Medicare Reimbursement for CPT 24101

CPT 24101 is a surgical procedure code; this page explains how its Medicare Physician Fee Schedule (PFS) allowed amount is derived. Figures shown include the national rate as well as locality-adjusted amounts, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$482.64	$482.64
ALASKA* (AK)	$581.77	$581.77
ALABAMA (AL)	$435.05	$435.05
ARKANSAS (AR)	$429.14	$429.14
ARIZONA (AZ)	$469.32	$469.32
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$574.80	$574.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$584.25	$584.25
OXNARD-THOUSAND OAKS-VENTURA (CA)	$515.56	$515.56
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$520.18	$520.18
NAPA (CA)	$550.01	$550.01
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$576.22	$576.22
VALLEJO (CA)	$547.96	$547.96
BAKERSFIELD (CA)	$492.85	$492.85
CHICO (CA)	$489.39	$489.39
FRESNO (CA)	$489.39	$489.39
HANFORD-CORCORAN (CA)	$489.39	$489.39
MADERA (CA)	$489.39	$489.39
MERCED (CA)	$489.39	$489.39
MODESTO (CA)	$489.39	$489.39
REDDING (CA)	$489.39	$489.39
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$502.83	$502.83
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$509.09	$509.09
SALINAS (CA)	$507.12	$507.12
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$590.06	$590.06
SANTA CRUZ-WATSONVILLE (CA)	$518.28	$518.28
SANTA ROSA-PETALUMA (CA)	$523.19	$523.19
STOCKTON (CA)	$489.39	$489.39
VISALIA (CA)	$489.39	$489.39
YUBA CITY (CA)	$489.39	$489.39
EL CENTRO (CA)	$489.60	$489.60
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$515.89	$515.89
SAN LUIS OBISPO-PASO ROBLES (CA)	$499.53	$499.53
SANTA MARIA-SANTA BARBARA (CA)	$508.16	$508.16
REST OF CALIFORNIA (CA)	$489.39	$489.39
COLORADO (CO)	$491.05	$491.05
CONNECTICUT (CT)	$513.67	$513.67
DC + MD/VA SUBURBS (DC)	$540.41	$540.41
DELAWARE (DE)	$476.62	$476.62
FORT LAUDERDALE (FL)	$519.44	$519.44
MIAMI (FL)	$556.15	$556.15
REST OF FLORIDA (FL)	$493.27	$493.27
ATLANTA (GA)	$495.42	$495.42
REST OF GEORGIA (GA)	$465.19	$465.19
HAWAII, GUAM (HI)	$497.37	$497.37
IOWA (IA)	$437.42	$437.42
IDAHO (ID)	$441.78	$441.78
EAST ST. LOUIS (IL)	$506.11	$506.11
SUBURBAN CHICAGO (IL)	$522.68	$522.68
CHICAGO (IL)	$539.33	$539.33
REST OF ILLINOIS (IL)	$485.63	$485.63
INDIANA (IN)	$443.97	$443.97
KANSAS (KS)	$439.30	$439.30
KENTUCKY (KY)	$452.92	$452.92
NEW ORLEANS (LA)	$474.41	$474.41
REST OF LOUISIANA (LA)	$453.77	$453.77
METROPOLITAN BOSTON (MA)	$532.21	$532.21
REST OF MASSACHUSETTS (MA)	$489.95	$489.95
BALTIMORE/SURR. CNTYS (MD)	$513.03	$513.03
REST OF MARYLAND (MD)	$484.10	$484.10
SOUTHERN MAINE (ME)	$465.11	$465.11
REST OF MAINE (ME)	$448.00	$448.00
DETROIT (MI)	$503.03	$503.03
REST OF MICHIGAN (MI)	$467.51	$467.51
MINNESOTA (MN)	$460.09	$460.09
METROPOLITAN ST. LOUIS (MO)	$471.41	$471.41
METROPOLITAN KANSAS CITY (MO)	$467.30	$467.30
REST OF MISSOURI (MO)	$449.02	$449.02
MISSISSIPPI (MS)	$438.97	$438.97
MONTANA** (MT)	$482.56	$482.56
NORTH CAROLINA (NC)	$451.77	$451.77
NORTH DAKOTA** (ND)	$457.84	$457.84
NEBRASKA (NE)	$438.52	$438.52
NEW HAMPSHIRE (NH)	$487.09	$487.09
NORTHERN NJ (NJ)	$536.13	$536.13
REST OF NEW JERSEY (NJ)	$516.59	$516.59
NEW MEXICO (NM)	$471.46	$471.46
NEVADA** (NV)	$475.91	$475.91
MANHATTAN (NY)	$558.44	$558.44
NYC SUBURBS/LONG ISLAND (NY)	$576.12	$576.12
POUGHKPSIE/N NYC SUBURBS (NY)	$523.04	$523.04
QUEENS (NY)	$557.14	$557.14
REST OF NEW YORK (NY)	$458.45	$458.45
OHIO (OH)	$462.46	$462.46
OKLAHOMA (OK)	$448.10	$448.10
PORTLAND (OR)	$501.41	$501.41
REST OF OREGON (OR)	$469.30	$469.30
METROPOLITAN PHILADELPHIA (PA)	$504.06	$504.06
REST OF PENNSYLVANIA (PA)	$461.01	$461.01
PUERTO RICO (PR)	$484.61	$484.61
RHODE ISLAND (RI)	$489.81	$489.81
SOUTH CAROLINA (SC)	$458.46	$458.46
SOUTH DAKOTA** (SD)	$454.92	$454.92
TENNESSEE (TN)	$441.85	$441.85
BRAZORIA (TX)	$472.98	$472.98
DALLAS (TX)	$477.62	$477.62
GALVESTON (TX)	$475.45	$475.45
HOUSTON (TX)	$498.33	$498.33
BEAUMONT (TX)	$458.46	$458.46
FORT WORTH (TX)	$475.80	$475.80
AUSTIN (TX)	$491.97	$491.97
REST OF TEXAS (TX)	$466.57	$466.57
UTAH (UT)	$464.24	$464.24
VIRGINIA (VA)	$466.36	$466.36
VIRGIN ISLANDS (VI)	$484.61	$484.61
VERMONT (VT)	$459.66	$459.66
SEATTLE (KING CNTY) (WA)	$538.79	$538.79
REST OF WASHINGTON (WA)	$487.83	$487.83
WISCONSIN (WI)	$443.85	$443.85
WEST VIRGINIA (WV)	$469.75	$469.75
WYOMING** (WY)	$471.79	$471.79

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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 starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted using the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is performed, reflecting local cost-of-living and practice differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, which is why the two amounts may differ — for this code they are the same, indicating equal practice-expense valuation in both settings for this year.

RVUs — work 6.14, practice expense 7.06 (non-facility) / 7.06 (facility), malpractice 1.25 — × 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, multiple-procedure or bilateral reductions, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

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

Amounts differ only when the practice-expense RVU differs between settings. For this code, the practice-expense RVU is identical in non-facility and facility settings, so the calculated allowed amounts match.

Why does the Medicare rate vary by location?

The Geographic Practice Cost Index (GPCI) adjusts the work, practice-expense, and malpractice RVUs to reflect regional differences in wages and operating costs, which changes the final payment amount by locality.

Does this amount reflect what the practice will actually collect?

No. It reflects the Medicare-allowed amount before patient responsibility, deductible status, modifiers, or any contractual adjustments are applied.

Can modifiers change this amount?

Yes. Modifiers such as those indicating bilateral procedures, multiple procedures, or reduced services can increase or decrease the final paid amount relative to the base PFS rate shown here.

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.