Medicare Reimbursement for CPT 22010

CPT 22010 is a procedure code reported to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and adjusted for your locality, broken out by non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$950.92	$950.92
ALASKA* (AK)	$1124.83	$1124.83
ALABAMA (AL)	$842.77	$842.77
ARKANSAS (AR)	$829.54	$829.54
ARIZONA (AZ)	$919.26	$919.26
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1078.75	$1078.75
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1094.13	$1094.13
OXNARD-THOUSAND OAKS-VENTURA (CA)	$985.56	$985.56
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$996.82	$996.82
NAPA (CA)	$1039.50	$1039.50
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1083.28	$1083.28
VALLEJO (CA)	$1032.97	$1032.97
BAKERSFIELD (CA)	$945.34	$945.34
CHICO (CA)	$934.78	$934.78
FRESNO (CA)	$934.78	$934.78
HANFORD-CORCORAN (CA)	$934.78	$934.78
MADERA (CA)	$934.78	$934.78
MERCED (CA)	$934.78	$934.78
MODESTO (CA)	$934.78	$934.78
REDDING (CA)	$934.78	$934.78
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$977.44	$977.44
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$969.64	$969.64
SALINAS (CA)	$965.95	$965.95
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1112.65	$1112.65
SANTA CRUZ-WATSONVILLE (CA)	$984.34	$984.34
SANTA ROSA-PETALUMA (CA)	$993.31	$993.31
STOCKTON (CA)	$934.78	$934.78
VISALIA (CA)	$934.78	$934.78
YUBA CITY (CA)	$934.78	$934.78
EL CENTRO (CA)	$935.45	$935.45
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$981.23	$981.23
SAN LUIS OBISPO-PASO ROBLES (CA)	$952.09	$952.09
SANTA MARIA-SANTA BARBARA (CA)	$967.52	$967.52
REST OF CALIFORNIA (CA)	$934.78	$934.78
COLORADO (CO)	$952.48	$952.48
CONNECTICUT (CT)	$1018.20	$1018.20
DC + MD/VA SUBURBS (DC)	$1060.04	$1060.04
DELAWARE (DE)	$934.71	$934.71
FORT LAUDERDALE (FL)	$1063.84	$1063.84
MIAMI (FL)	$1171.19	$1171.19
REST OF FLORIDA (FL)	$1000.25	$1000.25
ATLANTA (GA)	$985.40	$985.40
REST OF GEORGIA (GA)	$933.04	$933.04
HAWAII, GUAM (HI)	$949.96	$949.96
IOWA (IA)	$836.35	$836.35
IDAHO (ID)	$848.49	$848.49
EAST ST. LOUIS (IL)	$1053.86	$1053.86
SUBURBAN CHICAGO (IL)	$1067.58	$1067.58
CHICAGO (IL)	$1128.43	$1128.43
REST OF ILLINOIS (IL)	$990.94	$990.94
INDIANA (IN)	$853.04	$853.04
KANSAS (KS)	$846.18	$846.18
KENTUCKY (KY)	$894.92	$894.92
NEW ORLEANS (LA)	$945.30	$945.30
REST OF LOUISIANA (LA)	$899.04	$899.04
METROPOLITAN BOSTON (MA)	$1031.37	$1031.37
REST OF MASSACHUSETTS (MA)	$951.84	$951.84
BALTIMORE/SURR. CNTYS (MD)	$1018.53	$1018.53
REST OF MARYLAND (MD)	$948.98	$948.98
SOUTHERN MAINE (ME)	$898.12	$898.12
REST OF MAINE (ME)	$868.35	$868.35
DETROIT (MI)	$1028.26	$1028.26
REST OF MICHIGAN (MI)	$933.10	$933.10
MINNESOTA (MN)	$868.77	$868.77
METROPOLITAN ST. LOUIS (MO)	$931.87	$931.87
METROPOLITAN KANSAS CITY (MO)	$923.31	$923.31
REST OF MISSOURI (MO)	$891.92	$891.92
MISSISSIPPI (MS)	$860.20	$860.20
MONTANA** (MT)	$950.66	$950.66
NORTH CAROLINA (NC)	$875.85	$875.85
NORTH DAKOTA** (ND)	$871.76	$871.76
NEBRASKA (NE)	$837.04	$837.04
NEW HAMPSHIRE (NH)	$950.77	$950.77
NORTHERN NJ (NJ)	$1050.54	$1050.54
REST OF NEW JERSEY (NJ)	$1017.49	$1017.49
NEW MEXICO (NM)	$944.30	$944.30
NEVADA** (NV)	$929.07	$929.07
MANHATTAN (NY)	$1120.79	$1120.79
NYC SUBURBS/LONG ISLAND (NY)	$1167.78	$1167.78
POUGHKPSIE/N NYC SUBURBS (NY)	$1035.83	$1035.83
QUEENS (NY)	$1109.65	$1109.65
REST OF NEW YORK (NY)	$891.22	$891.22
OHIO (OH)	$916.97	$916.97
OKLAHOMA (OK)	$878.14	$878.14
PORTLAND (OR)	$968.12	$968.12
REST OF OREGON (OR)	$909.73	$909.73
METROPOLITAN PHILADELPHIA (PA)	$1000.62	$1000.62
REST OF PENNSYLVANIA (PA)	$910.59	$910.59
PUERTO RICO (PR)	$953.35	$953.35
RHODE ISLAND (RI)	$957.70	$957.70
SOUTH CAROLINA (SC)	$900.34	$900.34
SOUTH DAKOTA** (SD)	$862.43	$862.43
TENNESSEE (TN)	$852.59	$852.59
BRAZORIA (TX)	$921.30	$921.30
DALLAS (TX)	$934.13	$934.13
GALVESTON (TX)	$928.51	$928.51
HOUSTON (TX)	$1001.54	$1001.54
BEAUMONT (TX)	$905.24	$905.24
FORT WORTH (TX)	$931.83	$931.83
AUSTIN (TX)	$959.91	$959.91
REST OF TEXAS (TX)	$917.47	$917.47
UTAH (UT)	$913.18	$913.18
VIRGINIA (VA)	$904.90	$904.90
VIRGIN ISLANDS (VI)	$953.35	$953.35
VERMONT (VT)	$881.06	$881.06
SEATTLE (KING CNTY) (WA)	$1038.66	$1038.66
REST OF WASHINGTON (WA)	$945.80	$945.80
WISCONSIN (WI)	$841.80	$841.80
WEST VIRGINIA (WV)	$955.64	$955.64
WYOMING** (WY)	$916.27	$916.27

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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's Physician Fee Schedule 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 Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice expense RVUs can differ between non-facility and facility settings depending on the code, which is why the two allowed amounts may not match; for this code, those practice-expense values happen to be the same, so the resulting non-facility and facility amounts are equal.

RVUs — work 12.43, practice expense 12.05 (non-facility) / 12.05 (facility), malpractice 3.99 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment — actual reimbursement depends on claim-specific factors.
Medicare typically pays 80% of the allowed amount after the patient meets their Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs and the conversion factor are updated periodically; always confirm current-year figures.
Verify the exact allowed amount and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the amount differ between non-facility and facility settings for other codes?

Some codes have different practice-expense RVUs for non-facility versus facility settings because overhead costs (equipment, staff, supplies) are assumed to be borne by the facility rather than the billing physician. For this code, those practice-expense values are the same, so the two amounts match.

Why might my locality's amount differ from the national figure shown here?

The national amount uses a GPCI value of 1.0 for all components, while your locality's actual GPCIs adjust for regional differences in wages, rent, and malpractice costs, which can raise or lower the final allowed amount.

Does this amount reflect what Medicare will actually pay?

No. The PFS allowed amount is the basis for payment, but Medicare generally reimburses 80% of it after the deductible is met, and the actual claim payment can be affected by modifiers, sequestration, and other adjustments.

Where can I find the official, current-year rate for my area?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules, and CMS releases the annual Physician Fee Schedule final rule with updated RVUs and conversion factors each year.

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.