Medicare Reimbursement for CPT 21470

CPT 21470 is a procedure code reported to Medicare for physician and outpatient billing purposes; the full descriptor is maintained by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and, where applicable, by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1039.44	$1039.44
ALASKA* (AK)	$1311.50	$1311.50
ALABAMA (AL)	$954.48	$954.48
ARKANSAS (AR)	$943.99	$943.99
ARIZONA (AZ)	$1015.26	$1015.26
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1201.47	$1201.47
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1219.89	$1219.89
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1092.86	$1092.86
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1104.17	$1104.17
NAPA (CA)	$1155.07	$1155.07
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1204.37	$1204.37
VALLEJO (CA)	$1150.88	$1150.88
BAKERSFIELD (CA)	$1053.60	$1053.60
CHICO (CA)	$1046.22	$1046.22
FRESNO (CA)	$1046.22	$1046.22
HANFORD-CORCORAN (CA)	$1046.22	$1046.22
MADERA (CA)	$1046.22	$1046.22
MERCED (CA)	$1046.22	$1046.22
MODESTO (CA)	$1046.22	$1046.22
REDDING (CA)	$1046.22	$1046.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1073.89	$1073.89
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1082.71	$1082.71
SALINAS (CA)	$1078.33	$1078.33
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1231.77	$1231.77
SANTA CRUZ-WATSONVILLE (CA)	$1094.05	$1094.05
SANTA ROSA-PETALUMA (CA)	$1104.17	$1104.17
STOCKTON (CA)	$1046.22	$1046.22
VISALIA (CA)	$1046.22	$1046.22
YUBA CITY (CA)	$1046.22	$1046.22
EL CENTRO (CA)	$1046.64	$1046.64
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1092.43	$1092.43
SAN LUIS OBISPO-PASO ROBLES (CA)	$1062.68	$1062.68
SANTA MARIA-SANTA BARBARA (CA)	$1079.29	$1079.29
REST OF CALIFORNIA (CA)	$1046.22	$1046.22
COLORADO (CO)	$1052.06	$1052.06
CONNECTICUT (CT)	$1098.29	$1098.29
DC + MD/VA SUBURBS (DC)	$1148.07	$1148.07
DELAWARE (DE)	$1029.06	$1029.06
FORT LAUDERDALE (FL)	$1113.50	$1113.50
MIAMI (FL)	$1185.87	$1185.87
REST OF FLORIDA (FL)	$1065.60	$1065.60
ATLANTA (GA)	$1064.46	$1064.46
REST OF GEORGIA (GA)	$1014.51	$1014.51
HAWAII, GUAM (HI)	$1055.88	$1055.88
IOWA (IA)	$955.34	$955.34
IDAHO (ID)	$963.75	$963.75
EAST ST. LOUIS (IL)	$1095.52	$1095.52
SUBURBAN CHICAGO (IL)	$1119.78	$1119.78
CHICAGO (IL)	$1156.08	$1156.08
REST OF ILLINOIS (IL)	$1054.27	$1054.27
INDIANA (IN)	$967.54	$967.54
KANSAS (KS)	$960.28	$960.28
KENTUCKY (KY)	$989.68	$989.68
NEW ORLEANS (LA)	$1028.48	$1028.48
REST OF LOUISIANA (LA)	$991.83	$991.83
METROPOLITAN BOSTON (MA)	$1127.71	$1127.71
REST OF MASSACHUSETTS (MA)	$1051.50	$1051.50
BALTIMORE/SURR. CNTYS (MD)	$1096.78	$1096.78
REST OF MARYLAND (MD)	$1042.73	$1042.73
SOUTHERN MAINE (ME)	$1004.44	$1004.44
REST OF MAINE (ME)	$976.49	$976.49
DETROIT (MI)	$1084.70	$1084.70
REST OF MICHIGAN (MI)	$1017.16	$1017.16
MINNESOTA (MN)	$990.34	$990.34
METROPOLITAN ST. LOUIS (MO)	$1021.23	$1021.23
METROPOLITAN KANSAS CITY (MO)	$1014.12	$1014.12
REST OF MISSOURI (MO)	$984.39	$984.39
MISSISSIPPI (MS)	$963.91	$963.91
MONTANA** (MT)	$1039.26	$1039.26
NORTH CAROLINA (NC)	$982.92	$982.92
NORTH DAKOTA** (ND)	$988.65	$988.65
NEBRASKA (NE)	$956.78	$956.78
NEW HAMPSHIRE (NH)	$1044.44	$1044.44
NORTHERN NJ (NJ)	$1142.48	$1142.48
REST OF NEW JERSEY (NJ)	$1105.79	$1105.79
NEW MEXICO (NM)	$1024.85	$1024.85
NEVADA** (NV)	$1025.54	$1025.54
MANHATTAN (NY)	$1188.11	$1188.11
NYC SUBURBS/LONG ISLAND (NY)	$1221.61	$1221.61
POUGHKPSIE/N NYC SUBURBS (NY)	$1119.46	$1119.46
QUEENS (NY)	$1183.45	$1183.45
REST OF NEW YORK (NY)	$994.90	$994.90
OHIO (OH)	$1006.82	$1006.82
OKLAHOMA (OK)	$979.41	$979.41
PORTLAND (OR)	$1069.17	$1069.17
REST OF OREGON (OR)	$1012.51	$1012.51
METROPOLITAN PHILADELPHIA (PA)	$1081.91	$1081.91
REST OF PENNSYLVANIA (PA)	$1003.35	$1003.35
PUERTO RICO (PR)	$1042.36	$1042.36
RHODE ISLAND (RI)	$1053.68	$1053.68
SOUTH CAROLINA (SC)	$997.52	$997.52
SOUTH DAKOTA** (SD)	$982.66	$982.66
TENNESSEE (TN)	$965.01	$965.01
BRAZORIA (TX)	$1021.75	$1021.75
DALLAS (TX)	$1030.90	$1030.90
GALVESTON (TX)	$1026.62	$1026.62
HOUSTON (TX)	$1073.48	$1073.48
BEAUMONT (TX)	$998.92	$998.92
FORT WORTH (TX)	$1028.19	$1028.19
AUSTIN (TX)	$1053.03	$1053.03
REST OF TEXAS (TX)	$1011.62	$1011.62
UTAH (UT)	$1007.75	$1007.75
VIRGINIA (VA)	$1007.79	$1007.79
VIRGIN ISLANDS (VI)	$1042.36	$1042.36
VERMONT (VT)	$993.37	$993.37
SEATTLE (KING CNTY) (WA)	$1139.24	$1139.24
REST OF WASHINGTON (WA)	$1046.71	$1046.71
WISCONSIN (WI)	$964.19	$964.19
WEST VIRGINIA (WV)	$1026.15	$1026.15
WYOMING** (WY)	$1017.20	$1017.20

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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) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs often differ between non-facility (e.g., physician office) and facility (e.g., hospital, ASC) settings because the practice absorbs different overhead costs in each setting; for this code, the practice-expense RVU and resulting allowed amount are shown as the same in both settings. The conversion factor and RVU values are updated annually by CMS and can change due to budget-neutrality adjustments or legislative action.

RVUs — work 17.1, practice expense 11.46 (non-facility) / 11.46 (facility), malpractice 2.56 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This figure is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the beneficiary's deductible is met; the beneficiary 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 budget-neutrality adjustments and conversion factor updates can shift amounts year to year.
Local Medicare Administrative Contractor (MAC) policies and coverage determinations may affect payment; verify current rates with your MAC before billing.

Frequently asked

Why is the non-facility and facility amount the same for this code?

When the practice-expense RVU is identical in both settings, the resulting PFS allowed amount will also be the same, since the other RVU components (work and malpractice) are not setting-dependent.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare-allowed amount before the standard 80/20 split, deductible, modifiers, or any local adjustments are applied.

Why do amounts vary by locality?

GPCIs adjust the work, practice-expense, and malpractice RVUs to reflect differences in local labor, rent, and liability costs, so the same code can price differently across regions.

Where can I find the official CPT descriptor for this code?

CPT descriptors are copyrighted by the American Medical Association; consult your AMA CPT codebook or licensed coding software for the official language.

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.