Medicare Reimbursement for CPT 24365

CPT 24365 is a procedure code reported to Medicare for physician and outpatient services; the specific clinical descriptor is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and, where available, by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$605.56	$605.56
ALASKA* (AK)	$736.41	$736.41
ALABAMA (AL)	$546.56	$546.56
ARKANSAS (AR)	$539.28	$539.28
ARIZONA (AZ)	$588.77	$588.77
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$706.90	$706.90
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$717.94	$717.94
OXNARD-THOUSAND OAKS-VENTURA (CA)	$639.33	$639.33
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$645.68	$645.68
NAPA (CA)	$678.42	$678.42
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$708.92	$708.92
VALLEJO (CA)	$675.51	$675.51
BAKERSFIELD (CA)	$613.13	$613.13
CHICO (CA)	$608.23	$608.23
FRESNO (CA)	$608.23	$608.23
HANFORD-CORCORAN (CA)	$608.23	$608.23
MADERA (CA)	$608.23	$608.23
MERCED (CA)	$608.23	$608.23
MODESTO (CA)	$608.23	$608.23
REDDING (CA)	$608.23	$608.23
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$627.36	$627.36
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$631.35	$631.35
SALINAS (CA)	$628.89	$628.89
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$726.20	$726.20
SANTA CRUZ-WATSONVILLE (CA)	$640.95	$640.95
SANTA ROSA-PETALUMA (CA)	$646.93	$646.93
STOCKTON (CA)	$608.23	$608.23
VISALIA (CA)	$608.23	$608.23
YUBA CITY (CA)	$608.23	$608.23
EL CENTRO (CA)	$608.53	$608.53
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$638.79	$638.79
SAN LUIS OBISPO-PASO ROBLES (CA)	$619.65	$619.65
SANTA MARIA-SANTA BARBARA (CA)	$629.91	$629.91
REST OF CALIFORNIA (CA)	$608.23	$608.23
COLORADO (CO)	$612.90	$612.90
CONNECTICUT (CT)	$644.10	$644.10
DC + MD/VA SUBURBS (DC)	$674.69	$674.69
DELAWARE (DE)	$597.77	$597.77
FORT LAUDERDALE (FL)	$657.05	$657.05
MIAMI (FL)	$707.35	$707.35
REST OF FLORIDA (FL)	$623.78	$623.78
ATLANTA (GA)	$622.60	$622.60
REST OF GEORGIA (GA)	$588.30	$588.30
HAWAII, GUAM (HI)	$616.91	$616.91
IOWA (IA)	$547.14	$547.14
IDAHO (ID)	$552.98	$552.98
EAST ST. LOUIS (IL)	$644.60	$644.60
SUBURBAN CHICAGO (IL)	$660.59	$660.59
CHICAGO (IL)	$685.84	$685.84
REST OF ILLINOIS (IL)	$615.93	$615.93
INDIANA (IN)	$555.61	$555.61
KANSAS (KS)	$550.58	$550.58
KENTUCKY (KY)	$571.03	$571.03
NEW ORLEANS (LA)	$597.98	$597.98
REST OF LOUISIANA (LA)	$572.52	$572.52
METROPOLITAN BOSTON (MA)	$662.04	$662.04
REST OF MASSACHUSETTS (MA)	$612.05	$612.05
BALTIMORE/SURR. CNTYS (MD)	$643.52	$643.52
REST OF MARYLAND (MD)	$606.68	$606.68
SOUTHERN MAINE (ME)	$581.23	$581.23
REST OF MAINE (ME)	$561.84	$561.84
DETROIT (MI)	$637.05	$637.05
REST OF MICHIGAN (MI)	$590.13	$590.13
MINNESOTA (MN)	$571.40	$571.40
METROPOLITAN ST. LOUIS (MO)	$592.93	$592.93
METROPOLITAN KANSAS CITY (MO)	$587.99	$587.99
REST OF MISSOURI (MO)	$567.37	$567.37
MISSISSIPPI (MS)	$553.13	$553.13
MONTANA** (MT)	$605.44	$605.44
NORTH CAROLINA (NC)	$566.30	$566.30
NORTH DAKOTA** (ND)	$570.24	$570.24
NEBRASKA (NE)	$548.13	$548.13
NEW HAMPSHIRE (NH)	$609.01	$609.01
NORTHERN NJ (NJ)	$669.76	$669.76
REST OF NEW JERSEY (NJ)	$646.98	$646.98
NEW MEXICO (NM)	$595.47	$595.47
NEVADA** (NV)	$595.90	$595.90
MANHATTAN (NY)	$701.37	$701.37
NYC SUBURBS/LONG ISLAND (NY)	$724.65	$724.65
POUGHKPSIE/N NYC SUBURBS (NY)	$655.90	$655.90
QUEENS (NY)	$698.12	$698.12
REST OF NEW YORK (NY)	$574.62	$574.62
OHIO (OH)	$582.93	$582.93
OKLAHOMA (OK)	$563.89	$563.89
PORTLAND (OR)	$624.30	$624.30
REST OF OREGON (OR)	$586.84	$586.84
METROPOLITAN PHILADELPHIA (PA)	$632.97	$632.97
REST OF PENNSYLVANIA (PA)	$580.51	$580.51
PUERTO RICO (PR)	$607.59	$607.59
RHODE ISLAND (RI)	$613.23	$613.23
SOUTH CAROLINA (SC)	$576.46	$576.46
SOUTH DAKOTA** (SD)	$566.08	$566.08
TENNESSEE (TN)	$553.87	$553.87
BRAZORIA (TX)	$592.33	$592.33
DALLAS (TX)	$598.58	$598.58
GALVESTON (TX)	$595.72	$595.72
HOUSTON (TX)	$628.30	$628.30
BEAUMONT (TX)	$577.44	$577.44
FORT WORTH (TX)	$596.70	$596.70
AUSTIN (TX)	$614.74	$614.74
REST OF TEXAS (TX)	$586.25	$586.25
UTAH (UT)	$583.56	$583.56
VIRGINIA (VA)	$583.56	$583.56
VIRGIN ISLANDS (VI)	$607.59	$607.59
VERMONT (VT)	$573.53	$573.53
SEATTLE (KING CNTY) (WA)	$668.98	$668.98
REST OF WASHINGTON (WA)	$609.07	$609.07
WISCONSIN (WI)	$553.26	$553.26
WEST VIRGINIA (WV)	$596.40	$596.40
WYOMING** (WY)	$590.10	$590.10

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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 — assigned to each code. Each RVU component is adjusted by a locality-specific Geographic Practice Cost Index (GPCI) to reflect regional cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs because overhead costs are allocated differently depending on where the service is performed. The conversion factor is updated each year, which changes payment amounts even if RVUs stay the same.

RVUs — work 8.4, practice expense 7.95 (non-facility) / 7.95 (facility), malpractice 1.78 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary insurer is generally responsible for the remainder.
Actual payment can vary by locality GPCI, applicable modifiers, claims-based adjustments, sequestration, and annual budget-neutrality changes to the fee schedule.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The practice-expense RVU component is calculated differently depending on whether the service is performed in a non-facility setting (like a physician's office, where the provider bears more overhead) or a facility setting (like a hospital, where the facility bears some costs). This often results in different total RVUs and payment amounts.

Why might the amount shown differ from what I see on my Medicare remittance?

The published fee schedule amount is a baseline. Final payment can be affected by locality-specific GPCIs, modifiers (e.g., bilateral, multiple procedure), sequestration, claim-specific adjustments, and annual updates to the conversion factor under budget-neutrality rules.

Does this page tell me if CPT 24365 is covered by Medicare?

No. This page reflects the fee schedule amount assuming the service is covered and payable; it does not address medical necessity, coverage determinations, or documentation requirements, which should be verified separately.

How often does the conversion factor change?

The conversion factor is typically updated annually, though it can be affected by mid-year legislative changes or adjustments related to Medicare's budget-neutrality requirements.

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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.