Medicare Reimbursement for CPT 11622

CPT 11622 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both nationally and adjustable by locality, and compares non-facility versus facility payment rates.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$249.84	$143.96
ALASKA* (AK)	$295.76	$183.00
ALABAMA (AL)	$225.74	$133.09
ARKANSAS (AR)	$222.69	$131.74
ARIZONA (AZ)	$243.55	$140.95
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$318.99	$169.70
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$325.13	$172.45
OXNARD-THOUSAND OAKS-VENTURA (CA)	$278.37	$153.22
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$279.91	$154.65
NAPA (CA)	$302.24	$162.69
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$319.29	$170.00
VALLEJO (CA)	$301.81	$162.26
BAKERSFIELD (CA)	$263.55	$147.50
CHICO (CA)	$262.76	$146.71
FRESNO (CA)	$262.76	$146.71
HANFORD-CORCORAN (CA)	$262.76	$146.71
MADERA (CA)	$262.76	$146.71
MERCED (CA)	$262.76	$146.71
MODESTO (CA)	$262.76	$146.71
REDDING (CA)	$262.76	$146.71
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$265.59	$149.55
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$275.15	$152.01
SALINAS (CA)	$274.11	$151.39
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$326.34	$173.66
SANTA CRUZ-WATSONVILLE (CA)	$282.43	$153.78
SANTA ROSA-PETALUMA (CA)	$285.25	$155.23
STOCKTON (CA)	$262.76	$146.71
VISALIA (CA)	$262.76	$146.71
YUBA CITY (CA)	$262.76	$146.71
EL CENTRO (CA)	$262.80	$146.76
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$280.10	$153.46
SAN LUIS OBISPO-PASO ROBLES (CA)	$269.75	$149.16
SANTA MARIA-SANTA BARBARA (CA)	$275.01	$151.55
REST OF CALIFORNIA (CA)	$262.76	$146.71
COLORADO (CO)	$259.29	$146.63
CONNECTICUT (CT)	$265.76	$151.72
DC + MD/VA SUBURBS (DC)	$284.01	$159.28
DELAWARE (DE)	$247.40	$142.79
FORT LAUDERDALE (FL)	$258.97	$151.71
MIAMI (FL)	$269.79	$159.56
REST OF FLORIDA (FL)	$247.05	$145.83
ATLANTA (GA)	$254.42	$146.85
REST OF GEORGIA (GA)	$233.94	$139.49
HAWAII, GUAM (HI)	$268.47	$148.08
IOWA (IA)	$230.78	$133.89
IDAHO (ID)	$232.25	$134.84
EAST ST. LOUIS (IL)	$245.63	$148.22
SUBURBAN CHICAGO (IL)	$261.48	$152.74
CHICAGO (IL)	$262.45	$156.04
REST OF ILLINOIS (IL)	$240.58	$143.91
INDIANA (IN)	$233.50	$135.35
KANSAS (KS)	$229.92	$134.20
KENTUCKY (KY)	$231.05	$136.92
NEW ORLEANS (LA)	$241.42	$141.79
REST OF LOUISIANA (LA)	$230.77	$137.06
METROPOLITAN BOSTON (MA)	$283.66	$157.24
REST OF MASSACHUSETTS (MA)	$257.95	$146.46
BALTIMORE/SURR. CNTYS (MD)	$265.03	$151.42
REST OF MARYLAND (MD)	$251.86	$144.71
SOUTHERN MAINE (ME)	$245.17	$140.24
REST OF MAINE (ME)	$233.54	$136.13
DETROIT (MI)	$250.10	$147.93
REST OF MICHIGAN (MI)	$236.81	$140.14
MINNESOTA (MN)	$248.44	$139.49
METROPOLITAN ST. LOUIS (MO)	$242.05	$141.25
METROPOLITAN KANSAS CITY (MO)	$239.72	$140.29
REST OF MISSOURI (MO)	$227.17	$135.90
MISSISSIPPI (MS)	$224.96	$133.80
MONTANA** (MT)	$249.82	$143.94
NORTH CAROLINA (NC)	$235.81	$137.02
NORTH DAKOTA** (ND)	$244.68	$138.80
NEBRASKA (NE)	$231.91	$134.18
NEW HAMPSHIRE (NH)	$255.42	$145.20
NORTHERN NJ (NJ)	$281.40	$158.58
REST OF NEW JERSEY (NJ)	$268.79	$153.16
NEW MEXICO (NM)	$238.08	$140.99
NEVADA** (NV)	$248.55	$142.56
MANHATTAN (NY)	$286.30	$163.27
NYC SUBURBS/LONG ISLAND (NY)	$293.05	$167.16
POUGHKPSIE/N NYC SUBURBS (NY)	$270.65	$154.71
QUEENS (NY)	$288.31	$163.15
REST OF NEW YORK (NY)	$239.13	$138.54
OHIO (OH)	$235.76	$139.09
OKLAHOMA (OK)	$230.50	$135.95
PORTLAND (OR)	$266.93	$149.29
REST OF OREGON (OR)	$246.61	$141.15
METROPOLITAN PHILADELPHIA (PA)	$259.60	$149.37
REST OF PENNSYLVANIA (PA)	$236.02	$138.82
PUERTO RICO (PR)	$251.50	$144.45
RHODE ISLAND (RI)	$255.76	$146.39
SOUTH CAROLINA (SC)	$236.17	$138.34
SOUTH DAKOTA** (SD)	$244.07	$138.19
TENNESSEE (TN)	$231.02	$134.77
BRAZORIA (TX)	$247.09	$142.16
DALLAS (TX)	$248.66	$143.20
GALVESTON (TX)	$247.83	$142.69
HOUSTON (TX)	$252.59	$147.45
BEAUMONT (TX)	$234.58	$138.23
FORT WORTH (TX)	$247.15	$142.75
AUSTIN (TX)	$258.44	$146.42
REST OF TEXAS (TX)	$240.70	$140.22
UTAH (UT)	$239.19	$139.67
VIRGINIA (VA)	$244.52	$140.44
VIRGIN ISLANDS (VI)	$251.50	$144.45
VERMONT (VT)	$243.92	$139.10
SEATTLE (KING CNTY) (WA)	$289.10	$159.18
REST OF WASHINGTON (WA)	$257.40	$145.91
WISCONSIN (WI)	$237.00	$135.56
WEST VIRGINIA (WV)	$232.27	$140.26
WYOMING** (WY)	$247.58	$141.70

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 units 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 payment for a procedure code is based on three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to 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. Non-facility rates apply when the service is performed in a physician's office or similar non-institutional setting, while facility rates apply when performed in a hospital or other facility setting, reflecting differences in the practice-expense RVU for overhead costs. Because GPCIs vary by geographic area, the same code can have different allowed amounts depending on where the service is billed.

RVUs — work 2.35, practice expense 4.87 (non-facility) / 1.7 (facility), malpractice 0.26 — × 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 patient meets their Part B deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, place of service, sequestration reductions, and annual budget-neutrality adjustments.
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 facility rate uses a lower practice-expense RVU because overhead costs (like equipment and supplies) are borne by the facility rather than the billing provider.

Why might the payment for this code differ between two states?

Each locality has its own Geographic Practice Cost Indices (GPCIs), which adjust the work, practice-expense, and malpractice RVUs to reflect local cost differences before the conversion factor is applied.

Does this page tell me what CPT 11622 actually is?

No. CPT code descriptors are copyrighted by the American Medical Association and are not reproduced here; consult your CPT codebook or EHR system for the official descriptor.

Will Medicare pay the full allowed amount shown here?

No. Medicare generally reimburses 80% of the allowed amount after the annual Part B deductible is met, with the remaining portion owed by the patient or secondary payer.

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.