Medicare Reimbursement for CPT 24105
CPT 24105 is a surgical procedure code; the AMA-owned descriptor is not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both the national rate and the rate adjusted for your locality, broken out by non-facility and facility settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $358.06 | $358.06 |
| ALASKA* (AK) | $422.07 | $422.07 |
| ALABAMA (AL) | $320.97 | $320.97 |
| ARKANSAS (AR) | $316.33 | $316.33 |
| ARIZONA (AZ) | $347.95 | $347.95 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $441.36 | $441.36 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $449.22 | $449.22 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $390.24 | $390.24 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $393.08 | $393.08 |
| NAPA (CA) | $420.20 | $420.20 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $442.21 | $442.21 |
| VALLEJO (CA) | $418.97 | $418.97 |
| BAKERSFIELD (CA) | $370.74 | $370.74 |
| CHICO (CA) | $368.67 | $368.67 |
| FRESNO (CA) | $368.67 | $368.67 |
| HANFORD-CORCORAN (CA) | $368.67 | $368.67 |
| MADERA (CA) | $368.67 | $368.67 |
| MERCED (CA) | $368.67 | $368.67 |
| MODESTO (CA) | $368.67 | $368.67 |
| REDDING (CA) | $368.67 | $368.67 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $376.73 | $376.73 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $385.06 | $385.06 |
| SALINAS (CA) | $383.61 | $383.61 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $452.70 | $452.70 |
| SANTA CRUZ-WATSONVILLE (CA) | $394.12 | $394.12 |
| SANTA ROSA-PETALUMA (CA) | $397.96 | $397.96 |
| STOCKTON (CA) | $368.67 | $368.67 |
| VISALIA (CA) | $368.67 | $368.67 |
| YUBA CITY (CA) | $368.67 | $368.67 |
| EL CENTRO (CA) | $368.79 | $368.79 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $391.39 | $391.39 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $377.69 | $377.69 |
| SANTA MARIA-SANTA BARBARA (CA) | $384.70 | $384.70 |
| REST OF CALIFORNIA (CA) | $368.67 | $368.67 |
| COLORADO (CO) | $367.48 | $367.48 |
| CONNECTICUT (CT) | $381.93 | $381.93 |
| DC + MD/VA SUBURBS (DC) | $404.88 | $404.88 |
| DELAWARE (DE) | $353.63 | $353.63 |
| FORT LAUDERDALE (FL) | $381.03 | $381.03 |
| MIAMI (FL) | $404.96 | $404.96 |
| REST OF FLORIDA (FL) | $361.43 | $361.43 |
| ATLANTA (GA) | $366.82 | $366.82 |
| REST OF GEORGIA (GA) | $340.21 | $340.21 |
| HAWAII, GUAM (HI) | $376.25 | $376.25 |
| IOWA (IA) | $325.12 | $325.12 |
| IDAHO (ID) | $328.08 | $328.08 |
| EAST ST. LOUIS (IL) | $366.68 | $366.68 |
| SUBURBAN CHICAGO (IL) | $383.92 | $383.92 |
| CHICAGO (IL) | $392.41 | $392.41 |
| REST OF ILLINOIS (IL) | $353.91 | $353.91 |
| INDIANA (IN) | $329.87 | $329.87 |
| KANSAS (KS) | $325.50 | $325.50 |
| KENTUCKY (KY) | $332.65 | $332.65 |
| NEW ORLEANS (LA) | $349.09 | $349.09 |
| REST OF LOUISIANA (LA) | $332.88 | $332.88 |
| METROPOLITAN BOSTON (MA) | $401.05 | $401.05 |
| REST OF MASSACHUSETTS (MA) | $366.06 | $366.06 |
| BALTIMORE/SURR. CNTYS (MD) | $381.28 | $381.28 |
| REST OF MARYLAND (MD) | $359.75 | $359.75 |
| SOUTHERN MAINE (ME) | $346.93 | $346.93 |
| REST OF MAINE (ME) | $331.81 | $331.81 |
| DETROIT (MI) | $367.90 | $367.90 |
| REST OF MICHIGAN (MI) | $343.04 | $343.04 |
| MINNESOTA (MN) | $346.50 | $346.50 |
| METROPOLITAN ST. LOUIS (MO) | $348.04 | $348.04 |
| METROPOLITAN KANSAS CITY (MO) | $344.69 | $344.69 |
| REST OF MISSOURI (MO) | $328.46 | $328.46 |
| MISSISSIPPI (MS) | $322.36 | $322.36 |
| MONTANA** (MT) | $358.01 | $358.01 |
| NORTH CAROLINA (NC) | $334.96 | $334.96 |
| NORTH DAKOTA** (ND) | $343.18 | $343.18 |
| NEBRASKA (NE) | $326.32 | $326.32 |
| NEW HAMPSHIRE (NH) | $363.53 | $363.53 |
| NORTHERN NJ (NJ) | $401.09 | $401.09 |
| REST OF NEW JERSEY (NJ) | $384.72 | $384.72 |
| NEW MEXICO (NM) | $345.68 | $345.68 |
| NEVADA** (NV) | $354.08 | $354.08 |
| MANHATTAN (NY) | $414.61 | $414.61 |
| NYC SUBURBS/LONG ISLAND (NY) | $427.06 | $427.06 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $388.79 | $388.79 |
| QUEENS (NY) | $415.19 | $415.19 |
| REST OF NEW YORK (NY) | $340.13 | $340.13 |
| OHIO (OH) | $340.01 | $340.01 |
| OKLAHOMA (OK) | $330.03 | $330.03 |
| PORTLAND (OR) | $376.90 | $376.90 |
| REST OF OREGON (OR) | $349.78 | $349.78 |
| METROPOLITAN PHILADELPHIA (PA) | $373.71 | $373.71 |
| REST OF PENNSYLVANIA (PA) | $339.48 | $339.48 |
| PUERTO RICO (PR) | $359.99 | $359.99 |
| RHODE ISLAND (RI) | $364.62 | $364.62 |
| SOUTH CAROLINA (SC) | $338.36 | $338.36 |
| SOUTH DAKOTA** (SD) | $341.42 | $341.42 |
| TENNESSEE (TN) | $327.37 | $327.37 |
| BRAZORIA (TX) | $351.64 | $351.64 |
| DALLAS (TX) | $354.77 | $354.77 |
| GALVESTON (TX) | $353.27 | $353.27 |
| HOUSTON (TX) | $366.99 | $366.99 |
| BEAUMONT (TX) | $337.40 | $337.40 |
| FORT WORTH (TX) | $353.00 | $353.00 |
| AUSTIN (TX) | $367.61 | $367.61 |
| REST OF TEXAS (TX) | $344.93 | $344.93 |
| UTAH (UT) | $342.92 | $342.92 |
| VIRGINIA (VA) | $347.13 | $347.13 |
| VIRGIN ISLANDS (VI) | $359.99 | $359.99 |
| VERMONT (VT) | $343.59 | $343.59 |
| SEATTLE (KING CNTY) (WA) | $407.25 | $407.25 |
| REST OF WASHINGTON (WA) | $364.79 | $364.79 |
| WISCONSIN (WI) | $331.91 | $331.91 |
| WEST VIRGINIA (WV) | $341.38 | $341.38 |
| WYOMING** (WY) | $351.54 | $351.54 |
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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
The Medicare PFS amount for this code is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed. These GPCI-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because overhead costs differ; for this code those practice-expense RVUs happen to be the same, so the resulting rates are equal in both settings. The formula and all RVU values are updated annually by CMS and can shift due to policy changes even when the code itself doesn't change.
RVUs — work 3.69, practice expense 6.28 (non-facility) / 6.28 (facility), malpractice 0.75 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- This is an estimate only, not a guarantee of payment — actual reimbursement depends on claim adjudication.
- Medicare typically pays 80% of the allowed amount after the patient meets the Part B deductible; the patient or secondary payer is responsible for the rest.
- Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
- Locality-specific GPCI adjustments mean actual rates can differ from the national average shown here.
- Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.
Frequently asked
Why do non-facility and facility rates differ for some codes but not this one?
Facility and non-facility rates differ when the practice-expense RVU differs because the site of service affects overhead costs. For this code, the practice-expense RVU is the same in both settings, so the calculated amounts match.
Does this amount reflect what my practice will actually be paid?
No — it's an estimate based on national RVUs, GPCIs, and the conversion factor. Actual payment depends on your specific MAC, contract terms, modifiers used, and claim-level adjustments.
Why might this rate change next year?
CMS updates the conversion factor and RVUs annually, and applies budget-neutrality adjustments that can shift payment amounts even if the code's clinical definition stays the same.
How is the GPCI applied to this code's RVUs?
Each RVU component (work, practice expense, malpractice) is multiplied by its corresponding locality GPCI before the components are summed and multiplied by the conversion factor to produce the locality-adjusted allowed amount.
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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