Medicare Reimbursement for CPT 21432

This page covers the Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code. Because CPT code descriptors are copyrighted by the AMA, we refer to it generically here rather than reproducing the official description. The figures shown reflect the national PFS rate and how it is adjusted for a specific locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$672.03	$672.03
ALASKA* (AK)	$813.36	$813.36
ALABAMA (AL)	$607.52	$607.52
ARKANSAS (AR)	$599.50	$599.50
ARIZONA (AZ)	$654.10	$654.10
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$804.76	$804.76
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$818.20	$818.20
OXNARD-THOUSAND OAKS-VENTURA (CA)	$720.41	$720.41
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$726.65	$726.65
NAPA (CA)	$769.47	$769.47
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$806.57	$806.57
VALLEJO (CA)	$766.86	$766.86
BAKERSFIELD (CA)	$688.56	$688.56
CHICO (CA)	$684.11	$684.11
FRESNO (CA)	$684.11	$684.11
HANFORD-CORCORAN (CA)	$684.11	$684.11
MADERA (CA)	$684.11	$684.11
MERCED (CA)	$684.11	$684.11
MODESTO (CA)	$684.11	$684.11
REDDING (CA)	$684.11	$684.11
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$701.23	$701.23
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$711.79	$711.79
SALINAS (CA)	$709.02	$709.02
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$825.58	$825.58
SANTA CRUZ-WATSONVILLE (CA)	$724.73	$724.73
SANTA ROSA-PETALUMA (CA)	$731.62	$731.62
STOCKTON (CA)	$684.11	$684.11
VISALIA (CA)	$684.11	$684.11
YUBA CITY (CA)	$684.11	$684.11
EL CENTRO (CA)	$684.37	$684.37
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$721.33	$721.33
SAN LUIS OBISPO-PASO ROBLES (CA)	$698.37	$698.37
SANTA MARIA-SANTA BARBARA (CA)	$710.48	$710.48
REST OF CALIFORNIA (CA)	$684.11	$684.11
COLORADO (CO)	$685.07	$685.07
CONNECTICUT (CT)	$714.46	$714.46
DC + MD/VA SUBURBS (DC)	$752.58	$752.58
DELAWARE (DE)	$664.12	$664.12
FORT LAUDERDALE (FL)	$719.25	$719.25
MIAMI (FL)	$766.83	$766.83
REST OF FLORIDA (FL)	$684.15	$684.15
ATLANTA (GA)	$688.87	$688.87
REST OF GEORGIA (GA)	$646.40	$646.40
HAWAII, GUAM (HI)	$695.11	$695.11
IOWA (IA)	$611.81	$611.81
IDAHO (ID)	$617.50	$617.50
EAST ST. LOUIS (IL)	$699.34	$699.34
SUBURBAN CHICAGO (IL)	$723.99	$723.99
CHICAGO (IL)	$744.47	$744.47
REST OF ILLINOIS (IL)	$673.07	$673.07
INDIANA (IN)	$620.52	$620.52
KANSAS (KS)	$613.84	$613.84
KENTUCKY (KY)	$630.70	$630.70
NEW ORLEANS (LA)	$659.68	$659.68
REST OF LOUISIANA (LA)	$631.65	$631.65
METROPOLITAN BOSTON (MA)	$742.31	$742.31
REST OF MASSACHUSETTS (MA)	$683.42	$683.42
BALTIMORE/SURR. CNTYS (MD)	$713.42	$713.42
REST OF MARYLAND (MD)	$674.52	$674.52
SOUTHERN MAINE (ME)	$649.44	$649.44
REST OF MAINE (ME)	$625.42	$625.42
DETROIT (MI)	$696.85	$696.85
REST OF MICHIGAN (MI)	$650.02	$650.02
MINNESOTA (MN)	$644.26	$644.26
METROPOLITAN ST. LOUIS (MO)	$656.21	$656.21
METROPOLITAN KANSAS CITY (MO)	$650.57	$650.57
REST OF MISSOURI (MO)	$624.87	$624.87
MISSISSIPPI (MS)	$612.06	$612.06
MONTANA** (MT)	$671.92	$671.92
NORTH CAROLINA (NC)	$630.63	$630.63
NORTH DAKOTA** (ND)	$640.48	$640.48
NEBRASKA (NE)	$613.45	$613.45
NEW HAMPSHIRE (NH)	$678.99	$678.99
NORTHERN NJ (NJ)	$746.80	$746.80
REST OF NEW JERSEY (NJ)	$719.18	$719.18
NEW MEXICO (NM)	$655.17	$655.17
NEVADA** (NV)	$663.49	$663.49
MANHATTAN (NY)	$775.26	$775.26
NYC SUBURBS/LONG ISLAND (NY)	$798.61	$798.61
POUGHKPSIE/N NYC SUBURBS (NY)	$727.61	$727.61
QUEENS (NY)	$774.25	$774.25
REST OF NEW YORK (NY)	$639.67	$639.67
OHIO (OH)	$643.60	$643.60
OKLAHOMA (OK)	$624.69	$624.69
PORTLAND (OR)	$699.84	$699.84
REST OF OREGON (OR)	$654.93	$654.93
METROPOLITAN PHILADELPHIA (PA)	$701.04	$701.04
REST OF PENNSYLVANIA (PA)	$641.91	$641.91
PUERTO RICO (PR)	$674.88	$674.88
RHODE ISLAND (RI)	$682.69	$682.69
SOUTH CAROLINA (SC)	$638.85	$638.85
SOUTH DAKOTA** (SD)	$636.76	$636.76
TENNESSEE (TN)	$617.26	$617.26
BRAZORIA (TX)	$659.66	$659.66
DALLAS (TX)	$665.74	$665.74
GALVESTON (TX)	$662.87	$662.87
HOUSTON (TX)	$691.97	$691.97
BEAUMONT (TX)	$638.41	$638.41
FORT WORTH (TX)	$663.12	$663.12
AUSTIN (TX)	$685.78	$685.78
REST OF TEXAS (TX)	$649.96	$649.96
UTAH (UT)	$646.71	$646.71
VIRGINIA (VA)	$650.77	$650.77
VIRGIN ISLANDS (VI)	$674.88	$674.88
VERMONT (VT)	$642.47	$642.47
SEATTLE (KING CNTY) (WA)	$751.96	$751.96
REST OF WASHINGTON (WA)	$680.65	$680.65
WISCONSIN (WI)	$621.35	$621.35
WEST VIRGINIA (WV)	$651.47	$651.47
WYOMING** (WY)	$658.22	$658.22

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) assigned to a code: physician work, practice expense, and malpractice risk. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed, since costs vary by region. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar allowance. Non-facility and facility rates differ because practice-expense RVUs are lower in facility settings, where the facility itself absorbs certain overhead costs.

RVUs — work 8.6, practice expense 9.93 (non-facility) / 9.93 (facility), malpractice 1.59 — × 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 insurer is responsible for the remainder.
Modifiers, place of service, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Rates shown are illustrative; always confirm the current locality-specific rate with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the Medicare payment for this code differ by locality?

Medicare applies Geographic Practice Cost Indices (GPCIs) to the work, practice expense, and malpractice RVUs to reflect regional differences in wages, rent, and other costs, which changes the final allowed amount from one locality to another.

Why is the non-facility amount sometimes different from the facility amount?

The practice-expense RVU is typically higher in non-facility settings because the billing provider bears the overhead costs, whereas in facility settings (like a hospital), some of those costs are billed separately by the facility.

Does this amount reflect what Medicare will actually pay on a claim?

No. It's an estimated allowed amount based on standard PFS inputs. Actual payment can be affected by modifiers, secondary payer coordination, sequestration cuts, and other claim-specific factors.

Where can I verify the exact rate for my locality?

Your Medicare Administrative Contractor (MAC) publishes the finalized, locality-specific fee schedule, which should be used as the authoritative source for billing and appeals.

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.