Medicare Reimbursement for CPT 21502

CPT 21502 is a physician procedure code billed 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, with separate non-facility and facility rate columns.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$511.70	$511.70
ALASKA* (AK)	$620.14	$620.14
ALABAMA (AL)	$459.37	$459.37
ARKANSAS (AR)	$452.96	$452.96
ARIZONA (AZ)	$496.48	$496.48
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$583.20	$583.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$591.69	$591.69
OXNARD-THOUSAND OAKS-VENTURA (CA)	$532.43	$532.43
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$538.37	$538.37
NAPA (CA)	$561.68	$561.68
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$585.30	$585.30
VALLEJO (CA)	$558.66	$558.66
BAKERSFIELD (CA)	$511.80	$511.80
CHICO (CA)	$506.80	$506.80
FRESNO (CA)	$506.80	$506.80
HANFORD-CORCORAN (CA)	$506.80	$506.80
MADERA (CA)	$506.80	$506.80
MERCED (CA)	$506.80	$506.80
MODESTO (CA)	$506.80	$506.80
REDDING (CA)	$506.80	$506.80
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$526.63	$526.63
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$525.15	$525.15
SALINAS (CA)	$523.10	$523.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$600.27	$600.27
SANTA CRUZ-WATSONVILLE (CA)	$532.07	$532.07
SANTA ROSA-PETALUMA (CA)	$536.94	$536.94
STOCKTON (CA)	$506.80	$506.80
VISALIA (CA)	$506.80	$506.80
YUBA CITY (CA)	$506.80	$506.80
EL CENTRO (CA)	$507.11	$507.11
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$530.78	$530.78
SAN LUIS OBISPO-PASO ROBLES (CA)	$515.58	$515.58
SANTA MARIA-SANTA BARBARA (CA)	$523.79	$523.79
REST OF CALIFORNIA (CA)	$506.80	$506.80
COLORADO (CO)	$514.18	$514.18
CONNECTICUT (CT)	$545.31	$545.31
DC + MD/VA SUBURBS (DC)	$568.29	$568.29
DELAWARE (DE)	$504.24	$504.24
FORT LAUDERDALE (FL)	$564.28	$564.28
MIAMI (FL)	$614.55	$614.55
REST OF FLORIDA (FL)	$533.80	$533.80
ATLANTA (GA)	$528.12	$528.12
REST OF GEORGIA (GA)	$501.53	$501.53
HAWAII, GUAM (HI)	$513.65	$513.65
IOWA (IA)	$457.09	$457.09
IDAHO (ID)	$462.81	$462.81
EAST ST. LOUIS (IL)	$558.03	$558.03
SUBURBAN CHICAGO (IL)	$566.64	$566.64
CHICAGO (IL)	$594.46	$594.46
REST OF ILLINOIS (IL)	$528.74	$528.74
INDIANA (IN)	$465.04	$465.04
KANSAS (KS)	$461.46	$461.46
KENTUCKY (KY)	$483.80	$483.80
NEW ORLEANS (LA)	$508.06	$508.06
REST OF LOUISIANA (LA)	$485.64	$485.64
METROPOLITAN BOSTON (MA)	$554.58	$554.58
REST OF MASSACHUSETTS (MA)	$513.91	$513.91
BALTIMORE/SURR. CNTYS (MD)	$545.18	$545.18
REST OF MARYLAND (MD)	$511.54	$511.54
SOUTHERN MAINE (ME)	$487.06	$487.06
REST OF MAINE (ME)	$472.02	$472.02
DETROIT (MI)	$546.95	$546.95
REST OF MICHIGAN (MI)	$501.92	$501.92
MINNESOTA (MN)	$474.12	$474.12
METROPOLITAN ST. LOUIS (MO)	$502.03	$502.03
METROPOLITAN KANSAS CITY (MO)	$497.83	$497.83
REST OF MISSOURI (MO)	$481.93	$481.93
MISSISSIPPI (MS)	$467.21	$467.21
MONTANA** (MT)	$511.58	$511.58
NORTH CAROLINA (NC)	$475.72	$475.72
NORTH DAKOTA** (ND)	$475.00	$475.00
NEBRASKA (NE)	$457.55	$457.55
NEW HAMPSHIRE (NH)	$512.35	$512.35
NORTHERN NJ (NJ)	$564.04	$564.04
REST OF NEW JERSEY (NJ)	$546.30	$546.30
NEW MEXICO (NM)	$507.18	$507.18
NEVADA** (NV)	$501.59	$501.59
MANHATTAN (NY)	$596.71	$596.71
NYC SUBURBS/LONG ISLAND (NY)	$618.96	$618.96
POUGHKPSIE/N NYC SUBURBS (NY)	$555.13	$555.13
QUEENS (NY)	$591.89	$591.89
REST OF NEW YORK (NY)	$483.15	$483.15
OHIO (OH)	$494.44	$494.44
OKLAHOMA (OK)	$476.09	$476.09
PORTLAND (OR)	$522.47	$522.47
REST OF OREGON (OR)	$492.53	$492.53
METROPOLITAN PHILADELPHIA (PA)	$536.42	$536.42
REST OF PENNSYLVANIA (PA)	$491.57	$491.57
PUERTO RICO (PR)	$513.02	$513.02
RHODE ISLAND (RI)	$516.43	$516.43
SOUTH CAROLINA (SC)	$486.92	$486.92
SOUTH DAKOTA** (SD)	$470.67	$470.67
TENNESSEE (TN)	$464.52	$464.52
BRAZORIA (TX)	$498.24	$498.24
DALLAS (TX)	$504.32	$504.32
GALVESTON (TX)	$501.61	$501.61
HOUSTON (TX)	$535.47	$535.47
BEAUMONT (TX)	$488.95	$488.95
FORT WORTH (TX)	$503.09	$503.09
AUSTIN (TX)	$516.99	$516.99
REST OF TEXAS (TX)	$495.30	$495.30
UTAH (UT)	$493.15	$493.15
VIRGINIA (VA)	$490.07	$490.07
VIRGIN ISLANDS (VI)	$513.02	$513.02
VERMONT (VT)	$479.14	$479.14
SEATTLE (KING CNTY) (WA)	$559.01	$559.01
REST OF WASHINGTON (WA)	$510.95	$510.95
WISCONSIN (WI)	$460.37	$460.37
WEST VIRGINIA (WV)	$511.60	$511.60
WYOMING** (WY)	$495.64	$495.64

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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: 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's PFS amount is built from three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, which is why two separate allowed amounts are often shown.

RVUs — work 7.36, practice expense 6.11 (non-facility) / 6.11 (facility), malpractice 1.85 — × 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 the annual Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Rates vary by locality based on GPCI values; always confirm the applicable locality for the place of service.
Verify final payment rules and local coverage determinations with your Medicare Administrative Contractor (MAC).

Frequently asked

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

Facility and non-facility amounts can differ because the practice-expense RVU component accounts for different overhead costs depending on where the service is performed (e.g., physician office versus hospital).

Why might the amount I'm paid differ from the national rate shown here?

The national rate uses an average GPCI; actual payment depends on the GPCI values for your specific Medicare locality, plus any modifiers, sequestration, or annual adjustments applied to the claim.

Does this amount represent what the patient owes?

No. The figure shown is the total Medicare-allowed amount. After the deductible is met, Medicare generally pays 80%, leaving the patient or supplemental insurance responsible for the remaining 20%.

Will this rate change next year?

Yes. The conversion factor, RVUs, and GPCI values are updated annually (and sometimes mid-year), so allowed amounts can change from one year to the next.

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.