Billing code 11920Medicare rate & RVUs
Compare 11920 physician payment amounts across CMS localities, including office and facility settings.
Medicare pays $216.44 for 11920 nationally in the office and $102.54 in a hospital or facility. Local office rates run $190.10–$286.22.
Medicare rate · 11920
Code 11920
- Work RVUs
- 1.57
- Total RVUs
- 6.48
- Global days
- 000
National rate · 2026
$216.44
Office setting, before claim adjustments.
See every locality for 11920 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 6 sections
Where 11920 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$190.10 to $286.22
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $193.05 | $93.39 |
| Alaska* | $248.51 | $127.21 |
| Arizona | $210.30 | $99.93 |
| Arkansas | $190.10 | $92.26 |
| Atlanta | $220.95 | $105.23 |
| Austin | $224.45 | $103.94 |
| Bakersfield | $228.62 | $103.79 |
| Baltimore/Surr. Cntys | $230.78 | $108.57 |
| Beaumont | $201.86 | $98.21 |
| Brazoria | $213.41 | $100.54 |
| Chicago | $229.69 | $115.22 |
| Chico | $227.84 | $103.00 |
| Colorado | $224.92 | $103.73 |
| Connecticut | $231.36 | $108.69 |
| Dallas | $214.96 | $101.52 |
| Dc + Md/Va Suburbs | $247.85 | $113.68 |
| Delaware | $213.90 | $101.37 |
| Detroit | $217.44 | $107.53 |
| East St. Louis | $213.55 | $108.76 |
| El Centro | $227.88 | $103.05 |
| Fort Lauderdale | $226.00 | $110.63 |
| Fort Worth | $213.54 | $101.24 |
| Fresno | $227.84 | $103.00 |
| Galveston | $214.17 | $101.07 |
| Hanford-Corcoran | $227.84 | $103.00 |
| Hawaii, Guam | $233.69 | $104.19 |
| Houston | $219.29 | $106.19 |
| Idaho | $199.14 | $94.35 |
| Indiana | $200.34 | $94.76 |
| Iowa | $197.65 | $93.44 |
| Kansas | $196.95 | $93.99 |
| Kentucky | $198.48 | $97.22 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $243.75 | $109.01 |
| Madera | $227.84 | $103.00 |
| Manhattan | $250.33 | $117.98 |
| Merced | $227.84 | $103.00 |
| Metropolitan Boston | $247.56 | $111.57 |
| Metropolitan Kansas City | $206.79 | $99.84 |
| Metropolitan Philadelphia | $225.53 | $106.96 |
| Metropolitan St. Louis | $209.03 | $100.60 |
| Miami | $237.08 | $118.51 |
| Minnesota | $214.34 | $97.14 |
| Mississippi | $192.50 | $94.44 |
| Modesto | $227.84 | $103.00 |
| Montana** | $216.42 | $102.52 |
| Napa | $264.32 | $114.20 |
| Nebraska | $198.71 | $93.59 |
| Nevada** | $215.03 | $101.02 |
| New Hampshire | $221.61 | $103.04 |
| New Mexico | $205.48 | $101.04 |
| New Orleans | $208.59 | $101.41 |
| North Carolina | $202.70 | $96.43 |
| North Dakota** | $210.88 | $96.99 |
| Northern Nj | $245.12 | $113.00 |
| Nyc Suburbs/Long Island | $257.04 | $121.61 |
| Ohio | $203.06 | $99.07 |
| Oklahoma | $197.81 | $96.10 |
| Oxnard-Thousand Oaks-Ventura | $242.53 | $107.90 |
| Portland | $232.05 | $105.51 |
| Poughkpsie/N Nyc Suburbs | $235.45 | $110.74 |
| Puerto Rico | $218.00 | $102.85 |
| Queens | $252.07 | $117.45 |
| Redding | $227.84 | $103.00 |
| Rest Of California | $227.84 | $103.00 |
| Rest Of Florida | $214.34 | $105.45 |
| Rest Of Georgia | $201.53 | $99.94 |
| Rest Of Illinois | $208.25 | $104.26 |
| Rest Of Louisiana | $198.26 | $97.46 |
| Rest Of Maine | $200.53 | $95.75 |
| Rest Of Maryland | $218.05 | $102.79 |
| Rest Of Massachusetts | $223.57 | $103.64 |
| Rest Of Michigan | $204.19 | $100.20 |
| Rest Of Missouri | $194.85 | $96.67 |
| Rest Of New Jersey | $233.67 | $109.29 |
| Rest Of New York | $205.93 | $97.73 |
| Rest Of Oregon | $213.04 | $99.60 |
| Rest Of Pennsylvania | $203.24 | $98.68 |
| Rest Of Texas | $207.64 | $99.56 |
| Rest Of Washington | $223.08 | $103.15 |
| Rhode Island | $221.53 | $103.87 |
| Riverside-San Bernardino-Ontario | $230.85 | $106.02 |
| Sacramento-Roseville-Folsom | $239.19 | $106.73 |
| Salinas | $238.31 | $106.31 |
| San Diego-Chula Vista-Carlsbad | $244.04 | $107.82 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $279.76 | $119.17 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $279.45 | $118.85 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $286.22 | $121.98 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $284.92 | $120.68 |
| San Luis Obispo-Paso Robles | $234.49 | $104.76 |
| Santa Cruz-Watsonville | $246.45 | $108.06 |
| Santa Maria-Santa Barbara | $239.24 | $106.43 |
| Santa Rosa-Petaluma | $248.93 | $109.07 |
| Seattle (King Cnty) | $252.45 | $112.70 |
| South Carolina | $203.28 | $98.04 |
| South Dakota** | $210.23 | $96.33 |
| Southern Maine | $211.60 | $98.72 |
| Stockton | $227.84 | $103.00 |
| Suburban Chicago | $228.20 | $111.23 |
| Tennessee | $198.03 | $94.50 |
| Utah | $206.21 | $99.14 |
| Vallejo | $263.86 | $113.74 |
| Vermont | $210.27 | $97.51 |
| Virgin Islands | $218.00 | $102.85 |
| Virginia | $211.06 | $99.10 |
| Visalia | $227.84 | $103.00 |
| West Virginia | $200.21 | $101.23 |
| Wisconsin | $203.47 | $94.36 |
| Wyoming** | $214.01 | $100.11 |
| Yuba City | $227.84 | $103.00 |
11920 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$190.10
$257.03
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $248.51 | 1 |
| AL | $193.05 | 1 |
| AR | $190.10 | 1 |
| AZ | $210.30 | 1 |
| CA | $227.84–$286.22 | 29 |
| CO | $224.92 | 1 |
| CT | $231.36 | 1 |
| DC | $247.85 | 1 |
| DE | $213.90 | 1 |
| FL | $214.34–$237.08 | 3 |
| GA | $201.53–$220.95 | 2 |
| GU | $233.69 | 1 |
| HI | $233.69 | 1 |
| IA | $197.65 | 1 |
| ID | $199.14 | 1 |
| IL | $208.25–$229.69 | 4 |
| IN | $200.34 | 1 |
| KS | $196.95 | 1 |
| KY | $198.48 | 1 |
| LA | $198.26–$208.59 | 2 |
| MA | $223.57–$247.56 | 2 |
| MD | $218.05–$247.85 | 3 |
| ME | $200.53–$211.60 | 2 |
| MI | $204.19–$217.44 | 2 |
| MN | $214.34 | 1 |
| MO | $194.85–$209.03 | 3 |
| MS | $192.50 | 1 |
| MT | $216.42 | 1 |
| NC | $202.70 | 1 |
| ND | $210.88 | 1 |
| NE | $198.71 | 1 |
| NH | $221.61 | 1 |
| NJ | $233.67–$245.12 | 2 |
| NM | $205.48 | 1 |
| NV | $215.03 | 1 |
| NY | $205.93–$257.04 | 5 |
| OH | $203.06 | 1 |
| OK | $197.81 | 1 |
| OR | $213.04–$232.05 | 2 |
| PA | $203.24–$225.53 | 2 |
| PR | $218.00 | 1 |
| RI | $221.53 | 1 |
| SC | $203.28 | 1 |
| SD | $210.23 | 1 |
| TN | $198.03 | 1 |
| TX | $201.86–$224.45 | 8 |
| UT | $206.21 | 1 |
| VA | $211.06–$247.85 | 2 |
| VI | $218.00 | 1 |
| VT | $210.27 | 1 |
| WA | $223.08–$252.45 | 2 |
| WI | $203.47 | 1 |
| WV | $200.21 | 1 |
| WY | $214.01 | 1 |
How the 11920 rate is calculated
Each of 11920’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 11920
RVUs × geographic indexes × conversion factor
Work1.57
1.57 RVUs× 1.000 GPCI
Practice expense4.63
4.63 RVUs× 1.000 GPCI
Malpractice0.28
0.28 RVUs× 1.000 GPCI
Adjusted RVUs
6.4800
Conversion factor
$33.4009
Medicare rate
$216.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11920
The CMS indicators that decide how 11920 is paid alongside other services.
CMS payment indicators · 11920
Code 11920
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11920 without 51 · national office
$216.44
11920-51 · Second procedure: 50%
$108.22
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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