Medicare Reimbursement for CPT 24116

CPT 24116 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and adjusted for your locality, comparing non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$797.95	$797.95
ALASKA* (AK)	$979.40	$979.40
ALABAMA (AL)	$721.76	$721.76
ARKANSAS (AR)	$712.39	$712.39
ARIZONA (AZ)	$775.97	$775.97
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$916.13	$916.13
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$929.80	$929.80
OXNARD-THOUSAND OAKS-VENTURA (CA)	$834.44	$834.44
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$843.41	$843.41
NAPA (CA)	$881.45	$881.45
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$919.01	$919.01
VALLEJO (CA)	$877.29	$877.29
BAKERSFIELD (CA)	$802.58	$802.58
CHICO (CA)	$795.59	$795.59
FRESNO (CA)	$795.59	$795.59
HANFORD-CORCORAN (CA)	$795.59	$795.59
MADERA (CA)	$795.59	$795.59
MERCED (CA)	$795.59	$795.59
MODESTO (CA)	$795.59	$795.59
REDDING (CA)	$795.59	$795.59
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$822.88	$822.88
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$824.26	$824.26
SALINAS (CA)	$821.01	$821.01
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$941.59	$941.59
SANTA CRUZ-WATSONVILLE (CA)	$834.66	$834.66
SANTA ROSA-PETALUMA (CA)	$842.34	$842.34
STOCKTON (CA)	$795.59	$795.59
VISALIA (CA)	$795.59	$795.59
YUBA CITY (CA)	$795.59	$795.59
EL CENTRO (CA)	$796.01	$796.01
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$832.77	$832.77
SAN LUIS OBISPO-PASO ROBLES (CA)	$809.13	$809.13
SANTA MARIA-SANTA BARBARA (CA)	$822.02	$822.02
REST OF CALIFORNIA (CA)	$795.59	$795.59
COLORADO (CO)	$804.30	$804.30
CONNECTICUT (CT)	$847.98	$847.98
DC + MD/VA SUBURBS (DC)	$885.10	$885.10
DELAWARE (DE)	$787.59	$787.59
FORT LAUDERDALE (FL)	$870.59	$870.59
MIAMI (FL)	$940.58	$940.58
REST OF FLORIDA (FL)	$826.76	$826.76
ATLANTA (GA)	$821.23	$821.23
REST OF GEORGIA (GA)	$780.22	$780.22
HAWAII, GUAM (HI)	$805.38	$805.38
IOWA (IA)	$720.02	$720.02
IDAHO (ID)	$728.04	$728.04
EAST ST. LOUIS (IL)	$858.78	$858.78
SUBURBAN CHICAGO (IL)	$874.73	$874.73
CHICAGO (IL)	$912.17	$912.17
REST OF ILLINOIS (IL)	$818.31	$818.31
INDIANA (IN)	$731.35	$731.35
KANSAS (KS)	$725.63	$725.63
KENTUCKY (KY)	$755.77	$755.77
NEW ORLEANS (LA)	$790.90	$790.90
REST OF LOUISIANA (LA)	$758.16	$758.16
METROPOLITAN BOSTON (MA)	$866.04	$866.04
REST OF MASSACHUSETTS (MA)	$803.79	$803.79
BALTIMORE/SURR. CNTYS (MD)	$847.42	$847.42
REST OF MARYLAND (MD)	$798.75	$798.75
SOUTHERN MAINE (ME)	$763.81	$763.81
REST OF MAINE (ME)	$740.68	$740.68
DETROIT (MI)	$845.12	$845.12
REST OF MICHIGAN (MI)	$781.49	$781.49
MINNESOTA (MN)	$747.36	$747.36
METROPOLITAN ST. LOUIS (MO)	$783.00	$783.00
METROPOLITAN KANSAS CITY (MO)	$776.78	$776.78
REST OF MISSOURI (MO)	$752.28	$752.28
MISSISSIPPI (MS)	$732.02	$732.02
MONTANA** (MT)	$797.78	$797.78
NORTH CAROLINA (NC)	$746.22	$746.22
NORTH DAKOTA** (ND)	$747.55	$747.55
NEBRASKA (NE)	$720.93	$720.93
NEW HAMPSHIRE (NH)	$800.26	$800.26
NORTHERN NJ (NJ)	$879.19	$879.19
REST OF NEW JERSEY (NJ)	$851.08	$851.08
NEW MEXICO (NM)	$788.86	$788.86
NEVADA** (NV)	$784.09	$784.09
MANHATTAN (NY)	$924.17	$924.17
NYC SUBURBS/LONG ISLAND (NY)	$955.66	$955.66
POUGHKPSIE/N NYC SUBURBS (NY)	$863.60	$863.60
QUEENS (NY)	$918.25	$918.25
REST OF NEW YORK (NY)	$757.00	$757.00
OHIO (OH)	$771.22	$771.22
OKLAHOMA (OK)	$745.33	$745.33
PORTLAND (OR)	$817.56	$817.56
REST OF OREGON (OR)	$771.49	$771.49
METROPOLITAN PHILADELPHIA (PA)	$834.40	$834.40
REST OF PENNSYLVANIA (PA)	$767.45	$767.45
PUERTO RICO (PR)	$800.14	$800.14
RHODE ISLAND (RI)	$806.74	$806.74
SOUTH CAROLINA (SC)	$761.28	$761.28
SOUTH DAKOTA** (SD)	$741.61	$741.61
TENNESSEE (TN)	$730.01	$730.01
BRAZORIA (TX)	$779.63	$779.63
DALLAS (TX)	$788.22	$788.22
GALVESTON (TX)	$784.34	$784.34
HOUSTON (TX)	$830.83	$830.83
BEAUMONT (TX)	$763.58	$763.58
FORT WORTH (TX)	$786.18	$786.18
AUSTIN (TX)	$807.34	$807.34
REST OF TEXAS (TX)	$773.65	$773.65
UTAH (UT)	$770.40	$770.40
VIRGINIA (VA)	$767.65	$767.65
VIRGIN ISLANDS (VI)	$800.14	$800.14
VERMONT (VT)	$752.89	$752.89
SEATTLE (KING CNTY) (WA)	$873.83	$873.83
REST OF WASHINGTON (WA)	$799.54	$799.54
WISCONSIN (WI)	$726.01	$726.01
WEST VIRGINIA (WV)	$793.25	$793.25
WYOMING** (WY)	$775.89	$775.89

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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: 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's allowed amount 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 service locality. These GPCI-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which can make the allowed amount vary by place of service. The conversion factor and RVU values are updated annually and are subject to budget-neutrality adjustments.

RVUs — work 11.92, practice expense 9.43 (non-facility) / 9.43 (facility), malpractice 2.54 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This figure 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.
Modifiers, multiple-procedure reductions, sequestration, and locality-specific GPCIs can all change the final payment.
Annual budget-neutrality adjustments and fee schedule updates may change RVUs and the conversion factor from year to year.
Always confirm actual payment amounts and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does the facility amount differ from the non-facility amount?

The practice-expense RVU component is calculated separately for non-facility and facility settings to reflect differing overhead costs, which can change the total allowed amount even though work and malpractice RVUs stay the same.

Is this the amount my practice will actually be paid?

No. This is an estimate based on national PFS data. Actual payment depends on your specific locality GPCIs, any applicable modifiers, secondary payer rules, and sequestration adjustments.

Does this amount include the patient's share?

The listed amount is the total Medicare-allowed amount. Medicare generally pays 80% after the deductible, with the patient or secondary insurance responsible for the remaining 20%.

Why can this amount change year to year?

RVUs and the conversion factor are reviewed and updated annually, and budget-neutrality adjustments required by law can shift allowed amounts even if the code's relative value is unchanged.

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.