Medicare Reimbursement for CPT Code 24100

CPT code 24100 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both at the national level and adjusted for locality, in non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$411.17	$411.17
ALASKA* (AK)	$491.30	$491.30
ALABAMA (AL)	$369.35	$369.35
ARKANSAS (AR)	$364.16	$364.16
ARIZONA (AZ)	$399.50	$399.50
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$492.56	$492.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$500.77	$500.77
OXNARD-THOUSAND OAKS-VENTURA (CA)	$440.61	$440.61
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$444.43	$444.43
NAPA (CA)	$470.89	$470.89
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$493.78	$493.78
VALLEJO (CA)	$469.14	$469.14
BAKERSFIELD (CA)	$420.53	$420.53
CHICO (CA)	$417.59	$417.59
FRESNO (CA)	$417.59	$417.59
HANFORD-CORCORAN (CA)	$417.59	$417.59
MADERA (CA)	$417.59	$417.59
MERCED (CA)	$417.59	$417.59
MODESTO (CA)	$417.59	$417.59
REDDING (CA)	$417.59	$417.59
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$429.08	$429.08
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$434.82	$434.82
SALINAS (CA)	$433.15	$433.15
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$505.74	$505.74
SANTA CRUZ-WATSONVILLE (CA)	$443.29	$443.29
SANTA ROSA-PETALUMA (CA)	$447.51	$447.51
STOCKTON (CA)	$417.59	$417.59
VISALIA (CA)	$417.59	$417.59
YUBA CITY (CA)	$417.59	$417.59
EL CENTRO (CA)	$417.77	$417.77
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$440.99	$440.99
SAN LUIS OBISPO-PASO ROBLES (CA)	$426.64	$426.64
SANTA MARIA-SANTA BARBARA (CA)	$434.13	$434.13
REST OF CALIFORNIA (CA)	$417.59	$417.59
COLORADO (CO)	$418.79	$418.79
CONNECTICUT (CT)	$438.17	$438.17
DC + MD/VA SUBURBS (DC)	$461.57	$461.57
DELAWARE (DE)	$405.86	$405.86
FORT LAUDERDALE (FL)	$442.78	$442.78
MIAMI (FL)	$474.44	$474.44
REST OF FLORIDA (FL)	$419.88	$419.88
ATLANTA (GA)	$422.21	$422.21
REST OF GEORGIA (GA)	$395.30	$395.30
HAWAII, GUAM (HI)	$424.95	$424.95
IOWA (IA)	$371.73	$371.73
IDAHO (ID)	$375.50	$375.50
EAST ST. LOUIS (IL)	$430.57	$430.57
SUBURBAN CHICAGO (IL)	$445.59	$445.59
CHICAGO (IL)	$459.65	$459.65
REST OF ILLINOIS (IL)	$412.98	$412.98
INDIANA (IN)	$377.43	$377.43
KANSAS (KS)	$373.24	$373.24
KENTUCKY (KY)	$384.77	$384.77
NEW ORLEANS (LA)	$403.61	$403.61
REST OF LOUISIANA (LA)	$385.47	$385.47
METROPOLITAN BOSTON (MA)	$454.82	$454.82
REST OF MASSACHUSETTS (MA)	$417.70	$417.70
BALTIMORE/SURR. CNTYS (MD)	$437.64	$437.64
REST OF MARYLAND (MD)	$412.41	$412.41
SOUTHERN MAINE (ME)	$396.08	$396.08
REST OF MAINE (ME)	$380.82	$380.82
DETROIT (MI)	$428.32	$428.32
REST OF MICHIGAN (MI)	$397.47	$397.47
MINNESOTA (MN)	$392.11	$392.11
METROPOLITAN ST. LOUIS (MO)	$401.14	$401.14
METROPOLITAN KANSAS CITY (MO)	$397.51	$397.51
REST OF MISSOURI (MO)	$381.20	$381.20
MISSISSIPPI (MS)	$372.59	$372.59
MONTANA** (MT)	$411.09	$411.09
NORTH CAROLINA (NC)	$384.16	$384.16
NORTH DAKOTA** (ND)	$389.94	$389.94
NEBRASKA (NE)	$372.73	$372.73
NEW HAMPSHIRE (NH)	$415.33	$415.33
NORTHERN NJ (NJ)	$457.66	$457.66
REST OF NEW JERSEY (NJ)	$440.59	$440.59
NEW MEXICO (NM)	$400.88	$400.88
NEVADA** (NV)	$405.41	$405.41
MANHATTAN (NY)	$476.76	$476.76
NYC SUBURBS/LONG ISLAND (NY)	$492.12	$492.12
POUGHKPSIE/N NYC SUBURBS (NY)	$446.09	$446.09
QUEENS (NY)	$475.82	$475.82
REST OF NEW YORK (NY)	$390.03	$390.03
OHIO (OH)	$393.14	$393.14
OKLAHOMA (OK)	$380.68	$380.68
PORTLAND (OR)	$428.01	$428.01
REST OF OREGON (OR)	$399.71	$399.71
METROPOLITAN PHILADELPHIA (PA)	$429.66	$429.66
REST OF PENNSYLVANIA (PA)	$391.94	$391.94
PUERTO RICO (PR)	$412.94	$412.94
RHODE ISLAND (RI)	$417.38	$417.38
SOUTH CAROLINA (SC)	$389.81	$389.81
SOUTH DAKOTA** (SD)	$387.43	$387.43
TENNESSEE (TN)	$375.47	$375.47
BRAZORIA (TX)	$402.73	$402.73
DALLAS (TX)	$406.73	$406.73
GALVESTON (TX)	$404.87	$404.87
HOUSTON (TX)	$424.45	$424.45
BEAUMONT (TX)	$389.69	$389.69
FORT WORTH (TX)	$405.09	$405.09
AUSTIN (TX)	$419.63	$419.63
REST OF TEXAS (TX)	$396.97	$396.97
UTAH (UT)	$394.89	$394.89
VIRGINIA (VA)	$397.08	$397.08
VIRGIN ISLANDS (VI)	$412.94	$412.94
VERMONT (VT)	$391.41	$391.41
SEATTLE (KING CNTY) (WA)	$460.64	$460.64
REST OF WASHINGTON (WA)	$415.92	$415.92
WISCONSIN (WI)	$377.60	$377.60
WEST VIRGINIA (WV)	$399.00	$399.00
WYOMING** (WY)	$401.87	$401.87

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 — which are each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs, reflecting differences in overhead costs, though for this code the two settings may be aligned. The result is the Medicare-allowed amount before any applicable modifiers, deductible, or coinsurance are applied.

RVUs — work 4.94, practice expense 6.3 (non-facility) / 6.3 (facility), malpractice 1.07 — × 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 payer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, place of service, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the amount differ between non-facility and facility settings?

Practice-expense RVUs differ because non-facility settings (like a private office) bear overhead costs that facilities (like hospitals) do not, since the facility itself bills separately for those costs.

Why might my locality's payment differ from the national amount?

GPCIs adjust the work, practice-expense, and malpractice RVUs to reflect regional cost differences in wages, rent, and liability insurance before the conversion factor is applied.

Does this amount include modifiers or bilateral adjustments?

No. The figures shown reflect the base PFS calculation; modifiers, bilateral procedures, multiple-procedure reductions, and other adjustments can change the final payment.

Will this change during the year?

The conversion factor and RVUs are set annually but can be affected by legislative changes, budget-neutrality adjustments, or mid-year corrections published by CMS.

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.