Medicare Reimbursement for CPT 23921

CPT 23921 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for the code nationally and by locality, broken out by non-facility and facility settings. Because CPT descriptors are licensed by the AMA, the specific procedure description is not reproduced here.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$459.26	$459.26
ALASKA* (AK)	$549.59	$549.59
ALABAMA (AL)	$412.77	$412.77
ARKANSAS (AR)	$407.00	$407.00
ARIZONA (AZ)	$446.27	$446.27
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$549.37	$549.37
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$558.49	$558.49
OXNARD-THOUSAND OAKS-VENTURA (CA)	$491.74	$491.74
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$496.04	$496.04
NAPA (CA)	$525.32	$525.32
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$550.73	$550.73
VALLEJO (CA)	$523.35	$523.35
BAKERSFIELD (CA)	$469.48	$469.48
CHICO (CA)	$466.18	$466.18
FRESNO (CA)	$466.18	$466.18
HANFORD-CORCORAN (CA)	$466.18	$466.18
MADERA (CA)	$466.18	$466.18
MERCED (CA)	$466.18	$466.18
MODESTO (CA)	$466.18	$466.18
REDDING (CA)	$466.18	$466.18
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$479.07	$479.07
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$485.32	$485.32
SALINAS (CA)	$483.46	$483.46
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$564.07	$564.07
SANTA CRUZ-WATSONVILLE (CA)	$494.63	$494.63
SANTA ROSA-PETALUMA (CA)	$499.34	$499.34
STOCKTON (CA)	$466.18	$466.18
VISALIA (CA)	$466.18	$466.18
YUBA CITY (CA)	$466.18	$466.18
EL CENTRO (CA)	$466.38	$466.38
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$492.13	$492.13
SAN LUIS OBISPO-PASO ROBLES (CA)	$476.19	$476.19
SANTA MARIA-SANTA BARBARA (CA)	$484.53	$484.53
REST OF CALIFORNIA (CA)	$466.18	$466.18
COLORADO (CO)	$467.62	$467.62
CONNECTICUT (CT)	$489.33	$489.33
DC + MD/VA SUBURBS (DC)	$515.30	$515.30
DELAWARE (DE)	$453.35	$453.35
FORT LAUDERDALE (FL)	$494.67	$494.67
MIAMI (FL)	$530.09	$530.09
REST OF FLORIDA (FL)	$469.18	$469.18
ATLANTA (GA)	$471.60	$471.60
REST OF GEORGIA (GA)	$441.82	$441.82
HAWAII, GUAM (HI)	$474.28	$474.28
IOWA (IA)	$415.31	$415.31
IDAHO (ID)	$419.52	$419.52
EAST ST. LOUIS (IL)	$481.28	$481.28
SUBURBAN CHICAGO (IL)	$497.80	$497.80
CHICAGO (IL)	$513.64	$513.64
REST OF ILLINOIS (IL)	$461.57	$461.57
INDIANA (IN)	$421.67	$421.67
KANSAS (KS)	$417.03	$417.03
KENTUCKY (KY)	$430.01	$430.01
NEW ORLEANS (LA)	$450.98	$450.98
REST OF LOUISIANA (LA)	$430.81	$430.81
METROPOLITAN BOSTON (MA)	$507.66	$507.66
REST OF MASSACHUSETTS (MA)	$466.45	$466.45
BALTIMORE/SURR. CNTYS (MD)	$488.74	$488.74
REST OF MARYLAND (MD)	$460.63	$460.63
SOUTHERN MAINE (ME)	$442.38	$442.38
REST OF MAINE (ME)	$425.49	$425.49
DETROIT (MI)	$478.61	$478.61
REST OF MICHIGAN (MI)	$444.18	$444.18
MINNESOTA (MN)	$437.80	$437.80
METROPOLITAN ST. LOUIS (MO)	$448.17	$448.17
METROPOLITAN KANSAS CITY (MO)	$444.14	$444.14
REST OF MISSOURI (MO)	$426.09	$426.09
MISSISSIPPI (MS)	$416.44	$416.44
MONTANA** (MT)	$459.18	$459.18
NORTH CAROLINA (NC)	$429.20	$429.20
NORTH DAKOTA** (ND)	$435.45	$435.45
NEBRASKA (NE)	$416.41	$416.41
NEW HAMPSHIRE (NH)	$463.80	$463.80
NORTHERN NJ (NJ)	$510.98	$510.98
REST OF NEW JERSEY (NJ)	$492.02	$492.02
NEW MEXICO (NM)	$448.00	$448.00
NEVADA** (NV)	$452.80	$452.80
MANHATTAN (NY)	$532.39	$532.39
NYC SUBURBS/LONG ISLAND (NY)	$549.54	$549.54
POUGHKPSIE/N NYC SUBURBS (NY)	$498.18	$498.18
QUEENS (NY)	$531.28	$531.28
REST OF NEW YORK (NY)	$435.72	$435.72
OHIO (OH)	$439.33	$439.33
OKLAHOMA (OK)	$425.41	$425.41
PORTLAND (OR)	$477.82	$477.82
REST OF OREGON (OR)	$446.43	$446.43
METROPOLITAN PHILADELPHIA (PA)	$479.90	$479.90
REST OF PENNSYLVANIA (PA)	$437.97	$437.97
PUERTO RICO (PR)	$461.22	$461.22
RHODE ISLAND (RI)	$466.16	$466.16
SOUTH CAROLINA (SC)	$435.56	$435.56
SOUTH DAKOTA** (SD)	$432.65	$432.65
TENNESSEE (TN)	$419.52	$419.52
BRAZORIA (TX)	$449.84	$449.84
DALLAS (TX)	$454.32	$454.32
GALVESTON (TX)	$452.23	$452.23
HOUSTON (TX)	$474.19	$474.19
BEAUMONT (TX)	$435.46	$435.46
FORT WORTH (TX)	$452.51	$452.51
AUSTIN (TX)	$468.57	$468.57
REST OF TEXAS (TX)	$443.50	$443.50
UTAH (UT)	$441.21	$441.21
VIRGINIA (VA)	$443.52	$443.52
VIRGIN ISLANDS (VI)	$461.22	$461.22
VERMONT (VT)	$437.13	$437.13
SEATTLE (KING CNTY) (WA)	$514.09	$514.09
REST OF WASHINGTON (WA)	$464.44	$464.44
WISCONSIN (WI)	$421.75	$421.75
WEST VIRGINIA (WV)	$446.04	$446.04
WYOMING** (WY)	$448.84	$448.84

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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) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the locality where the service is performed. The geographically adjusted RVUs are summed and multiplied by the annual Conversion Factor to produce a dollar amount. Practice-expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts may differ; for this code, the practice-expense RVU is the same in both settings, so the non-facility and facility estimates match. These values update annually and are subject to CMS rulemaking and budget-neutrality adjustments.

RVUs — work 5.58, practice expense 6.97 (non-facility) / 6.97 (facility), malpractice 1.2 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on published 2026 PFS RVUs and conversion factor — actual payment may differ.
Medicare typically pays 80% of the allowed amount after the patient meets their Part B deductible; the beneficiary or secondary payer is generally responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, sequestration, and locality-specific GPCIs can all change the final paid amount.
Annual conversion factor changes and budget-neutrality adjustments can alter amounts from one year to the next.
Always verify the actual allowed amount with your Medicare Administrative Contractor (MAC) or official CMS fee schedule files before billing or appealing a claim.

Frequently asked

Why do the non-facility and facility amounts for this code match?

The practice-expense RVU used in the calculation is the same for both settings for this code, so the geographically adjusted totals — and resulting PFS amounts — come out equal.

Why might my locality's allowed amount differ from the national figure shown?

The national amount uses a GPCI value of 1.0 for all three RVU components, while local amounts apply your Medicare Administrative Contractor's locality-specific GPCIs, which can raise or lower the final figure.

Does this amount reflect what Medicare will actually pay me?

No — it's an estimated allowed amount. Medicare generally reimburses 80% of this figure after the deductible is met, and modifiers, denials, or sequestration can further change the actual payment.

Where can I find the official RVU and conversion factor values used here?

CMS publishes the annual Physician Fee Schedule Final Rule and RVU files, which list the work, practice expense, and malpractice RVUs along with the conversion factor and GPCI tables by locality.

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.