Medicare Reimbursement for CPT 24065
CPT 24065 is a procedure code billed under Medicare Part B. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both at the national level and adjusted by locality, and separately for non-facility (e.g., office) and facility (e.g., hospital) settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $262.20 | $148.63 |
| ALASKA* (AK) | $304.65 | $183.71 |
| ALABAMA (AL) | $235.22 | $135.85 |
| ARKANSAS (AR) | $231.81 | $134.26 |
| ARIZONA (AZ) | $255.17 | $145.12 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $338.60 | $178.48 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $345.25 | $181.49 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $293.99 | $159.76 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $295.46 | $161.11 |
| NAPA (CA) | $320.28 | $170.61 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $338.92 | $178.80 |
| VALLEJO (CA) | $319.83 | $170.15 |
| BAKERSFIELD (CA) | $277.46 | $153.00 |
| CHICO (CA) | $276.64 | $152.18 |
| FRESNO (CA) | $276.64 | $152.18 |
| HANFORD-CORCORAN (CA) | $276.64 | $152.18 |
| MADERA (CA) | $276.64 | $152.18 |
| MERCED (CA) | $276.64 | $152.18 |
| MODESTO (CA) | $276.64 | $152.18 |
| REDDING (CA) | $276.64 | $152.18 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $279.68 | $155.21 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $290.25 | $158.17 |
| SALINAS (CA) | $289.17 | $157.55 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $346.55 | $182.79 |
| SANTA CRUZ-WATSONVILLE (CA) | $298.74 | $160.76 |
| SANTA ROSA-PETALUMA (CA) | $301.75 | $162.29 |
| STOCKTON (CA) | $276.64 | $152.18 |
| VISALIA (CA) | $276.64 | $152.18 |
| YUBA CITY (CA) | $276.64 | $152.18 |
| EL CENTRO (CA) | $276.69 | $152.22 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $295.94 | $160.12 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $284.53 | $155.18 |
| SANTA MARIA-SANTA BARBARA (CA) | $290.24 | $157.83 |
| REST OF CALIFORNIA (CA) | $276.64 | $152.18 |
| COLORADO (CO) | $272.72 | $151.89 |
| CONNECTICUT (CT) | $279.67 | $157.36 |
| DC + MD/VA SUBURBS (DC) | $299.65 | $165.87 |
| DELAWARE (DE) | $259.40 | $147.20 |
| FORT LAUDERDALE (FL) | $272.14 | $157.10 |
| MIAMI (FL) | $284.01 | $165.80 |
| REST OF FLORIDA (FL) | $258.83 | $150.27 |
| ATLANTA (GA) | $267.22 | $151.84 |
| REST OF GEORGIA (GA) | $244.19 | $142.89 |
| HAWAII, GUAM (HI) | $283.38 | $154.26 |
| IOWA (IA) | $240.97 | $137.06 |
| IDAHO (ID) | $242.60 | $138.12 |
| EAST ST. LOUIS (IL) | $257.01 | $152.53 |
| SUBURBAN CHICAGO (IL) | $274.85 | $158.23 |
| CHICAGO (IL) | $275.71 | $161.58 |
| REST OF ILLINOIS (IL) | $251.51 | $147.83 |
| INDIANA (IN) | $244.00 | $138.73 |
| KANSAS (KS) | $239.95 | $137.29 |
| KENTUCKY (KY) | $241.05 | $140.09 |
| NEW ORLEANS (LA) | $252.65 | $145.79 |
| REST OF LOUISIANA (LA) | $240.72 | $140.21 |
| METROPOLITAN BOSTON (MA) | $299.59 | $164.00 |
| REST OF MASSACHUSETTS (MA) | $271.13 | $151.55 |
| BALTIMORE/SURR. CNTYS (MD) | $278.91 | $157.06 |
| REST OF MARYLAND (MD) | $264.33 | $149.40 |
| SOUTHERN MAINE (ME) | $257.10 | $144.55 |
| REST OF MAINE (ME) | $243.99 | $139.51 |
| DETROIT (MI) | $262.19 | $152.61 |
| REST OF MICHIGAN (MI) | $247.45 | $143.77 |
| MINNESOTA (MN) | $260.93 | $144.07 |
| METROPOLITAN ST. LOUIS (MO) | $253.41 | $145.30 |
| METROPOLITAN KANSAS CITY (MO) | $250.80 | $144.16 |
| REST OF MISSOURI (MO) | $236.65 | $138.76 |
| MISSISSIPPI (MS) | $234.27 | $136.49 |
| MONTANA** (MT) | $262.18 | $148.62 |
| NORTH CAROLINA (NC) | $246.54 | $140.58 |
| NORTH DAKOTA** (ND) | $256.64 | $143.08 |
| NEBRASKA (NE) | $242.26 | $137.44 |
| NEW HAMPSHIRE (NH) | $268.55 | $150.33 |
| NORTHERN NJ (NJ) | $296.55 | $164.82 |
| REST OF NEW JERSEY (NJ) | $282.75 | $158.74 |
| NEW MEXICO (NM) | $248.86 | $144.72 |
| NEVADA** (NV) | $260.82 | $147.14 |
| MANHATTAN (NY) | $301.83 | $169.87 |
| NYC SUBURBS/LONG ISLAND (NY) | $309.32 | $174.29 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $284.71 | $160.36 |
| QUEENS (NY) | $304.15 | $169.92 |
| REST OF NEW YORK (NY) | $250.25 | $142.37 |
| OHIO (OH) | $246.32 | $142.64 |
| OKLAHOMA (OK) | $240.49 | $139.08 |
| PORTLAND (OR) | $281.27 | $155.10 |
| REST OF OREGON (OR) | $258.69 | $145.58 |
| METROPOLITAN PHILADELPHIA (PA) | $272.77 | $154.55 |
| REST OF PENNSYLVANIA (PA) | $246.65 | $142.40 |
| PUERTO RICO (PR) | $264.07 | $149.26 |
| RHODE ISLAND (RI) | $268.56 | $151.25 |
| SOUTH CAROLINA (SC) | $246.86 | $141.93 |
| SOUTH DAKOTA** (SD) | $255.99 | $142.42 |
| TENNESSEE (TN) | $241.18 | $137.95 |
| BRAZORIA (TX) | $259.05 | $146.50 |
| DALLAS (TX) | $260.76 | $147.65 |
| GALVESTON (TX) | $259.86 | $147.09 |
| HOUSTON (TX) | $264.99 | $152.22 |
| BEAUMONT (TX) | $245.03 | $141.69 |
| FORT WORTH (TX) | $259.05 | $147.08 |
| AUSTIN (TX) | $271.91 | $151.76 |
| REST OF TEXAS (TX) | $251.94 | $144.17 |
| UTAH (UT) | $250.24 | $143.49 |
| VIRGINIA (VA) | $256.33 | $144.70 |
| VIRGIN ISLANDS (VI) | $264.07 | $149.26 |
| VERMONT (VT) | $255.74 | $143.32 |
| SEATTLE (KING CNTY) (WA) | $305.58 | $166.24 |
| REST OF WASHINGTON (WA) | $270.58 | $151.00 |
| WISCONSIN (WI) | $248.02 | $139.23 |
| WEST VIRGINIA (WV) | $242.21 | $143.52 |
| WYOMING** (WY) | $259.77 | $146.20 |
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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 pricing is based on three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice expense RVUs differ between non-facility and facility settings because facilities (like hospitals) absorb some overhead costs that would otherwise be billed by the physician's office.
RVUs — work 2.08, practice expense 5.49 (non-facility) / 2.09 (facility), malpractice 0.28 — × 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 annual Part B deductible is met; the patient or secondary insurance is responsible for the remainder.
- Actual payment can vary by locality, applicable modifiers, claim-specific adjustments, sequestration, and annual budget-neutrality adjustments to RVUs or the conversion factor.
- Always verify the exact allowed amount and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.
Frequently asked
Why does the facility amount differ from the non-facility amount for this code?
The practice expense RVU is lower in the facility setting because the facility, not the billing physician, incurs most of the overhead and supply costs for the service.
Does this amount reflect what Medicare actually paid on a specific claim?
No. This is a calculated estimate based on current RVUs, GPCIs, and the conversion factor. Actual claim payment can differ due to modifiers, place of service, deductible status, and other adjustments.
Why might the amount change from one year to the next?
RVUs, GPCIs, and the conversion factor are all updated annually by CMS, and budget-neutrality adjustments can shift relative values even if the code itself hasn't changed.
Can I use this figure to predict patient responsibility?
It can provide a rough estimate, but actual patient responsibility depends on deductible status, secondary coverage, and any applicable modifiers or site-of-service differentials.
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.
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