Medicare Reimbursement for CPT 21700

CPT 21700 is a physician procedure code, and its official descriptor cannot be reproduced here due to AMA licensing. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both nationally and adjusted for your locality, and compares non-facility (office) and facility (e.g., hospital) payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$332.34	$332.34
ALASKA* (AK)	$416.34	$416.34
ALABAMA (AL)	$300.27	$300.27
ARKANSAS (AR)	$296.40	$296.40
ARIZONA (AZ)	$322.48	$322.48
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$352.24	$352.24
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$356.24	$356.24
OXNARD-THOUSAND OAKS-VENTURA (CA)	$331.88	$331.88
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$336.77	$336.77
NAPA (CA)	$343.17	$343.17
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$354.02	$354.02
VALLEJO (CA)	$340.60	$340.60
BAKERSFIELD (CA)	$322.89	$322.89
CHICO (CA)	$318.65	$318.65
FRESNO (CA)	$318.65	$318.65
HANFORD-CORCORAN (CA)	$318.65	$318.65
MADERA (CA)	$318.65	$318.65
MERCED (CA)	$318.65	$318.65
MODESTO (CA)	$318.65	$318.65
REDDING (CA)	$318.65	$318.65
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$335.48	$335.48
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$327.54	$327.54
SALINAS (CA)	$326.22	$326.22
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$363.52	$363.52
SANTA CRUZ-WATSONVILLE (CA)	$328.33	$328.33
SANTA ROSA-PETALUMA (CA)	$331.15	$331.15
STOCKTON (CA)	$318.65	$318.65
VISALIA (CA)	$318.65	$318.65
YUBA CITY (CA)	$318.65	$318.65
EL CENTRO (CA)	$318.91	$318.91
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$329.08	$329.08
SAN LUIS OBISPO-PASO ROBLES (CA)	$321.85	$321.85
SANTA MARIA-SANTA BARBARA (CA)	$326.12	$326.12
REST OF CALIFORNIA (CA)	$318.65	$318.65
COLORADO (CO)	$328.09	$328.09
CONNECTICUT (CT)	$353.19	$353.19
DC + MD/VA SUBURBS (DC)	$362.62	$362.62
DELAWARE (DE)	$327.18	$327.18
FORT LAUDERDALE (FL)	$375.68	$375.68
MIAMI (FL)	$415.57	$415.57
REST OF FLORIDA (FL)	$355.44	$355.44
ATLANTA (GA)	$344.69	$344.69
REST OF GEORGIA (GA)	$334.36	$334.36
HAWAII, GUAM (HI)	$320.47	$320.47
IOWA (IA)	$294.39	$294.39
IDAHO (ID)	$298.74	$298.74
EAST ST. LOUIS (IL)	$379.55	$379.55
SUBURBAN CHICAGO (IL)	$376.27	$376.27
CHICAGO (IL)	$402.06	$402.06
REST OF ILLINOIS (IL)	$355.38	$355.38
INDIANA (IN)	$299.95	$299.95
KANSAS (KS)	$299.18	$299.18
KENTUCKY (KY)	$319.61	$319.61
NEW ORLEANS (LA)	$335.08	$335.08
REST OF LOUISIANA (LA)	$321.57	$321.57
METROPOLITAN BOSTON (MA)	$349.44	$349.44
REST OF MASSACHUSETTS (MA)	$328.93	$328.93
BALTIMORE/SURR. CNTYS (MD)	$353.49	$353.49
REST OF MARYLAND (MD)	$330.99	$330.99
SOUTHERN MAINE (ME)	$312.32	$312.32
REST OF MAINE (ME)	$306.56	$306.56
DETROIT (MI)	$365.71	$365.71
REST OF MICHIGAN (MI)	$332.62	$332.62
MINNESOTA (MN)	$297.58	$297.58
METROPOLITAN ST. LOUIS (MO)	$328.87	$328.87
METROPOLITAN KANSAS CITY (MO)	$326.59	$326.59
REST OF MISSOURI (MO)	$320.70	$320.70
MISSISSIPPI (MS)	$308.30	$308.30
MONTANA** (MT)	$332.23	$332.23
NORTH CAROLINA (NC)	$308.42	$308.42
NORTH DAKOTA** (ND)	$301.19	$301.19
NEBRASKA (NE)	$293.99	$293.99
NEW HAMPSHIRE (NH)	$328.84	$328.84
NORTHERN NJ (NJ)	$360.76	$360.76
REST OF NEW JERSEY (NJ)	$352.49	$352.49
NEW MEXICO (NM)	$336.70	$336.70
NEVADA** (NV)	$323.66	$323.66
MANHATTAN (NY)	$388.28	$388.28
NYC SUBURBS/LONG ISLAND (NY)	$404.50	$404.50
POUGHKPSIE/N NYC SUBURBS (NY)	$359.67	$359.67
QUEENS (NY)	$382.22	$382.22
REST OF NEW YORK (NY)	$313.04	$313.04
OHIO (OH)	$326.28	$326.28
OKLAHOMA (OK)	$312.68	$312.68
PORTLAND (OR)	$330.47	$330.47
REST OF OREGON (OR)	$316.47	$316.47
METROPOLITAN PHILADELPHIA (PA)	$349.21	$349.21
REST OF PENNSYLVANIA (PA)	$323.35	$323.35
PUERTO RICO (PR)	$332.37	$332.37
RHODE ISLAND (RI)	$333.04	$333.04
SOUTH CAROLINA (SC)	$318.81	$318.81
SOUTH DAKOTA** (SD)	$297.52	$297.52
TENNESSEE (TN)	$301.28	$301.28
BRAZORIA (TX)	$321.78	$321.78
DALLAS (TX)	$326.44	$326.44
GALVESTON (TX)	$324.44	$324.44
HOUSTON (TX)	$353.18	$353.18
BEAUMONT (TX)	$321.91	$321.91
FORT WORTH (TX)	$326.38	$326.38
AUSTIN (TX)	$331.09	$331.09
REST OF TEXAS (TX)	$323.45	$323.45
UTAH (UT)	$322.52	$322.52
VIRGINIA (VA)	$315.66	$315.66
VIRGIN ISLANDS (VI)	$332.37	$332.37
VERMONT (VT)	$305.69	$305.69
SEATTLE (KING CNTY) (WA)	$349.92	$349.92
REST OF WASHINGTON (WA)	$326.42	$326.42
WISCONSIN (WI)	$292.92	$292.92
WEST VIRGINIA (WV)	$345.18	$345.18
WYOMING** (WY)	$318.70	$318.70

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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 risk. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs typically differ between non-facility (e.g., physician office) and facility (e.g., hospital, ASC) settings because overhead costs differ, which can cause the allowed amount to vary by place of service. The result is the Medicare-approved amount before patient cost-sharing is applied.

RVUs — work 6.15, practice expense 2.23 (non-facility) / 2.23 (facility), malpractice 1.57 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only — actual payment can differ based on your specific Medicare Administrative Contractor (MAC), locality, and claim details.
Medicare typically pays 80% of the allowed amount after the patient's annual Part B deductible is met; the patient or secondary insurance is responsible for the remainder.
Modifiers (e.g., bilateral, multiple procedure, assistant surgeon), sequestration, and annual budget-neutrality adjustments can increase or decrease the final paid amount.
Fee schedule amounts update annually and can also change mid-year due to legislation; always confirm current rates with your MAC before billing or appealing a denial.

Frequently asked

Why does the non-facility amount sometimes differ from the facility amount?

The practice-expense RVU component reflects overhead costs, which are generally higher when a physician's office bears the cost of supplies/staff (non-facility) versus when a hospital or ASC bears those costs (facility). When PE RVUs are the same for both settings, the allowed amounts will match.

Is this the amount my practice will actually be paid?

No — this is the Medicare PFS allowed amount estimate. Actual payment depends on your locality GPCIs, any applicable modifiers, secondary payer coordination, sequestration, and whether the deductible has been met.

Why can't you show the CPT code description?

CPT codes and their official descriptors are copyrighted and licensed by the American Medical Association (AMA), so third-party tools cannot republish the descriptive text without a separate license.

What should I do if my remittance amount doesn't match this estimate?

Check for applied modifiers, correct place-of-service coding, sequestration reductions, and your specific locality GPCIs, then contact your MAC for a claim-specific explanation.

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.