Medicare Reimbursement for CPT 24138

This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code, both at the national level and adjusted for local cost differences. Amounts are shown separately for non-facility (e.g., office) and facility (e.g., hospital) settings, since the resources used to furnish the service can differ by site of service.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$661.00	$661.00
ALASKA* (AK)	$794.20	$794.20
ALABAMA (AL)	$594.83	$594.83
ARKANSAS (AR)	$586.62	$586.62
ARIZONA (AZ)	$642.45	$642.45
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$786.89	$786.89
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$799.81	$799.81
OXNARD-THOUSAND OAKS-VENTURA (CA)	$705.80	$705.80
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$712.14	$712.14
NAPA (CA)	$752.98	$752.98
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$788.89	$788.89
VALLEJO (CA)	$750.10	$750.10
BAKERSFIELD (CA)	$674.51	$674.51
CHICO (CA)	$669.67	$669.67
FRESNO (CA)	$669.67	$669.67
HANFORD-CORCORAN (CA)	$669.67	$669.67
MADERA (CA)	$669.67	$669.67
MERCED (CA)	$669.67	$669.67
MODESTO (CA)	$669.67	$669.67
REDDING (CA)	$669.67	$669.67
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$688.58	$688.58
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$696.72	$696.72
SALINAS (CA)	$694.04	$694.04
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$807.98	$807.98
SANTA CRUZ-WATSONVILLE (CA)	$709.49	$709.49
SANTA ROSA-PETALUMA (CA)	$716.21	$716.21
STOCKTON (CA)	$669.67	$669.67
VISALIA (CA)	$669.67	$669.67
YUBA CITY (CA)	$669.67	$669.67
EL CENTRO (CA)	$669.96	$669.96
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$706.15	$706.15
SAN LUIS OBISPO-PASO ROBLES (CA)	$683.65	$683.65
SANTA MARIA-SANTA BARBARA (CA)	$695.48	$695.48
REST OF CALIFORNIA (CA)	$669.67	$669.67
COLORADO (CO)	$672.27	$672.27
CONNECTICUT (CT)	$703.94	$703.94
DC + MD/VA SUBURBS (DC)	$740.51	$740.51
DELAWARE (DE)	$652.55	$652.55
FORT LAUDERDALE (FL)	$712.73	$712.73
MIAMI (FL)	$764.23	$764.23
REST OF FLORIDA (FL)	$676.26	$676.26
ATLANTA (GA)	$678.86	$678.86
REST OF GEORGIA (GA)	$637.16	$637.16
HAWAII, GUAM (HI)	$680.82	$680.82
IOWA (IA)	$597.90	$597.90
IDAHO (ID)	$604.00	$604.00
EAST ST. LOUIS (IL)	$694.59	$694.59
SUBURBAN CHICAGO (IL)	$717.11	$717.11
CHICAGO (IL)	$740.70	$740.70
REST OF ILLINOIS (IL)	$665.80	$665.80
INDIANA (IN)	$607.04	$607.04
KANSAS (KS)	$600.61	$600.61
KENTUCKY (KY)	$619.90	$619.90
NEW ORLEANS (LA)	$649.80	$649.80
REST OF LOUISIANA (LA)	$621.12	$621.12
METROPOLITAN BOSTON (MA)	$729.00	$729.00
REST OF MASSACHUSETTS (MA)	$670.74	$670.74
BALTIMORE/SURR. CNTYS (MD)	$703.11	$703.11
REST OF MARYLAND (MD)	$662.86	$662.86
SOUTHERN MAINE (ME)	$636.38	$636.38
REST OF MAINE (ME)	$612.76	$612.76
DETROIT (MI)	$689.94	$689.94
REST OF MICHIGAN (MI)	$640.28	$640.28
MINNESOTA (MN)	$629.05	$629.05
METROPOLITAN ST. LOUIS (MO)	$645.51	$645.51
METROPOLITAN KANSAS CITY (MO)	$639.81	$639.81
REST OF MISSOURI (MO)	$614.58	$614.58
MISSISSIPPI (MS)	$600.44	$600.44
MONTANA** (MT)	$660.89	$660.89
NORTH CAROLINA (NC)	$617.99	$617.99
NORTH DAKOTA** (ND)	$626.09	$626.09
NEBRASKA (NE)	$599.39	$599.39
NEW HAMPSHIRE (NH)	$666.99	$666.99
NORTHERN NJ (NJ)	$734.50	$734.50
REST OF NEW JERSEY (NJ)	$707.71	$707.71
NEW MEXICO (NM)	$645.82	$645.82
NEVADA** (NV)	$651.51	$651.51
MANHATTAN (NY)	$765.88	$765.88
NYC SUBURBS/LONG ISLAND (NY)	$790.59	$790.59
POUGHKPSIE/N NYC SUBURBS (NY)	$716.71	$716.71
QUEENS (NY)	$763.92	$763.92
REST OF NEW YORK (NY)	$627.28	$627.28
OHIO (OH)	$633.17	$633.17
OKLAHOMA (OK)	$613.08	$613.08
PORTLAND (OR)	$686.50	$686.50
REST OF OREGON (OR)	$642.24	$642.24
METROPOLITAN PHILADELPHIA (PA)	$690.67	$690.67
REST OF PENNSYLVANIA (PA)	$631.09	$631.09
PUERTO RICO (PR)	$663.70	$663.70
RHODE ISLAND (RI)	$670.65	$670.65
SOUTH CAROLINA (SC)	$627.46	$627.46
SOUTH DAKOTA** (SD)	$621.97	$621.97
TENNESSEE (TN)	$604.18	$604.18
BRAZORIA (TX)	$647.36	$647.36
DALLAS (TX)	$653.85	$653.85
GALVESTON (TX)	$650.83	$650.83
HOUSTON (TX)	$683.05	$683.05
BEAUMONT (TX)	$627.55	$627.55
FORT WORTH (TX)	$651.36	$651.36
AUSTIN (TX)	$673.72	$673.72
REST OF TEXAS (TX)	$638.71	$638.71
UTAH (UT)	$635.49	$635.49
VIRGINIA (VA)	$638.19	$638.19
VIRGIN ISLANDS (VI)	$663.70	$663.70
VERMONT (VT)	$628.71	$628.71
SEATTLE (KING CNTY) (WA)	$737.94	$737.94
REST OF WASHINGTON (WA)	$667.80	$667.80
WISCONSIN (WI)	$606.66	$606.66
WEST VIRGINIA (WV)	$643.72	$643.72
WYOMING** (WY)	$645.72	$645.72

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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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — that reflect the relative resources needed to perform the service. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, to account for regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs — and therefore the resulting payment — can differ between non-facility and facility settings because overhead costs differ depending on where the service is performed.

RVUs — work 8.29, practice expense 9.74 (non-facility) / 9.74 (facility), malpractice 1.76 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment; actual Medicare payment can differ.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Amounts shown use national averages and standard GPCIs; your specific Medicare Administrative Contractor (MAC) and locality may apply different figures.
Always verify current rates and coverage policy with your MAC before billing or appealing a denial.

Frequently asked

Why might the non-facility and facility amounts for this code be the same or different?

The practice-expense RVU component can vary by site of service because overhead costs differ between an office setting and a facility setting. When the practice-expense RVUs are identical for both settings, the resulting allowed amounts will also match.

How do I find the exact amount for my locality?

The national amount shown is adjusted using GPCIs specific to each Medicare locality. Check the locality-specific figure on this page or your MAC's fee schedule lookup tool for the amount applicable to where the service was performed.

Does this amount reflect what Medicare will actually pay?

No. The PFS amount is the allowed charge before cost-sharing. Medicare generally pays 80% of this amount after the deductible is met, with the remainder being the patient's or secondary payer's responsibility.

Why did the amount change from a prior year?

RVUs, GPCIs, and the conversion factor are updated annually and can also be affected by budget-neutrality adjustments, so the allowed amount for the same code may change year to year.

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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.