Medicare Reimbursement for CPT 21422

This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this procedure code (CPT descriptor not shown due to AMA licensing restrictions). Amounts are provided nationally and adjusted by locality, with separate figures for non-facility and facility settings where they differ.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$590.19	$590.19
ALASKA* (AK)	$730.91	$730.91
ALABAMA (AL)	$539.15	$539.15
ARKANSAS (AR)	$532.81	$532.81
ARIZONA (AZ)	$576.03	$576.03
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$701.84	$701.84
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$713.41	$713.41
OXNARD-THOUSAND OAKS-VENTURA (CA)	$630.68	$630.68
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$636.34	$636.34
NAPA (CA)	$671.85	$671.85
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$703.25	$703.25
VALLEJO (CA)	$669.82	$669.82
BAKERSFIELD (CA)	$604.80	$604.80
CHICO (CA)	$601.20	$601.20
FRESNO (CA)	$601.20	$601.20
HANFORD-CORCORAN (CA)	$601.20	$601.20
MADERA (CA)	$601.20	$601.20
MERCED (CA)	$601.20	$601.20
MODESTO (CA)	$601.20	$601.20
REDDING (CA)	$601.20	$601.20
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$614.62	$614.62
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$624.33	$624.33
SALINAS (CA)	$621.85	$621.85
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$719.17	$719.17
SANTA CRUZ-WATSONVILLE (CA)	$633.82	$633.82
SANTA ROSA-PETALUMA (CA)	$639.82	$639.82
STOCKTON (CA)	$601.20	$601.20
VISALIA (CA)	$601.20	$601.20
YUBA CITY (CA)	$601.20	$601.20
EL CENTRO (CA)	$601.41	$601.41
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$631.60	$631.60
SAN LUIS OBISPO-PASO ROBLES (CA)	$612.58	$612.58
SANTA MARIA-SANTA BARBARA (CA)	$622.85	$622.85
REST OF CALIFORNIA (CA)	$601.20	$601.20
COLORADO (CO)	$601.46	$601.46
CONNECTICUT (CT)	$624.95	$624.95
DC + MD/VA SUBURBS (DC)	$657.31	$657.31
DELAWARE (DE)	$584.26	$584.26
FORT LAUDERDALE (FL)	$627.10	$627.10
MIAMI (FL)	$664.37	$664.37
REST OF FLORIDA (FL)	$599.39	$599.39
ATLANTA (GA)	$603.60	$603.60
REST OF GEORGIA (GA)	$569.58	$569.58
HAWAII, GUAM (HI)	$609.00	$609.00
IOWA (IA)	$542.73	$542.73
IDAHO (ID)	$547.20	$547.20
EAST ST. LOUIS (IL)	$611.03	$611.03
SUBURBAN CHICAGO (IL)	$631.30	$631.30
CHICAGO (IL)	$647.14	$647.14
REST OF ILLINOIS (IL)	$590.50	$590.50
INDIANA (IN)	$549.59	$549.59
KANSAS (KS)	$544.26	$544.26
KENTUCKY (KY)	$557.31	$557.31
NEW ORLEANS (LA)	$580.22	$580.22
REST OF LOUISIANA (LA)	$558.03	$558.03
METROPOLITAN BOSTON (MA)	$648.61	$648.61
REST OF MASSACHUSETTS (MA)	$600.35	$600.35
BALTIMORE/SURR. CNTYS (MD)	$623.87	$623.87
REST OF MARYLAND (MD)	$592.81	$592.81
SOUTHERN MAINE (ME)	$572.53	$572.53
REST OF MAINE (ME)	$553.38	$553.38
DETROIT (MI)	$609.35	$609.35
REST OF MICHIGAN (MI)	$572.52	$572.52
MINNESOTA (MN)	$568.71	$568.71
METROPOLITAN ST. LOUIS (MO)	$577.58	$577.58
METROPOLITAN KANSAS CITY (MO)	$573.10	$573.10
REST OF MISSOURI (MO)	$552.61	$552.61
MISSISSIPPI (MS)	$542.61	$542.61
MONTANA** (MT)	$590.11	$590.11
NORTH CAROLINA (NC)	$557.52	$557.52
NORTH DAKOTA** (ND)	$565.59	$565.59
NEBRASKA (NE)	$544.06	$544.06
NEW HAMPSHIRE (NH)	$595.86	$595.86
NORTHERN NJ (NJ)	$653.24	$653.24
REST OF NEW JERSEY (NJ)	$629.92	$629.92
NEW MEXICO (NM)	$576.56	$576.56
NEVADA** (NV)	$583.54	$583.54
MANHATTAN (NY)	$675.51	$675.51
NYC SUBURBS/LONG ISLAND (NY)	$693.88	$693.88
POUGHKPSIE/N NYC SUBURBS (NY)	$636.81	$636.81
QUEENS (NY)	$674.84	$674.84
REST OF NEW YORK (NY)	$564.67	$564.67
OHIO (OH)	$567.51	$567.51
OKLAHOMA (OK)	$552.65	$552.65
PORTLAND (OR)	$613.50	$613.50
REST OF OREGON (OR)	$576.83	$576.83
METROPOLITAN PHILADELPHIA (PA)	$614.15	$614.15
REST OF PENNSYLVANIA (PA)	$566.22	$566.22
PUERTO RICO (PR)	$592.48	$592.48
RHODE ISLAND (RI)	$599.85	$599.85
SOUTH CAROLINA (SC)	$563.88	$563.88
SOUTH DAKOTA** (SD)	$562.69	$562.69
TENNESSEE (TN)	$546.95	$546.95
BRAZORIA (TX)	$580.98	$580.98
DALLAS (TX)	$585.81	$585.81
GALVESTON (TX)	$583.49	$583.49
HOUSTON (TX)	$606.19	$606.19
BEAUMONT (TX)	$563.45	$563.45
FORT WORTH (TX)	$583.71	$583.71
AUSTIN (TX)	$601.38	$601.38
REST OF TEXAS (TX)	$572.69	$572.69
UTAH (UT)	$570.10	$570.10
VIRGINIA (VA)	$573.52	$573.52
VIRGIN ISLANDS (VI)	$592.48	$592.48
VERMONT (VT)	$567.09	$567.09
SEATTLE (KING CNTY) (WA)	$656.88	$656.88
REST OF WASHINGTON (WA)	$598.01	$598.01
WISCONSIN (WI)	$550.42	$550.42
WEST VIRGINIA (WV)	$573.39	$573.39
WYOMING** (WY)	$579.43	$579.43

Look up another code or locality →

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 payment is based on three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. 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 Medicare conversion factor to produce a dollar amount. Practice-expense RVUs often differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings, which is why two allowed amounts may be shown. The conversion factor is updated annually and applies uniformly across all codes before locality adjustment.

RVUs — work 8.51, practice expense 7.92 (non-facility) / 7.92 (facility), malpractice 1.24 — × 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 annual Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
Actual payment can vary based on modifiers, place of service, sequestration reductions, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why are the non-facility and facility amounts the same for this code?

When the practice-expense RVUs are identical for both settings, the calculated allowed amounts will match, even though the formula conceptually separates them.

Why might my actual payment differ from the amount shown here?

Locality-specific GPCIs, applied modifiers, sequestration, and yearly updates to the conversion factor can all change the final paid amount from the national estimate.

Does this amount reflect what the patient will owe?

No. This figure is the Medicare-allowed amount before cost-sharing; patients generally owe 20% coinsurance after the deductible, unless other coverage applies.

Where can I find the official CPT descriptor for this code?

CPT code descriptors are copyrighted by the American Medical Association (AMA) and must be obtained through a licensed CPT reference, such as the AMA's CPT codebook or a licensed EHR/billing system.

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.