Medicare Reimbursement for CPT 24331
CPT 24331 is a surgical procedure code reported to Medicare for professional services. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and adjusted for your locality, reported separately for non-facility and facility settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $734.15 | $734.15 |
| ALASKA* (AK) | $898.07 | $898.07 |
| ALABAMA (AL) | $663.54 | $663.54 |
| ARKANSAS (AR) | $654.85 | $654.85 |
| ARIZONA (AZ) | $713.88 | $713.88 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $848.10 | $848.10 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $860.98 | $860.98 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $770.45 | $770.45 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $778.50 | $778.50 |
| NAPA (CA) | $815.23 | $815.23 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $850.68 | $850.68 |
| VALLEJO (CA) | $811.52 | $811.52 |
| BAKERSFIELD (CA) | $740.24 | $740.24 |
| CHICO (CA) | $733.99 | $733.99 |
| FRESNO (CA) | $733.99 | $733.99 |
| HANFORD-CORCORAN (CA) | $733.99 | $733.99 |
| MADERA (CA) | $733.99 | $733.99 |
| MERCED (CA) | $733.99 | $733.99 |
| MODESTO (CA) | $733.99 | $733.99 |
| REDDING (CA) | $733.99 | $733.99 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $758.38 | $758.38 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $760.98 | $760.98 |
| SALINAS (CA) | $757.99 | $757.99 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $871.52 | $871.52 |
| SANTA CRUZ-WATSONVILLE (CA) | $771.31 | $771.31 |
| SANTA ROSA-PETALUMA (CA) | $778.44 | $778.44 |
| STOCKTON (CA) | $733.99 | $733.99 |
| VISALIA (CA) | $733.99 | $733.99 |
| YUBA CITY (CA) | $733.99 | $733.99 |
| EL CENTRO (CA) | $734.37 | $734.37 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $769.24 | $769.24 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $746.96 | $746.96 |
| SANTA MARIA-SANTA BARBARA (CA) | $759.03 | $759.03 |
| REST OF CALIFORNIA (CA) | $733.99 | $733.99 |
| COLORADO (CO) | $741.13 | $741.13 |
| CONNECTICUT (CT) | $780.43 | $780.43 |
| DC + MD/VA SUBURBS (DC) | $815.67 | $815.67 |
| DELAWARE (DE) | $724.66 | $724.66 |
| FORT LAUDERDALE (FL) | $799.34 | $799.34 |
| MIAMI (FL) | $862.45 | $862.45 |
| REST OF FLORIDA (FL) | $759.02 | $759.02 |
| ATLANTA (GA) | $755.29 | $755.29 |
| REST OF GEORGIA (GA) | $716.14 | $716.14 |
| HAWAII, GUAM (HI) | $743.55 | $743.55 |
| IOWA (IA) | $662.80 | $662.80 |
| IDAHO (ID) | $670.07 | $670.07 |
| EAST ST. LOUIS (IL) | $786.90 | $786.90 |
| SUBURBAN CHICAGO (IL) | $803.33 | $803.33 |
| CHICAGO (IL) | $836.34 | $836.34 |
| REST OF ILLINOIS (IL) | $750.60 | $750.60 |
| INDIANA (IN) | $673.16 | $673.16 |
| KANSAS (KS) | $667.59 | $667.59 |
| KENTUCKY (KY) | $694.23 | $694.23 |
| NEW ORLEANS (LA) | $726.67 | $726.67 |
| REST OF LOUISIANA (LA) | $696.28 | $696.28 |
| METROPOLITAN BOSTON (MA) | $798.95 | $798.95 |
| REST OF MASSACHUSETTS (MA) | $740.45 | $740.45 |
| BALTIMORE/SURR. CNTYS (MD) | $779.85 | $779.85 |
| REST OF MARYLAND (MD) | $735.12 | $735.12 |
| SOUTHERN MAINE (ME) | $703.46 | $703.46 |
| REST OF MAINE (ME) | $681.36 | $681.36 |
| DETROIT (MI) | $775.61 | $775.61 |
| REST OF MICHIGAN (MI) | $717.69 | $717.69 |
| MINNESOTA (MN) | $689.52 | $689.52 |
| METROPOLITAN ST. LOUIS (MO) | $719.83 | $719.83 |
| METROPOLITAN KANSAS CITY (MO) | $714.01 | $714.01 |
| REST OF MISSOURI (MO) | $690.56 | $690.56 |
| MISSISSIPPI (MS) | $672.44 | $672.44 |
| MONTANA** (MT) | $734.00 | $734.00 |
| NORTH CAROLINA (NC) | $686.57 | $686.57 |
| NORTH DAKOTA** (ND) | $689.11 | $689.11 |
| NEBRASKA (NE) | $663.77 | $663.77 |
| NEW HAMPSHIRE (NH) | $737.04 | $737.04 |
| NORTHERN NJ (NJ) | $810.04 | $810.04 |
| REST OF NEW JERSEY (NJ) | $783.52 | $783.52 |
| NEW MEXICO (NM) | $724.36 | $724.36 |
| NEVADA** (NV) | $721.79 | $721.79 |
| MANHATTAN (NY) | $850.27 | $850.27 |
| NYC SUBURBS/LONG ISLAND (NY) | $878.96 | $878.96 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $794.78 | $794.78 |
| QUEENS (NY) | $845.39 | $845.39 |
| REST OF NEW YORK (NY) | $696.55 | $696.55 |
| OHIO (OH) | $708.52 | $708.52 |
| OKLAHOMA (OK) | $684.97 | $684.97 |
| PORTLAND (OR) | $753.93 | $753.93 |
| REST OF OREGON (OR) | $710.43 | $710.43 |
| METROPOLITAN PHILADELPHIA (PA) | $767.57 | $767.57 |
| REST OF PENNSYLVANIA (PA) | $705.25 | $705.25 |
| PUERTO RICO (PR) | $736.33 | $736.33 |
| RHODE ISLAND (RI) | $742.69 | $742.69 |
| SOUTH CAROLINA (SC) | $699.86 | $699.86 |
| SOUTH DAKOTA** (SD) | $683.81 | $683.81 |
| TENNESSEE (TN) | $671.60 | $671.60 |
| BRAZORIA (TX) | $717.61 | $717.61 |
| DALLAS (TX) | $725.39 | $725.39 |
| GALVESTON (TX) | $721.85 | $721.85 |
| HOUSTON (TX) | $763.40 | $763.40 |
| BEAUMONT (TX) | $701.62 | $701.62 |
| FORT WORTH (TX) | $723.36 | $723.36 |
| AUSTIN (TX) | $743.72 | $743.72 |
| REST OF TEXAS (TX) | $711.42 | $711.42 |
| UTAH (UT) | $708.32 | $708.32 |
| VIRGINIA (VA) | $706.73 | $706.73 |
| VIRGIN ISLANDS (VI) | $736.33 | $736.33 |
| VERMONT (VT) | $693.68 | $693.68 |
| SEATTLE (KING CNTY) (WA) | $806.58 | $806.58 |
| REST OF WASHINGTON (WA) | $736.65 | $736.65 |
| WISCONSIN (WI) | $669.02 | $669.02 |
| WEST VIRGINIA (WV) | $727.32 | $727.32 |
| WYOMING** (WY) | $714.44 | $714.44 |
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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 fee for a procedure code starts with 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 locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar 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 cause the allowed amount to vary by place of service. The conversion factor and RVU values are updated annually by CMS and can change the final amount even if the code itself is unchanged.
RVUs — work 10.68, practice expense 9.03 (non-facility) / 9.03 (facility), malpractice 2.27 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- This is an estimate only, based on the national PFS formula — actual payment depends on your specific Medicare Administrative Contractor (MAC) and locality GPCIs.
- 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, bilateral billing rules, and sequestration can reduce or otherwise change the actual paid amount.
- Annual budget-neutrality adjustments and conversion factor changes mean amounts shift each calendar year.
- Always verify the final allowed amount and any applicable edits with your MAC before billing or appealing a claim.
Frequently asked
Why does the non-facility amount differ from the facility amount for this code?
The practice expense RVU — and therefore the allowed amount — can differ between non-facility and facility settings because Medicare accounts for the fact that in a facility setting (like a hospital), the facility itself bears some of the overhead costs, while in a non-facility setting the billing practice bears those costs directly.
Is this the amount Medicare actually pays?
No. The figure shown is the Medicare-allowed amount before the standard 80/20 split and before any deductible, modifier, or policy-specific adjustments are applied.
Why might my MAC's payment differ from the national amount shown here?
The national amount uses a national conversion factor and RVUs, but actual payment is adjusted using your locality's specific GPCIs, which reflect local costs for work, practice expense, and malpractice.
Does this amount change year to year?
Yes. CMS updates the conversion factor and may revise RVUs annually, so the allowed amount for the same code can increase or decrease from one year to the next.
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.
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