Medicare Reimbursement for CPT 21600

CPT 21600 is a physician procedure code reported to Medicare for payment under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, with separate figures for non-facility and facility settings. All figures are estimates derived from published Medicare rate-setting inputs.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$567.82	$567.82
ALASKA* (AK)	$678.75	$678.75
ALABAMA (AL)	$509.06	$509.06
ARKANSAS (AR)	$501.79	$501.79
ARIZONA (AZ)	$551.20	$551.20
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$670.86	$670.86
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$681.64	$681.64
OXNARD-THOUSAND OAKS-VENTURA (CA)	$603.37	$603.37
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$609.02	$609.02
NAPA (CA)	$642.63	$642.63
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$672.76	$672.76
VALLEJO (CA)	$639.88	$639.88
BAKERSFIELD (CA)	$576.79	$576.79
CHICO (CA)	$572.22	$572.22
FRESNO (CA)	$572.22	$572.22
HANFORD-CORCORAN (CA)	$572.22	$572.22
MADERA (CA)	$572.22	$572.22
MERCED (CA)	$572.22	$572.22
MODESTO (CA)	$572.22	$572.22
REDDING (CA)	$572.22	$572.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$590.24	$590.24
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$595.15	$595.15
SALINAS (CA)	$592.87	$592.87
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$689.44	$689.44
SANTA CRUZ-WATSONVILLE (CA)	$605.92	$605.92
SANTA ROSA-PETALUMA (CA)	$611.62	$611.62
STOCKTON (CA)	$572.22	$572.22
VISALIA (CA)	$572.22	$572.22
YUBA CITY (CA)	$572.22	$572.22
EL CENTRO (CA)	$572.50	$572.50
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$603.15	$603.15
SAN LUIS OBISPO-PASO ROBLES (CA)	$584.05	$584.05
SANTA MARIA-SANTA BARBARA (CA)	$594.09	$594.09
REST OF CALIFORNIA (CA)	$572.22	$572.22
COLORADO (CO)	$575.98	$575.98
CONNECTICUT (CT)	$605.52	$605.52
DC + MD/VA SUBURBS (DC)	$635.92	$635.92
DELAWARE (DE)	$560.03	$560.03
FORT LAUDERDALE (FL)	$616.73	$616.73
MIAMI (FL)	$664.90	$664.90
REST OF FLORIDA (FL)	$583.93	$583.93
ATLANTA (GA)	$584.21	$584.21
REST OF GEORGIA (GA)	$548.86	$548.86
HAWAII, GUAM (HI)	$581.90	$581.90
IOWA (IA)	$510.58	$510.58
IDAHO (ID)	$516.23	$516.23
EAST ST. LOUIS (IL)	$602.70	$602.70
SUBURBAN CHICAGO (IL)	$620.22	$620.22
CHICAGO (IL)	$643.51	$643.51
REST OF ILLINOIS (IL)	$575.46	$575.46
INDIANA (IN)	$518.88	$518.88
KANSAS (KS)	$513.56	$513.56
KENTUCKY (KY)	$532.50	$532.50
NEW ORLEANS (LA)	$559.21	$559.21
REST OF LOUISIANA (LA)	$533.81	$533.81
METROPOLITAN BOSTON (MA)	$624.73	$624.73
REST OF MASSACHUSETTS (MA)	$574.79	$574.79
BALTIMORE/SURR. CNTYS (MD)	$604.99	$604.99
REST OF MARYLAND (MD)	$568.88	$568.88
SOUTHERN MAINE (ME)	$544.63	$544.63
REST OF MAINE (ME)	$524.59	$524.59
DETROIT (MI)	$596.68	$596.68
REST OF MICHIGAN (MI)	$551.11	$551.11
MINNESOTA (MN)	$536.29	$536.29
METROPOLITAN ST. LOUIS (MO)	$554.72	$554.72
METROPOLITAN KANSAS CITY (MO)	$549.74	$549.74
REST OF MISSOURI (MO)	$528.38	$528.38
MISSISSIPPI (MS)	$514.91	$514.91
MONTANA** (MT)	$567.70	$567.70
NORTH CAROLINA (NC)	$529.12	$529.12
NORTH DAKOTA** (ND)	$534.48	$534.48
NEBRASKA (NE)	$511.72	$511.72
NEW HAMPSHIRE (NH)	$572.09	$572.09
NORTHERN NJ (NJ)	$630.56	$630.56
REST OF NEW JERSEY (NJ)	$608.04	$608.04
NEW MEXICO (NM)	$556.25	$556.25
NEVADA** (NV)	$558.72	$558.72
MANHATTAN (NY)	$660.42	$660.42
NYC SUBURBS/LONG ISLAND (NY)	$683.06	$683.06
POUGHKPSIE/N NYC SUBURBS (NY)	$616.39	$616.39
QUEENS (NY)	$657.84	$657.84
REST OF NEW YORK (NY)	$537.39	$537.39
OHIO (OH)	$544.32	$544.32
OKLAHOMA (OK)	$525.85	$525.85
PORTLAND (OR)	$587.78	$587.78
REST OF OREGON (OR)	$550.05	$550.05
METROPOLITAN PHILADELPHIA (PA)	$594.19	$594.19
REST OF PENNSYLVANIA (PA)	$542.16	$542.16
PUERTO RICO (PR)	$570.00	$570.00
RHODE ISLAND (RI)	$575.33	$575.33
SOUTH CAROLINA (SC)	$538.48	$538.48
SOUTH DAKOTA** (SD)	$530.56	$530.56
TENNESSEE (TN)	$516.79	$516.79
BRAZORIA (TX)	$554.89	$554.89
DALLAS (TX)	$560.87	$560.87
GALVESTON (TX)	$558.13	$558.13
HOUSTON (TX)	$588.88	$588.88
BEAUMONT (TX)	$539.06	$539.06
FORT WORTH (TX)	$558.85	$558.85
AUSTIN (TX)	$577.85	$577.85
REST OF TEXAS (TX)	$548.34	$548.34
UTAH (UT)	$545.58	$545.58
VIRGINIA (VA)	$546.64	$546.64
VIRGIN ISLANDS (VI)	$570.00	$570.00
VERMONT (VT)	$537.34	$537.34
SEATTLE (KING CNTY) (WA)	$631.85	$631.85
REST OF WASHINGTON (WA)	$572.07	$572.07
WISCONSIN (WI)	$517.43	$517.43
WEST VIRGINIA (WV)	$555.95	$555.95
WYOMING** (WY)	$553.23	$553.23

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 5 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's Physician Fee Schedule amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by that locality's Geographic Practice Cost Indices (GPCIs) to reflect regional cost differences, then 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 the practice-expense RVU is typically higher in non-facility settings (e.g., a physician's own office) where the practice bears more of the overhead, versus facility settings (e.g., hospitals) where the facility is paid separately for overhead. Work and malpractice RVUs generally stay the same across settings, so the facility/non-facility difference is driven mainly by the practice-expense component.

RVUs — work 7.08, practice expense 8.24 (non-facility) / 8.24 (facility), malpractice 1.68 — × 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 their deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, modifiers appended to the claim, mandatory sequestration reductions, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the allowed amount differ by locality?

Medicare applies locality-specific Geographic Practice Cost Indices (GPCIs) to the work, practice-expense, and malpractice RVUs to account for regional differences in costs, so the same code can have different allowed amounts in different areas.

Why are the non-facility and facility amounts different for some codes?

In non-facility settings, the practice-expense RVU is usually higher because the billing physician's practice covers overhead costs; in facility settings, the facility is reimbursed separately, so the physician's practice-expense RVU is typically lower.

Does this amount reflect what I'll actually be paid?

No. This figure is an estimate based on standard PFS inputs. Actual reimbursement can be affected by modifiers, sequestration, secondary payers, and annual Medicare adjustments.

Where do the RVU and conversion factor values come from?

They come from the published Medicare Physician Fee Schedule for the applicable year, which CMS updates annually and which may change due to legislation or budget-neutrality requirements.

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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.