA** (SD)	$661.50	$661.50
TENNESSEE (TN)	$645.43	$645.43
BRAZORIA (TX)	$688.47	$688.47
DALLAS (TX)	$695.12	$695.12
GALVESTON (TX)	$692.03	$692.03
HOUSTON (TX)	$725.52	$725.52
BEAUMONT (TX)	$669.70	$669.70
FORT WORTH (TX)	$692.80	$692.80
AUSTIN (TX)	$713.85	$713.85
REST OF TEXAS (TX)	$680.26	$680.26
UTAH (UT)	$677.15	$677.15
VIRGINIA (VA)	$678.82	$678.82
VIRGIN ISLANDS (VI)	$704.60	$704.60
VERMONT (VT)	$668.78	$668.78
SEATTLE (KING CNTY) (WA)	$778.11	$778.11
REST OF WASHINGTON (WA)	$708.28	$708.28
WISCONSIN (WI)	$646.70	$646.70
WEST VIRGINIA (WV)	$687.61	$687.61
WYOMING** (WY)	$686.19	$686.19

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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) — physician work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by a Geographic Practice Cost Index (GPCI) specific to the locality where the service is performed, to reflect local cost differences. The locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor (a dollar-per-RVU rate set each year) to produce the allowed amount. Practice-expense RVUs often differ between non-facility and facility settings because overhead costs differ when a service is performed in a physician's office versus a hospital or ambulatory surgical center; when those RVUs are the same for both settings, the non-facility and facility allowed amounts will be identical.

RVUs — work 9.86, practice expense 9.33 (non-facility) / 9.33 (facility), malpractice 1.83 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment — actual payment can differ.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
GPCI values and the conversion factor are updated periodically; always confirm current-year figures and locality-specific rates with your Medicare Administrative Contractor (MAC).
This page does not constitute coding, billing, or clinical advice.

Frequently asked

Why do the non-facility and facility amounts differ for some codes but not others?

The difference comes from the practice-expense RVU, which accounts for overhead like staff, equipment, and supplies. When a procedure is typically performed only in a facility, or when CMS assigns the same practice-expense value to both settings, the non-facility and facility amounts can end up equal.

Why does the fee amount vary by locality?

Medicare adjusts each RVU component using locality-specific Geographic Practice Cost Indices (GPCIs) to reflect regional differences in wages, rent, and malpractice insurance costs before applying the conversion factor.

Does this amount reflect what the provider will actually be paid?

It reflects the Medicare-allowed amount before adjustments for modifiers, secondary payers, deductibles, coinsurance, and any claim-specific adjustments, so actual payment may differ.

Where can I verify the exact rate for my locality?

Check the current Medicare Physician Fee Schedule lookup tool or contact your Medicare Administrative Contractor (MAC) for the most current, locality-specific rate.

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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.