Medicare Reimbursement for CPT 24220

CPT 24220 is a physician procedure code reported to Medicare for payment under the Physician Fee Schedule (PFS); the specific clinical descriptor is omitted here because CPT text is licensed by the AMA. This page shows the estimated Medicare-allowed amount nationally and adjusted for your locality, broken out by non-facility (office) and facility (hospital/ASC) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$186.38	$56.11
ALASKA* (AK)	$214.86	$76.13
ALABAMA (AL)	$167.08	$53.10
ARKANSAS (AR)	$164.63	$52.74
ARIZONA (AZ)	$181.43	$55.21
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$245.05	$61.38
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$250.02	$62.18
OXNARD-THOUSAND OAKS-VENTURA (CA)	$211.29	$57.31
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$212.16	$58.06
NAPA (CA)	$231.23	$59.54
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$245.20	$61.52
VALLEJO (CA)	$231.01	$59.33
BAKERSFIELD (CA)	$198.86	$56.09
CHICO (CA)	$198.46	$55.69
FRESNO (CA)	$198.46	$55.69
HANFORD-CORCORAN (CA)	$198.46	$55.69
MADERA (CA)	$198.46	$55.69
MERCED (CA)	$198.46	$55.69
MODESTO (CA)	$198.46	$55.69
REDDING (CA)	$198.46	$55.69
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$199.88	$57.11
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$208.60	$57.11
SALINAS (CA)	$207.83	$56.86
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$250.63	$62.79
SANTA CRUZ-WATSONVILLE (CA)	$215.21	$56.94
SANTA ROSA-PETALUMA (CA)	$217.40	$57.44
STOCKTON (CA)	$198.46	$55.69
VISALIA (CA)	$198.46	$55.69
YUBA CITY (CA)	$198.46	$55.69
EL CENTRO (CA)	$198.48	$55.71
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$212.97	$57.17
SAN LUIS OBISPO-PASO ROBLES (CA)	$204.45	$56.08
SANTA MARIA-SANTA BARBARA (CA)	$208.68	$56.79
REST OF CALIFORNIA (CA)	$198.46	$55.69
COLORADO (CO)	$194.85	$56.25
CONNECTICUT (CT)	$198.87	$58.57
DC + MD/VA SUBURBS (DC)	$213.97	$60.52
DELAWARE (DE)	$184.48	$55.78
FORT LAUDERDALE (FL)	$191.70	$59.74
MIAMI (FL)	$198.73	$63.12
REST OF FLORIDA (FL)	$182.43	$57.90
ATLANTA (GA)	$189.61	$57.26
REST OF GEORGIA (GA)	$172.17	$55.97
HAWAII, GUAM (HI)	$203.63	$55.52
IOWA (IA)	$171.92	$52.73
IDAHO (ID)	$172.95	$53.10
EAST ST. LOUIS (IL)	$179.64	$59.79
SUBURBAN CHICAGO (IL)	$193.79	$60.01
CHICAGO (IL)	$193.00	$62.08
REST OF ILLINOIS (IL)	$176.70	$57.77
INDIANA (IN)	$173.98	$53.22
KANSAS (KS)	$170.85	$53.09
KENTUCKY (KY)	$170.55	$54.74
NEW ORLEANS (LA)	$178.75	$56.17
REST OF LOUISIANA (LA)	$170.18	$54.89
METROPOLITAN BOSTON (MA)	$214.67	$59.14
REST OF MASSACHUSETTS (MA)	$193.56	$56.39
BALTIMORE/SURR. CNTYS (MD)	$198.26	$58.48
REST OF MARYLAND (MD)	$188.12	$56.29
SOUTHERN MAINE (ME)	$183.52	$54.43
REST OF MAINE (ME)	$173.59	$53.75
DETROIT (MI)	$184.48	$58.78
REST OF MICHIGAN (MI)	$174.82	$55.89
MINNESOTA (MN)	$187.36	$53.32
METROPOLITAN ST. LOUIS (MO)	$179.70	$55.69
METROPOLITAN KANSAS CITY (MO)	$177.78	$55.46
REST OF MISSOURI (MO)	$167.04	$54.76
MISSISSIPPI (MS)	$165.88	$53.73
MONTANA** (MT)	$186.37	$56.10
NORTH CAROLINA (NC)	$175.48	$53.94
NORTH DAKOTA** (ND)	$183.80	$53.53
NEBRASKA (NE)	$172.95	$52.72
NEW HAMPSHIRE (NH)	$191.54	$55.94
NORTHERN NJ (NJ)	$211.65	$60.55
REST OF NEW JERSEY (NJ)	$201.32	$59.07
NEW MEXICO (NM)	$175.69	$56.24
NEVADA** (NV)	$185.79	$55.40
MANHATTAN (NY)	$214.22	$62.86
NYC SUBURBS/LONG ISLAND (NY)	$219.16	$64.28
POUGHKPSIE/N NYC SUBURBS (NY)	$202.44	$59.81
QUEENS (NY)	$216.38	$62.41
REST OF NEW YORK (NY)	$178.12	$54.37
OHIO (OH)	$174.29	$55.36
OKLAHOMA (OK)	$170.51	$54.18
PORTLAND (OR)	$201.41	$56.69
REST OF OREGON (OR)	$184.53	$54.79
METROPOLITAN PHILADELPHIA (PA)	$193.70	$58.09
REST OF PENNSYLVANIA (PA)	$174.72	$55.14
PUERTO RICO (PR)	$187.84	$56.15
RHODE ISLAND (RI)	$191.32	$56.75
SOUTH CAROLINA (SC)	$175.14	$54.78
SOUTH DAKOTA** (SD)	$183.49	$53.23
TENNESSEE (TN)	$171.69	$53.28
BRAZORIA (TX)	$184.51	$55.42
DALLAS (TX)	$185.59	$55.85
GALVESTON (TX)	$185.00	$55.65
HOUSTON (TX)	$187.38	$58.03
BEAUMONT (TX)	$173.53	$54.99
FORT WORTH (TX)	$184.25	$55.81
AUSTIN (TX)	$194.05	$56.23
REST OF TEXAS (TX)	$178.85	$55.23
UTAH (UT)	$177.58	$55.13
VIRGINIA (VA)	$182.73	$54.68
VIRGIN ISLANDS (VI)	$187.84	$56.15
VERMONT (VT)	$182.84	$53.88
SEATTLE (KING CNTY) (WA)	$219.34	$59.50
REST OF WASHINGTON (WA)	$193.28	$56.11
WISCONSIN (WI)	$177.52	$52.73
WEST VIRGINIA (WV)	$170.00	$56.80
WYOMING** (WY)	$185.25	$54.98

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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 billed. The GPCI-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility (e.g., physician office, where the practice bears more overhead) and facility (e.g., hospital, ASC) settings, which is why the two amounts differ. The conversion factor and GPCI values are updated annually and can shift payment even when RVUs stay constant.

RVUs — work 1.28, practice expense 4.17 (non-facility) / 0.27 (facility), malpractice 0.13 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment; actual claims processing may differ.
Medicare typically pays 80% of the allowed amount after the patient's Part B deductible is met; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs mean the national figures shown are reference points; your MAC's locality-adjusted amount may differ.
Always confirm current-year rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why is the facility amount lower than the non-facility amount for this code?

Facility payments assume the hospital or ASC absorbs most of the overhead (equipment, supplies, clinical staff), so the practice-expense RVU used in that setting is lower than when the service is performed in a physician's office.

Why does the Medicare payment for this code vary by location?

Each locality has its own GPCI values for work, practice expense, and malpractice, reflecting differences in local labor and business costs; these multiply against the RVUs before the conversion factor is applied.

Does this page show what Medicare will actually pay me?

No — it shows the PFS allowed amount estimate. Actual reimbursement depends on the beneficiary's deductible status, applicable modifiers, secondary coverage, and any budget-neutrality or sequestration adjustments in effect.

Where can I verify the final rate for my locality?

Check your Medicare Administrative Contractor's published fee schedule or the CMS PFS Lookup Tool, which applies the current-year conversion factor and locality GPCIs.

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.