Medicare Reimbursement for CPT 21933

CPT 21933 is a surgical procedure code reported to Medicare for physician and outpatient billing. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$700.08	$700.08
ALASKA* (AK)	$857.91	$857.91
ALABAMA (AL)	$630.63	$630.63
ARKANSAS (AR)	$622.14	$622.14
ARIZONA (AZ)	$679.65	$679.65
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$786.11	$786.11
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$797.06	$797.06
OXNARD-THOUSAND OAKS-VENTURA (CA)	$722.40	$722.40
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$730.97	$730.97
NAPA (CA)	$758.87	$758.87
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$789.10	$789.10
VALLEJO (CA)	$754.55	$754.55
BAKERSFIELD (CA)	$696.44	$696.44
CHICO (CA)	$689.28	$689.28
FRESNO (CA)	$689.28	$689.28
HANFORD-CORCORAN (CA)	$689.28	$689.28
MADERA (CA)	$689.28	$689.28
MERCED (CA)	$689.28	$689.28
MODESTO (CA)	$689.28	$689.28
REDDING (CA)	$689.28	$689.28
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$717.60	$717.60
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$712.88	$712.88
SALINAS (CA)	$710.07	$710.07
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$809.31	$809.31
SANTA CRUZ-WATSONVILLE (CA)	$720.42	$720.42
SANTA ROSA-PETALUMA (CA)	$726.93	$726.93
STOCKTON (CA)	$689.28	$689.28
VISALIA (CA)	$689.28	$689.28
YUBA CITY (CA)	$689.28	$689.28
EL CENTRO (CA)	$689.72	$689.72
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$719.47	$719.47
SAN LUIS OBISPO-PASO ROBLES (CA)	$700.01	$700.01
SANTA MARIA-SANTA BARBARA (CA)	$710.73	$710.73
REST OF CALIFORNIA (CA)	$689.28	$689.28
COLORADO (CO)	$701.09	$701.09
CONNECTICUT (CT)	$745.06	$745.06
DC + MD/VA SUBURBS (DC)	$774.03	$774.03
DELAWARE (DE)	$689.99	$689.99
FORT LAUDERDALE (FL)	$774.57	$774.57
MIAMI (FL)	$845.14	$845.14
REST OF FLORIDA (FL)	$733.46	$733.46
ATLANTA (GA)	$722.89	$722.89
REST OF GEORGIA (GA)	$690.07	$690.07
HAWAII, GUAM (HI)	$697.14	$697.14
IOWA (IA)	$625.70	$625.70
IDAHO (ID)	$633.65	$633.65
EAST ST. LOUIS (IL)	$769.54	$769.54
SUBURBAN CHICAGO (IL)	$777.43	$777.43
CHICAGO (IL)	$818.06	$818.06
REST OF ILLINOIS (IL)	$728.02	$728.02
INDIANA (IN)	$636.55	$636.55
KANSAS (KS)	$632.39	$632.39
KENTUCKY (KY)	$664.89	$664.89
NEW ORLEANS (LA)	$697.35	$697.35
REST OF LOUISIANA (LA)	$667.69	$667.69
METROPOLITAN BOSTON (MA)	$753.65	$753.65
REST OF MASSACHUSETTS (MA)	$701.20	$701.20
BALTIMORE/SURR. CNTYS (MD)	$744.99	$744.99
REST OF MARYLAND (MD)	$699.47	$699.47
SOUTHERN MAINE (ME)	$665.30	$665.30
REST OF MAINE (ME)	$646.79	$646.79
DETROIT (MI)	$751.84	$751.84
REST OF MICHIGAN (MI)	$689.75	$689.75
MINNESOTA (MN)	$645.24	$645.24
METROPOLITAN ST. LOUIS (MO)	$688.28	$688.28
METROPOLITAN KANSAS CITY (MO)	$682.83	$682.83
REST OF MISSOURI (MO)	$663.36	$663.36
MISSISSIPPI (MS)	$642.39	$642.39
MONTANA** (MT)	$699.91	$699.91
NORTH CAROLINA (NC)	$651.53	$651.53
NORTH DAKOTA** (ND)	$647.70	$647.70
NEBRASKA (NE)	$626.02	$626.02
NEW HAMPSHIRE (NH)	$699.29	$699.29
NORTHERN NJ (NJ)	$768.83	$768.83
REST OF NEW JERSEY (NJ)	$746.09	$746.09
NEW MEXICO (NM)	$697.10	$697.10
NEVADA** (NV)	$685.61	$685.61
MANHATTAN (NY)	$815.37	$815.37
NYC SUBURBS/LONG ISLAND (NY)	$846.00	$846.00
POUGHKPSIE/N NYC SUBURBS (NY)	$758.61	$758.61
QUEENS (NY)	$807.66	$807.66
REST OF NEW YORK (NY)	$661.42	$661.42
OHIO (OH)	$679.08	$679.08
OKLAHOMA (OK)	$653.72	$653.72
PORTLAND (OR)	$711.00	$711.00
REST OF OREGON (OR)	$672.90	$672.90
METROPOLITAN PHILADELPHIA (PA)	$733.85	$733.85
REST OF PENNSYLVANIA (PA)	$674.77	$674.77
PUERTO RICO (PR)	$701.50	$701.50
RHODE ISLAND (RI)	$705.68	$705.68
SOUTH CAROLINA (SC)	$667.89	$667.89
SOUTH DAKOTA** (SD)	$641.53	$641.53
TENNESSEE (TN)	$636.55	$636.55
BRAZORIA (TX)	$681.34	$681.34
DALLAS (TX)	$689.83	$689.83
GALVESTON (TX)	$686.07	$686.07
HOUSTON (TX)	$734.39	$734.39
BEAUMONT (TX)	$671.37	$671.37
FORT WORTH (TX)	$688.48	$688.48
AUSTIN (TX)	$705.23	$705.23
REST OF TEXAS (TX)	$678.80	$678.80
UTAH (UT)	$676.12	$676.12
VIRGINIA (VA)	$669.92	$669.92
VIRGIN ISLANDS (VI)	$701.50	$701.50
VERMONT (VT)	$654.03	$654.03
SEATTLE (KING CNTY) (WA)	$758.70	$758.70
REST OF WASHINGTON (WA)	$696.94	$696.94
WISCONSIN (WI)	$628.58	$628.58
WEST VIRGINIA (WV)	$705.40	$705.40
WYOMING** (WY)	$677.16	$677.16

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost-of-living and labor differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs typically differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings because overhead costs differ, which is why this code may show different amounts depending on place of service.

RVUs — work 10.85, practice expense 7.47 (non-facility) / 7.47 (facility), malpractice 2.64 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount is an estimate only and 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 due to GPCI differences; confirm the exact locality mapping with your Medicare Administrative Contractor (MAC).
Fee schedule values are updated annually and may be revised mid-year by CMS correction notices.

Frequently asked

Why does the non-facility amount differ from the facility amount for this code?

The two settings use different practice-expense RVUs because the physician incurs more direct overhead (staff, supplies, equipment) in a non-facility setting like an office, whereas in a facility setting the facility itself bills separately for those overhead costs.

Why does the allowed amount change by locality?

Medicare applies Geographic Practice Cost Indices (GPCIs) to the work, practice expense, and malpractice RVUs to reflect regional differences in wages, rents, and malpractice insurance costs, which changes the final dollar amount by locality.

Is this the amount my practice will actually be paid?

No. This is an estimate based on standard PFS methodology. Actual payment depends on the patient's specific plan, deductible status, applicable modifiers, secondary payer rules, and any sequestration or budget-neutrality adjustments in effect.

Where can I verify the exact rate for my locality?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules, and you can also cross-reference CMS's official Physician Fee Schedule Look-Up Tool.

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.