Medicare Reimbursement for CPT Code 24164

This page covers CPT code 24164, a procedure code defined by the American Medical Association. It shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount, both nationally and adjusted for your locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$682.38	$682.38
ALASKA* (AK)	$832.69	$832.69
ALABAMA (AL)	$616.32	$616.32
ARKANSAS (AR)	$608.18	$608.18
ARIZONA (AZ)	$663.47	$663.47
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$791.14	$791.14
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$803.27	$803.27
OXNARD-THOUSAND OAKS-VENTURA (CA)	$717.59	$717.59
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$724.96	$724.96
NAPA (CA)	$760.06	$760.06
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$793.50	$793.50
VALLEJO (CA)	$756.66	$756.66
BAKERSFIELD (CA)	$688.98	$688.98
CHICO (CA)	$683.26	$683.26
FRESNO (CA)	$683.26	$683.26
HANFORD-CORCORAN (CA)	$683.26	$683.26
MADERA (CA)	$683.26	$683.26
MERCED (CA)	$683.26	$683.26
MODESTO (CA)	$683.26	$683.26
REDDING (CA)	$683.26	$683.26
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$705.61	$705.61
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$708.69	$708.69
SALINAS (CA)	$705.91	$705.91
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$812.93	$812.93
SANTA CRUZ-WATSONVILLE (CA)	$718.74	$718.74
SANTA ROSA-PETALUMA (CA)	$725.41	$725.41
STOCKTON (CA)	$683.26	$683.26
VISALIA (CA)	$683.26	$683.26
YUBA CITY (CA)	$683.26	$683.26
EL CENTRO (CA)	$683.60	$683.60
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$716.63	$716.63
SAN LUIS OBISPO-PASO ROBLES (CA)	$695.61	$695.61
SANTA MARIA-SANTA BARBARA (CA)	$706.95	$706.95
REST OF CALIFORNIA (CA)	$683.26	$683.26
COLORADO (CO)	$689.46	$689.46
CONNECTICUT (CT)	$725.60	$725.60
DC + MD/VA SUBURBS (DC)	$758.95	$758.95
DELAWARE (DE)	$673.54	$673.54
FORT LAUDERDALE (FL)	$742.25	$742.25
MIAMI (FL)	$800.38	$800.38
REST OF FLORIDA (FL)	$704.69	$704.69
ATLANTA (GA)	$701.92	$701.92
REST OF GEORGIA (GA)	$664.70	$664.70
HAWAII, GUAM (HI)	$692.48	$692.48
IOWA (IA)	$616.07	$616.07
IDAHO (ID)	$622.79	$622.79
EAST ST. LOUIS (IL)	$729.85	$729.85
SUBURBAN CHICAGO (IL)	$746.05	$746.05
CHICAGO (IL)	$776.06	$776.06
REST OF ILLINOIS (IL)	$696.50	$696.50
INDIANA (IN)	$625.70	$625.70
KANSAS (KS)	$620.35	$620.35
KENTUCKY (KY)	$644.59	$644.59
NEW ORLEANS (LA)	$674.88	$674.88
REST OF LOUISIANA (LA)	$646.43	$646.43
METROPOLITAN BOSTON (MA)	$743.82	$743.82
REST OF MASSACHUSETTS (MA)	$688.71	$688.71
BALTIMORE/SURR. CNTYS (MD)	$725.03	$725.03
REST OF MARYLAND (MD)	$683.39	$683.39
SOUTHERN MAINE (ME)	$654.16	$654.16
REST OF MAINE (ME)	$633.14	$633.14
DETROIT (MI)	$719.99	$719.99
REST OF MICHIGAN (MI)	$666.35	$666.35
MINNESOTA (MN)	$641.80	$641.80
METROPOLITAN ST. LOUIS (MO)	$668.73	$668.73
METROPOLITAN KANSAS CITY (MO)	$663.26	$663.26
REST OF MISSOURI (MO)	$640.93	$640.93
MISSISSIPPI (MS)	$624.32	$624.32
MONTANA** (MT)	$682.24	$682.24
NORTH CAROLINA (NC)	$638.05	$638.05
NORTH DAKOTA** (ND)	$641.11	$641.11
NEBRASKA (NE)	$617.05	$617.05
NEW HAMPSHIRE (NH)	$685.47	$685.47
NORTHERN NJ (NJ)	$753.58	$753.58
REST OF NEW JERSEY (NJ)	$728.57	$728.57
NEW MEXICO (NM)	$672.50	$672.50
NEVADA** (NV)	$671.07	$671.07
MANHATTAN (NY)	$790.47	$790.47
NYC SUBURBS/LONG ISLAND (NY)	$817.05	$817.05
POUGHKPSIE/N NYC SUBURBS (NY)	$738.91	$738.91
QUEENS (NY)	$786.21	$786.21
REST OF NEW YORK (NY)	$647.38	$647.38
OHIO (OH)	$657.95	$657.95
OKLAHOMA (OK)	$636.15	$636.15
PORTLAND (OR)	$701.69	$701.69
REST OF OREGON (OR)	$660.60	$660.60
METROPOLITAN PHILADELPHIA (PA)	$713.43	$713.43
REST OF PENNSYLVANIA (PA)	$655.01	$655.01
PUERTO RICO (PR)	$684.50	$684.50
RHODE ISLAND (RI)	$690.54	$690.54
SOUTH CAROLINA (SC)	$650.13	$650.13
SOUTH DAKOTA** (SD)	$636.25	$636.25
TENNESSEE (TN)	$624.07	$624.07
BRAZORIA (TX)	$667.12	$667.12
DALLAS (TX)	$674.30	$674.30
GALVESTON (TX)	$671.03	$671.03
HOUSTON (TX)	$709.10	$709.10
BEAUMONT (TX)	$651.60	$651.60
FORT WORTH (TX)	$672.33	$672.33
AUSTIN (TX)	$691.77	$691.77
REST OF TEXAS (TX)	$660.99	$660.99
UTAH (UT)	$658.06	$658.06
VIRGINIA (VA)	$657.07	$657.07
VIRGIN ISLANDS (VI)	$684.50	$684.50
VERMONT (VT)	$645.19	$645.19
SEATTLE (KING CNTY) (WA)	$751.15	$751.15
REST OF WASHINGTON (WA)	$685.23	$685.23
WISCONSIN (WI)	$622.24	$622.24
WEST VIRGINIA (WV)	$674.69	$674.69
WYOMING** (WY)	$664.32	$664.32

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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 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 performed. The adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Practice expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts can diverge. The conversion factor is set annually by CMS and is subject to statutory and budget-neutrality adjustments.

RVUs — work 9.75, practice expense 8.6 (non-facility) / 8.6 (facility), malpractice 2.08 — × 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 insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and locality-specific GPCIs can change the actual paid amount.
Conversion factors and RVUs are updated annually and may be revised mid-year due to budget-neutrality or legislative changes.
Always confirm final allowed amounts and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why do the non-facility and facility amounts differ for some codes but not others?

The difference comes from practice expense RVUs, which reflect overhead costs. When a procedure typically requires the same resources regardless of setting, these RVUs — and the resulting allowed amounts — may be identical.

Does this amount reflect what my practice will actually be paid?

No. This is a national or locality-adjusted estimate based on standard PFS inputs. Actual payment depends on your specific locality GPCIs, any applicable modifiers, claim-specific adjustments, and current sequestration rules.

Why can't you show the CPT code's description?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so we reference the code generically rather than reproducing the official language.

How often does the conversion factor change?

CMS updates the conversion factor annually, and it can also be affected by mid-year legislative or budget-neutrality adjustments, so amounts should be rechecked each year.

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.