Medicare Reimbursement for CPT 20822

CPT 20822 is a surgical procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare PFS allowed amount for this code, nationally and adjustable by locality, in both non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1602.58	$1602.58
ALASKA* (AK)	$1989.25	$1989.25
ALABAMA (AL)	$1453.59	$1453.59
ARKANSAS (AR)	$1435.36	$1435.36
ARIZONA (AZ)	$1558.90	$1558.90
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1803.92	$1803.92
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1829.34	$1829.34
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1657.12	$1657.12
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1676.54	$1676.54
NAPA (CA)	$1740.95	$1740.95
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1810.21	$1810.21
VALLEJO (CA)	$1731.88	$1731.88
BAKERSFIELD (CA)	$1599.46	$1599.46
CHICO (CA)	$1584.22	$1584.22
FRESNO (CA)	$1584.22	$1584.22
HANFORD-CORCORAN (CA)	$1584.22	$1584.22
MADERA (CA)	$1584.22	$1584.22
MERCED (CA)	$1584.22	$1584.22
MODESTO (CA)	$1584.22	$1584.22
REDDING (CA)	$1584.22	$1584.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1643.75	$1643.75
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1637.53	$1637.53
SALINAS (CA)	$1630.99	$1630.99
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1855.06	$1855.06
SANTA CRUZ-WATSONVILLE (CA)	$1653.08	$1653.08
SANTA ROSA-PETALUMA (CA)	$1668.03	$1668.03
STOCKTON (CA)	$1584.22	$1584.22
VISALIA (CA)	$1584.22	$1584.22
YUBA CITY (CA)	$1584.22	$1584.22
EL CENTRO (CA)	$1585.15	$1585.15
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1651.56	$1651.56
SAN LUIS OBISPO-PASO ROBLES (CA)	$1607.85	$1607.85
SANTA MARIA-SANTA BARBARA (CA)	$1632.23	$1632.23
REST OF CALIFORNIA (CA)	$1584.22	$1584.22
COLORADO (CO)	$1607.63	$1607.63
CONNECTICUT (CT)	$1701.10	$1701.10
DC + MD/VA SUBURBS (DC)	$1768.16	$1768.16
DELAWARE (DE)	$1581.63	$1581.63
FORT LAUDERDALE (FL)	$1759.23	$1759.23
MIAMI (FL)	$1908.03	$1908.03
REST OF FLORIDA (FL)	$1671.48	$1671.48
ATLANTA (GA)	$1651.16	$1651.16
REST OF GEORGIA (GA)	$1578.76	$1578.76
HAWAII, GUAM (HI)	$1599.95	$1599.95
IOWA (IA)	$1444.29	$1444.29
IDAHO (ID)	$1461.10	$1461.10
EAST ST. LOUIS (IL)	$1746.25	$1746.25
SUBURBAN CHICAGO (IL)	$1766.34	$1766.34
CHICAGO (IL)	$1851.03	$1851.03
REST OF ILLINOIS (IL)	$1658.95	$1658.95
INDIANA (IN)	$1467.35	$1467.35
KANSAS (KS)	$1458.05	$1458.05
KENTUCKY (KY)	$1525.86	$1525.86
NEW ORLEANS (LA)	$1595.32	$1595.32
REST OF LOUISIANA (LA)	$1531.62	$1531.62
METROPOLITAN BOSTON (MA)	$1724.40	$1724.40
REST OF MASSACHUSETTS (MA)	$1608.02	$1608.02
BALTIMORE/SURR. CNTYS (MD)	$1700.43	$1700.43
REST OF MARYLAND (MD)	$1602.68	$1602.68
SOUTHERN MAINE (ME)	$1529.35	$1529.35
REST OF MAINE (ME)	$1488.67	$1488.67
DETROIT (MI)	$1710.28	$1710.28
REST OF MICHIGAN (MI)	$1578.64	$1578.64
MINNESOTA (MN)	$1488.24	$1488.24
METROPOLITAN ST. LOUIS (MO)	$1576.57	$1576.57
METROPOLITAN KANSAS CITY (MO)	$1564.80	$1564.80
REST OF MISSOURI (MO)	$1521.94	$1521.94
MISSISSIPPI (MS)	$1477.91	$1477.91
MONTANA** (MT)	$1602.21	$1602.21
NORTH CAROLINA (NC)	$1498.96	$1498.96
NORTH DAKOTA** (ND)	$1492.66	$1492.66
NEBRASKA (NE)	$1445.17	$1445.17
NEW HAMPSHIRE (NH)	$1601.97	$1601.97
NORTHERN NJ (NJ)	$1757.76	$1757.76
REST OF NEW JERSEY (NJ)	$1705.80	$1705.80
NEW MEXICO (NM)	$1594.16	$1594.16
NEVADA** (NV)	$1572.22	$1572.22
MANHATTAN (NY)	$1855.58	$1855.58
NYC SUBURBS/LONG ISLAND (NY)	$1920.56	$1920.56
POUGHKPSIE/N NYC SUBURBS (NY)	$1732.70	$1732.70
QUEENS (NY)	$1839.92	$1839.92
REST OF NEW YORK (NY)	$1520.15	$1520.15
OHIO (OH)	$1556.25	$1556.25
OKLAHOMA (OK)	$1502.52	$1502.52
PORTLAND (OR)	$1630.08	$1630.08
REST OF OREGON (OR)	$1545.42	$1545.42
METROPOLITAN PHILADELPHIA (PA)	$1676.44	$1676.44
REST OF PENNSYLVANIA (PA)	$1547.34	$1547.34
PUERTO RICO (PR)	$1605.84	$1605.84
RHODE ISLAND (RI)	$1617.22	$1617.22
SOUTH CAROLINA (SC)	$1533.06	$1533.06
SOUTH DAKOTA** (SD)	$1479.71	$1479.71
TENNESSEE (TN)	$1466.90	$1466.90
BRAZORIA (TX)	$1563.87	$1563.87
DALLAS (TX)	$1581.91	$1581.91
GALVESTON (TX)	$1573.85	$1573.85
HOUSTON (TX)	$1675.25	$1675.25
BEAUMONT (TX)	$1539.99	$1539.99
FORT WORTH (TX)	$1578.83	$1578.83
AUSTIN (TX)	$1615.08	$1615.08
REST OF TEXAS (TX)	$1556.60	$1556.60
UTAH (UT)	$1550.73	$1550.73
VIRGINIA (VA)	$1538.83	$1538.83
VIRGIN ISLANDS (VI)	$1605.84	$1605.84
VERMONT (VT)	$1505.67	$1505.67
SEATTLE (KING CNTY) (WA)	$1736.84	$1736.84
REST OF WASHINGTON (WA)	$1598.76	$1598.76
WISCONSIN (WI)	$1451.45	$1451.45
WEST VIRGINIA (WV)	$1610.35	$1610.35
WYOMING** (WY)	$1554.46	$1554.46

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 3 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's PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility settings often differ because the practice-expense RVU component changes depending on whether overhead costs (like supplies and staff) are borne by the physician's office or by a hospital/ASC. The work and malpractice RVUs generally stay the same across settings, while practice-expense RVUs shift the total payment up or down accordingly.

RVUs — work 25.99, practice expense 16.45 (non-facility) / 16.45 (facility), malpractice 5.54 — × 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 deductible; the patient or secondary payer is responsible for the remainder.
Actual payment varies by locality GPCI, applicable modifiers, sequestration, and annual budget-neutrality adjustments.
Always verify the current, locality-specific amount with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility and non-facility amount differ for some codes but not others?

The difference comes from the practice-expense RVU. If a code's overhead costs are similar regardless of site of service, the non-facility and facility amounts may be identical or very close.

Does this amount reflect what my specific locality will pay?

No. The national amount shown is before locality-specific GPCI adjustments are applied; actual payment will vary by where the service is performed.

Will modifiers change this amount?

Yes. Modifiers such as bilateral, multiple procedure, or assistant-at-surgery indicators can increase or decrease the final allowed amount relative to the base calculation shown here.

Is this the amount Medicare will actually pay?

This is an estimated allowed amount. Medicare generally reimburses 80% of it after the deductible is met, and sequestration or other adjustments may further reduce actual payment.

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.