Medicare Reimbursement for CPT 24130

This page covers CPT code 24130, a physician procedure code valued under the Medicare Physician Fee Schedule (PFS). It shows the estimated national Medicare allowed amount for both non-facility and facility settings, along with the locality-adjusted amount where available. The AMA-copyrighted descriptor for this code is not reproduced here.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$485.32	$485.32
ALASKA* (AK)	$586.70	$586.70
ALABAMA (AL)	$438.09	$438.09
ARKANSAS (AR)	$432.23	$432.23
ARIZONA (AZ)	$472.11	$472.11
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$577.96	$577.96
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$587.47	$587.47
OXNARD-THOUSAND OAKS-VENTURA (CA)	$518.48	$518.48
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$523.11	$523.11
NAPA (CA)	$553.05	$553.05
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$579.36	$579.36
VALLEJO (CA)	$551.04	$551.04
BAKERSFIELD (CA)	$495.80	$495.80
CHICO (CA)	$492.38	$492.38
FRESNO (CA)	$492.38	$492.38
HANFORD-CORCORAN (CA)	$492.38	$492.38
MADERA (CA)	$492.38	$492.38
MERCED (CA)	$492.38	$492.38
MODESTO (CA)	$492.38	$492.38
REDDING (CA)	$492.38	$492.38
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$505.61	$505.61
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$512.11	$512.11
SALINAS (CA)	$510.12	$510.12
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$593.19	$593.19
SANTA CRUZ-WATSONVILLE (CA)	$521.20	$521.20
SANTA ROSA-PETALUMA (CA)	$526.14	$526.14
STOCKTON (CA)	$492.38	$492.38
VISALIA (CA)	$492.38	$492.38
YUBA CITY (CA)	$492.38	$492.38
EL CENTRO (CA)	$492.59	$492.59
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$518.86	$518.86
SAN LUIS OBISPO-PASO ROBLES (CA)	$502.49	$502.49
SANTA MARIA-SANTA BARBARA (CA)	$511.14	$511.14
REST OF CALIFORNIA (CA)	$492.38	$492.38
COLORADO (CO)	$493.88	$493.88
CONNECTICUT (CT)	$516.23	$516.23
DC + MD/VA SUBURBS (DC)	$543.10	$543.10
DELAWARE (DE)	$479.39	$479.39
FORT LAUDERDALE (FL)	$521.57	$521.57
MIAMI (FL)	$557.77	$557.77
REST OF FLORIDA (FL)	$495.63	$495.63
ATLANTA (GA)	$497.96	$497.96
REST OF GEORGIA (GA)	$467.81	$467.81
HAWAII, GUAM (HI)	$500.23	$500.23
IOWA (IA)	$440.55	$440.55
IDAHO (ID)	$444.85	$444.85
EAST ST. LOUIS (IL)	$508.16	$508.16
SUBURBAN CHICAGO (IL)	$524.84	$524.84
CHICAGO (IL)	$541.16	$541.16
REST OF ILLINOIS (IL)	$487.99	$487.99
INDIANA (IN)	$447.03	$447.03
KANSAS (KS)	$442.36	$442.36
KENTUCKY (KY)	$455.72	$455.72
NEW ORLEANS (LA)	$477.03	$477.03
REST OF LOUISIANA (LA)	$456.55	$456.55
METROPOLITAN BOSTON (MA)	$534.99	$534.99
REST OF MASSACHUSETTS (MA)	$492.78	$492.78
BALTIMORE/SURR. CNTYS (MD)	$515.56	$515.56
REST OF MARYLAND (MD)	$486.86	$486.86
SOUTHERN MAINE (ME)	$468.04	$468.04
REST OF MAINE (ME)	$450.97	$450.97
DETROIT (MI)	$505.27	$505.27
REST OF MICHIGAN (MI)	$470.16	$470.16
MINNESOTA (MN)	$463.21	$463.21
METROPOLITAN ST. LOUIS (MO)	$474.11	$474.11
METROPOLITAN KANSAS CITY (MO)	$470.03	$470.03
REST OF MISSOURI (MO)	$451.80	$451.80
MISSISSIPPI (MS)	$441.91	$441.91
MONTANA** (MT)	$485.23	$485.23
NORTH CAROLINA (NC)	$454.73	$454.73
NORTH DAKOTA** (ND)	$460.91	$460.91
NEBRASKA (NE)	$441.66	$441.66
NEW HAMPSHIRE (NH)	$489.82	$489.82
NORTHERN NJ (NJ)	$538.90	$538.90
REST OF NEW JERSEY (NJ)	$519.30	$519.30
NEW MEXICO (NM)	$474.06	$474.06
NEVADA** (NV)	$478.69	$478.69
MANHATTAN (NY)	$560.86	$560.86
NYC SUBURBS/LONG ISLAND (NY)	$578.35	$578.35
POUGHKPSIE/N NYC SUBURBS (NY)	$525.69	$525.69
QUEENS (NY)	$559.65	$559.65
REST OF NEW YORK (NY)	$461.36	$461.36
OHIO (OH)	$465.19	$465.19
OKLAHOMA (OK)	$450.99	$450.99
PORTLAND (OR)	$504.24	$504.24
REST OF OREGON (OR)	$472.17	$472.17
METROPOLITAN PHILADELPHIA (PA)	$506.65	$506.65
REST OF PENNSYLVANIA (PA)	$463.77	$463.77
PUERTO RICO (PR)	$487.29	$487.29
RHODE ISLAND (RI)	$492.61	$492.61
SOUTH CAROLINA (SC)	$461.28	$461.28
SOUTH DAKOTA** (SD)	$458.04	$458.04
TENNESSEE (TN)	$444.90	$444.90
BRAZORIA (TX)	$475.83	$475.83
DALLAS (TX)	$480.42	$480.42
GALVESTON (TX)	$478.28	$478.28
HOUSTON (TX)	$500.79	$500.79
BEAUMONT (TX)	$461.24	$461.24
FORT WORTH (TX)	$478.61	$478.61
AUSTIN (TX)	$494.69	$494.69
REST OF TEXAS (TX)	$469.34	$469.34
UTAH (UT)	$467.02	$467.02
VIRGINIA (VA)	$469.24	$469.24
VIRGIN ISLANDS (VI)	$487.29	$487.29
VERMONT (VT)	$462.67	$462.67
SEATTLE (KING CNTY) (WA)	$541.63	$541.63
REST OF WASHINGTON (WA)	$490.68	$490.68
WISCONSIN (WI)	$447.01	$447.01
WEST VIRGINIA (WV)	$472.22	$472.22
WYOMING** (WY)	$474.63	$474.63

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 for a code is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is furnished, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings because overhead costs differ, which is why the two settings can show different allowed amounts. The conversion factor and RVU values are updated annually and are subject to federal budget-neutrality adjustments.

RVUs — work 6.26, practice expense 7.04 (non-facility) / 7.04 (facility), malpractice 1.23 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

All amounts shown are estimates only and are not a guarantee of payment.
Medicare Part B typically pays 80% of the allowed amount after the annual deductible is met; the patient or secondary insurer is generally responsible for the remainder.
Actual payment can vary by locality, facility type, modifiers, assistant-at-surgery or multiple-procedure rules, sequestration, and other claim-specific adjustments.
Conversion factors and RVUs can change mid-year or annually due to legislation or CMS rulemaking; verify current values before billing.
Always confirm final allowed 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 because overhead costs (equipment, staff, supplies) differ when a service is performed in a physician office versus a hospital or ambulatory surgical center.

Does this amount reflect what Medicare will actually pay?

No. The figure represents the Medicare-allowed amount before the patient's deductible and coinsurance are applied, and before any modifier, sequestration, or locality-specific adjustments are factored in.

Can the conversion factor change during the year?

Yes. CMS sets the conversion factor annually, but it can be adjusted by legislation or mid-year corrections, which would change the calculated allowed amount even if the RVUs stay the same.

Where can I find the official CPT descriptor for this code?

The CPT code set is maintained and copyrighted by the American Medical Association; refer to your licensed CPT codebook or AMA resources for the official descriptor.

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.