Medicare Reimbursement for CPT 21740

This page covers CPT code 21740, a physician procedure code. It shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount, both nationally and adjusted for your locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$989.67	$989.67
ALASKA* (AK)	$1228.89	$1228.89
ALABAMA (AL)	$893.00	$893.00
ARKANSAS (AR)	$881.28	$881.28
ARIZONA (AZ)	$960.46	$960.46
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1073.40	$1073.40
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1086.71	$1086.71
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1001.20	$1001.20
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1014.82	$1014.82
NAPA (CA)	$1041.88	$1041.88
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1078.30	$1078.30
VALLEJO (CA)	$1034.82	$1034.82
BAKERSFIELD (CA)	$970.51	$970.51
CHICO (CA)	$958.86	$958.86
FRESNO (CA)	$958.86	$958.86
HANFORD-CORCORAN (CA)	$958.86	$958.86
MADERA (CA)	$958.86	$958.86
MERCED (CA)	$958.86	$958.86
MODESTO (CA)	$958.86	$958.86
REDDING (CA)	$958.86	$958.86
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1005.07	$1005.07
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$988.06	$988.06
SALINAS (CA)	$984.10	$984.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1106.72	$1106.72
SANTA CRUZ-WATSONVILLE (CA)	$993.70	$993.70
SANTA ROSA-PETALUMA (CA)	$1002.41	$1002.41
STOCKTON (CA)	$958.86	$958.86
VISALIA (CA)	$958.86	$958.86
YUBA CITY (CA)	$958.86	$958.86
EL CENTRO (CA)	$959.58	$959.58
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$994.52	$994.52
SAN LUIS OBISPO-PASO ROBLES (CA)	$970.62	$970.62
SANTA MARIA-SANTA BARBARA (CA)	$984.30	$984.30
REST OF CALIFORNIA (CA)	$958.86	$958.86
COLORADO (CO)	$982.52	$982.52
CONNECTICUT (CT)	$1052.41	$1052.41
DC + MD/VA SUBURBS (DC)	$1085.52	$1085.52
DELAWARE (DE)	$974.71	$974.71
FORT LAUDERDALE (FL)	$1109.54	$1109.54
MIAMI (FL)	$1221.00	$1221.00
REST OF FLORIDA (FL)	$1050.04	$1050.04
ATLANTA (GA)	$1024.70	$1024.70
REST OF GEORGIA (GA)	$987.76	$987.76
HAWAII, GUAM (HI)	$966.54	$966.54
IOWA (IA)	$879.61	$879.61
IDAHO (ID)	$891.92	$891.92
EAST ST. LOUIS (IL)	$1113.76	$1113.76
SUBURBAN CHICAGO (IL)	$1112.20	$1112.20
CHICAGO (IL)	$1181.47	$1181.47
REST OF ILLINOIS (IL)	$1046.92	$1046.92
INDIANA (IN)	$895.70	$895.70
KANSAS (KS)	$892.00	$892.00
KENTUCKY (KY)	$947.07	$947.07
NEW ORLEANS (LA)	$993.11	$993.11
REST OF LOUISIANA (LA)	$952.16	$952.16
METROPOLITAN BOSTON (MA)	$1050.36	$1050.36
REST OF MASSACHUSETTS (MA)	$984.10	$984.10
BALTIMORE/SURR. CNTYS (MD)	$1052.91	$1052.91
REST OF MARYLAND (MD)	$986.87	$986.87
SOUTHERN MAINE (ME)	$934.09	$934.09
REST OF MAINE (ME)	$913.37	$913.37
DETROIT (MI)	$1078.85	$1078.85
REST OF MICHIGAN (MI)	$984.44	$984.44
MINNESOTA (MN)	$896.26	$896.26
METROPOLITAN ST. LOUIS (MO)	$976.83	$976.83
METROPOLITAN KANSAS CITY (MO)	$969.67	$969.67
REST OF MISSOURI (MO)	$948.18	$948.18
MISSISSIPPI (MS)	$914.07	$914.07
MONTANA** (MT)	$989.38	$989.38
NORTH CAROLINA (NC)	$919.37	$919.37
NORTH DAKOTA** (ND)	$904.16	$904.16
NEBRASKA (NE)	$879.06	$879.06
NEW HAMPSHIRE (NH)	$982.89	$982.89
NORTHERN NJ (NJ)	$1079.27	$1079.27
REST OF NEW JERSEY (NJ)	$1051.69	$1051.69
NEW MEXICO (NM)	$995.90	$995.90
NEVADA** (NV)	$965.90	$965.90
MANHATTAN (NY)	$1154.96	$1154.96
NYC SUBURBS/LONG ISLAND (NY)	$1201.36	$1201.36
POUGHKPSIE/N NYC SUBURBS (NY)	$1071.63	$1071.63
QUEENS (NY)	$1139.70	$1139.70
REST OF NEW YORK (NY)	$933.24	$933.24
OHIO (OH)	$967.02	$967.02
OKLAHOMA (OK)	$928.30	$928.30
PORTLAND (OR)	$992.33	$992.33
REST OF OREGON (OR)	$945.82	$945.82
METROPOLITAN PHILADELPHIA (PA)	$1038.97	$1038.97
REST OF PENNSYLVANIA (PA)	$959.32	$959.32
PUERTO RICO (PR)	$990.52	$990.52
RHODE ISLAND (RI)	$994.02	$994.02
SOUTH CAROLINA (SC)	$947.28	$947.28
SOUTH DAKOTA** (SD)	$894.08	$894.08
TENNESSEE (TN)	$898.12	$898.12
BRAZORIA (TX)	$960.11	$960.11
DALLAS (TX)	$973.28	$973.28
GALVESTON (TX)	$967.57	$967.57
HOUSTON (TX)	$1046.46	$1046.46
BEAUMONT (TX)	$954.83	$954.83
FORT WORTH (TX)	$972.42	$972.42
AUSTIN (TX)	$990.27	$990.27
REST OF TEXAS (TX)	$961.75	$961.75
UTAH (UT)	$958.57	$958.57
VIRGINIA (VA)	$942.69	$942.69
VIRGIN ISLANDS (VI)	$990.52	$990.52
VERMONT (VT)	$915.82	$915.82
SEATTLE (KING CNTY) (WA)	$1054.03	$1054.03
REST OF WASHINGTON (WA)	$977.20	$977.20
WISCONSIN (WI)	$878.56	$878.56
WEST VIRGINIA (WV)	$1015.88	$1015.88
WYOMING** (WY)	$952.24	$952.24

Look up another code or locality →

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) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Practice-expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which is why this code can show different amounts depending on place of service. The conversion factor is set annually by CMS and can change due to legislative or budget-neutrality adjustments.

RVUs — work 17.13, practice expense 8.19 (non-facility) / 8.19 (facility), malpractice 4.31 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on national or locality-level inputs — actual payment can vary.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Always verify current rates and local adjustments with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why does CPT 21740 show different amounts for non-facility and facility settings?

The practice-expense RVU component differs by setting because overhead costs (equipment, staff, supplies) are typically higher when a service is performed outside a facility, which can change the total RVUs and resulting fee.

Why might my locality's fee differ from the national amount shown here?

Medicare applies Geographic Practice Cost Indices (GPCIs) to adjust work, practice expense, and malpractice RVUs for regional cost differences, so the same code can price differently across localities.

Does this amount reflect what Medicare will actually pay?

No — it's an estimate of the allowed amount. Medicare generally pays 80% of this figure after the deductible, and the actual payment can be affected by modifiers, sequestration, and other claim-specific factors.

Will this fee change next year?

Yes, potentially. CMS updates the conversion factor and may revise RVUs annually, so the estimated amount for CPT 21740 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.