Medicare Reimbursement for CPT Code 21440

CPT code 21440 is a physician procedure code reported under Medicare Part B. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both nationally and adjusted by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$794.27	$601.55
ALASKA* (AK)	$886.33	$681.08
ALABAMA (AL)	$704.02	$535.39
ARKANSAS (AR)	$692.54	$526.99
ARIZONA (AZ)	$771.31	$584.56
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1068.89	$797.15
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1091.44	$813.53
OXNARD-THOUSAND OAKS-VENTURA (CA)	$912.64	$684.84
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$915.42	$687.42
NAPA (CA)	$1005.33	$751.32
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1069.43	$797.69
VALLEJO (CA)	$1004.55	$750.54
BAKERSFIELD (CA)	$854.10	$642.88
CHICO (CA)	$852.71	$641.48
FRESNO (CA)	$852.71	$641.48
HANFORD-CORCORAN (CA)	$852.71	$641.48
MADERA (CA)	$852.71	$641.48
MERCED (CA)	$852.71	$641.48
MODESTO (CA)	$852.71	$641.48
REDDING (CA)	$852.71	$641.48
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$857.90	$646.68
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$899.48	$675.34
SALINAS (CA)	$896.25	$672.89
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1093.67	$815.76
SANTA CRUZ-WATSONVILLE (CA)	$932.45	$698.29
SANTA ROSA-PETALUMA (CA)	$942.12	$705.45
STOCKTON (CA)	$852.71	$641.48
VISALIA (CA)	$852.71	$641.48
YUBA CITY (CA)	$852.71	$641.48
EL CENTRO (CA)	$852.79	$641.56
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$920.89	$690.39
SAN LUIS OBISPO-PASO ROBLES (CA)	$881.36	$661.85
SANTA MARIA-SANTA BARBARA (CA)	$900.58	$675.87
REST OF CALIFORNIA (CA)	$852.71	$641.48
COLORADO (CO)	$834.75	$629.69
CONNECTICUT (CT)	$851.19	$643.62
DC + MD/VA SUBURBS (DC)	$920.74	$693.71
DELAWARE (DE)	$785.22	$594.81
FORT LAUDERDALE (FL)	$815.89	$620.66
MIAMI (FL)	$846.11	$645.48
REST OF FLORIDA (FL)	$773.02	$588.78
ATLANTA (GA)	$808.49	$612.69
REST OF GEORGIA (GA)	$725.39	$553.48
HAWAII, GUAM (HI)	$878.81	$659.69
IOWA (IA)	$727.97	$551.62
IDAHO (ID)	$732.52	$555.21
EAST ST. LOUIS (IL)	$757.22	$579.92
SUBURBAN CHICAGO (IL)	$825.43	$627.50
CHICAGO (IL)	$819.15	$625.46
REST OF ILLINOIS (IL)	$745.33	$569.37
INDIANA (IN)	$737.39	$558.73
KANSAS (KS)	$722.35	$548.13
KENTUCKY (KY)	$718.95	$547.62
NEW ORLEANS (LA)	$757.14	$575.79
REST OF LOUISIANA (LA)	$716.97	$546.41
METROPOLITAN BOSTON (MA)	$926.37	$696.26
REST OF MASSACHUSETTS (MA)	$828.13	$625.19
BALTIMORE/SURR. CNTYS (MD)	$848.51	$641.71
REST OF MARYLAND (MD)	$802.07	$607.04
SOUTHERN MAINE (ME)	$782.36	$591.37
REST OF MAINE (ME)	$734.91	$557.60
DETROIT (MI)	$781.95	$595.97
REST OF MICHIGAN (MI)	$738.37	$562.41
MINNESOTA (MN)	$802.31	$604.00
METROPOLITAN ST. LOUIS (MO)	$762.32	$578.85
METROPOLITAN KANSAS CITY (MO)	$753.26	$572.29
REST OF MISSOURI (MO)	$701.90	$535.77
MISSISSIPPI (MS)	$697.47	$531.53
MONTANA** (MT)	$794.24	$601.52
NORTH CAROLINA (NC)	$743.84	$564.03
NORTH DAKOTA** (ND)	$784.75	$592.03
NEBRASKA (NE)	$732.99	$555.11
NEW HAMPSHIRE (NH)	$819.59	$618.96
NORTHERN NJ (NJ)	$909.03	$685.47
REST OF NEW JERSEY (NJ)	$861.61	$651.15
NEW MEXICO (NM)	$742.19	$565.46
NEVADA** (NV)	$792.26	$599.35
MANHATTAN (NY)	$918.78	$694.83
NYC SUBURBS/LONG ISLAND (NY)	$941.11	$711.97
POUGHKPSIE/N NYC SUBURBS (NY)	$865.98	$654.95
QUEENS (NY)	$929.80	$702.00
REST OF NEW YORK (NY)	$756.19	$573.11
OHIO (OH)	$736.43	$560.47
OKLAHOMA (OK)	$719.40	$547.30
PORTLAND (OR)	$865.92	$651.81
REST OF OREGON (OR)	$786.85	$594.89
METROPOLITAN PHILADELPHIA (PA)	$826.70	$626.08
REST OF PENNSYLVANIA (PA)	$738.75	$561.83
PUERTO RICO (PR)	$801.36	$606.52
RHODE ISLAND (RI)	$816.66	$617.57
SOUTH CAROLINA (SC)	$741.23	$563.15
SOUTH DAKOTA** (SD)	$783.63	$590.90
TENNESSEE (TN)	$726.21	$551.03
BRAZORIA (TX)	$785.64	$594.66
DALLAS (TX)	$790.34	$598.39
GALVESTON (TX)	$787.75	$596.37
HOUSTON (TX)	$796.53	$605.16
BEAUMONT (TX)	$733.16	$557.79
FORT WORTH (TX)	$783.88	$593.86
AUSTIN (TX)	$831.32	$627.42
REST OF TEXAS (TX)	$758.73	$575.84
UTAH (UT)	$752.66	$571.50
VIRGINIA (VA)	$778.23	$588.79
VIRGIN ISLANDS (VI)	$801.36	$606.52
VERMONT (VT)	$779.69	$588.89
SEATTLE (KING CNTY) (WA)	$948.20	$711.72
REST OF WASHINGTON (WA)	$827.21	$624.28
WISCONSIN (WI)	$755.19	$570.56
WEST VIRGINIA (WV)	$713.89	$546.42
WYOMING** (WY)	$790.10	$597.38

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 units per patient per day — Date of Service Edit: Clinical. 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 PFS amounts are 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 a dollar allowed amount. Practice-expense RVUs differ between non-facility and facility settings because overhead costs (equipment, supplies, staff) are treated differently depending on where the service is furnished.

RVUs — work 3.35, practice expense 19.95 (non-facility) / 14.18 (facility), malpractice 0.48 — × 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 beneficiary or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Amounts shown use the conversion factor and GPCIs in effect for the stated year and may change in future rulemaking.
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 non-facility and facility settings?

The practice-expense RVU is lower in the facility setting because the facility (e.g., hospital) separately bills for overhead, equipment, and supplies, whereas in a non-facility setting the physician's practice absorbs those costs.

Why does the amount change by locality?

Each Medicare locality has its own GPCI values for work, practice expense, and malpractice, reflecting local wage and cost differences, which are applied to the RVUs before the conversion factor is applied.

Does this amount represent what Medicare actually pays?

No. It represents the estimated Medicare-allowed amount before the standard 80/20 cost-sharing split, deductible application, and any applicable modifiers or adjustments.

Why can't you show the CPT code description?

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

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.