Medicare Reimbursement for CPT 22102

CPT 22102 is a surgical procedure code; the exact clinical description is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and by locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$702.09	$702.09
ALASKA* (AK)	$874.60	$874.60
ALABAMA (AL)	$641.36	$641.36
ARKANSAS (AR)	$633.85	$633.85
ARIZONA (AZ)	$684.90	$684.90
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$818.74	$818.74
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$831.57	$831.57
OXNARD-THOUSAND OAKS-VENTURA (CA)	$741.64	$741.64
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$749.01	$749.01
NAPA (CA)	$786.02	$786.02
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$820.73	$820.73
VALLEJO (CA)	$783.15	$783.15
BAKERSFIELD (CA)	$713.25	$713.25
CHICO (CA)	$708.26	$708.26
FRESNO (CA)	$708.26	$708.26
HANFORD-CORCORAN (CA)	$708.26	$708.26
MADERA (CA)	$708.26	$708.26
MERCED (CA)	$708.26	$708.26
MODESTO (CA)	$708.26	$708.26
REDDING (CA)	$708.26	$708.26
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$727.15	$727.15
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$734.07	$734.07
SALINAS (CA)	$731.13	$731.13
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$839.69	$839.69
SANTA CRUZ-WATSONVILLE (CA)	$743.37	$743.37
SANTA ROSA-PETALUMA (CA)	$750.29	$750.29
STOCKTON (CA)	$708.26	$708.26
VISALIA (CA)	$708.26	$708.26
YUBA CITY (CA)	$708.26	$708.26
EL CENTRO (CA)	$708.55	$708.55
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$741.59	$741.59
SAN LUIS OBISPO-PASO ROBLES (CA)	$720.42	$720.42
SANTA MARIA-SANTA BARBARA (CA)	$732.03	$732.03
REST OF CALIFORNIA (CA)	$708.26	$708.26
COLORADO (CO)	$711.72	$711.72
CONNECTICUT (CT)	$743.36	$743.36
DC + MD/VA SUBURBS (DC)	$778.53	$778.53
DELAWARE (DE)	$694.59	$694.59
FORT LAUDERDALE (FL)	$752.99	$752.99
MIAMI (FL)	$803.06	$803.06
REST OF FLORIDA (FL)	$719.04	$719.04
ATLANTA (GA)	$719.44	$719.44
REST OF GEORGIA (GA)	$682.76	$682.76
HAWAII, GUAM (HI)	$716.24	$716.24
IOWA (IA)	$642.79	$642.79
IDAHO (ID)	$648.65	$648.65
EAST ST. LOUIS (IL)	$738.72	$738.72
SUBURBAN CHICAGO (IL)	$757.38	$757.38
CHICAGO (IL)	$781.72	$781.72
REST OF ILLINOIS (IL)	$710.38	$710.38
INDIANA (IN)	$651.39	$651.39
KANSAS (KS)	$645.94	$645.94
KENTUCKY (KY)	$665.72	$665.72
NEW ORLEANS (LA)	$693.34	$693.34
REST OF LOUISIANA (LA)	$667.10	$667.10
METROPOLITAN BOSTON (MA)	$765.33	$765.33
REST OF MASSACHUSETTS (MA)	$710.99	$710.99
BALTIMORE/SURR. CNTYS (MD)	$742.36	$742.36
REST OF MARYLAND (MD)	$704.30	$704.30
SOUTHERN MAINE (ME)	$677.97	$677.97
REST OF MAINE (ME)	$657.36	$657.36
DETROIT (MI)	$732.28	$732.28
REST OF MICHIGAN (MI)	$685.01	$685.01
MINNESOTA (MN)	$669.14	$669.14
METROPOLITAN ST. LOUIS (MO)	$688.62	$688.62
METROPOLITAN KANSAS CITY (MO)	$683.49	$683.49
REST OF MISSOURI (MO)	$661.53	$661.53
MISSISSIPPI (MS)	$647.51	$647.51
MONTANA** (MT)	$701.97	$701.97
NORTH CAROLINA (NC)	$662.03	$662.03
NORTH DAKOTA** (ND)	$667.37	$667.37
NEBRASKA (NE)	$643.95	$643.95
NEW HAMPSHIRE (NH)	$706.38	$706.38
NORTHERN NJ (NJ)	$774.05	$774.05
REST OF NEW JERSEY (NJ)	$748.21	$748.21
NEW MEXICO (NM)	$690.35	$690.35
NEVADA** (NV)	$692.61	$692.61
MANHATTAN (NY)	$805.26	$805.26
NYC SUBURBS/LONG ISLAND (NY)	$828.74	$828.74
POUGHKPSIE/N NYC SUBURBS (NY)	$757.47	$757.47
QUEENS (NY)	$802.50	$802.50
REST OF NEW YORK (NY)	$670.58	$670.58
OHIO (OH)	$677.94	$677.94
OKLAHOMA (OK)	$658.78	$658.78
PORTLAND (OR)	$724.30	$724.30
REST OF OREGON (OR)	$683.60	$683.60
METROPOLITAN PHILADELPHIA (PA)	$731.46	$731.46
REST OF PENNSYLVANIA (PA)	$675.67	$675.67
PUERTO RICO (PR)	$704.32	$704.32
RHODE ISLAND (RI)	$711.96	$711.96
SOUTH CAROLINA (SC)	$671.82	$671.82
SOUTH DAKOTA** (SD)	$663.28	$663.28
TENNESSEE (TN)	$649.28	$649.28
BRAZORIA (TX)	$689.57	$689.57
DALLAS (TX)	$695.90	$695.90
GALVESTON (TX)	$692.94	$692.94
HOUSTON (TX)	$724.97	$724.97
BEAUMONT (TX)	$672.48	$672.48
FORT WORTH (TX)	$693.83	$693.83
AUSTIN (TX)	$712.55	$712.55
REST OF TEXAS (TX)	$681.99	$681.99
UTAH (UT)	$679.15	$679.15
VIRGINIA (VA)	$680.09	$680.09
VIRGIN ISLANDS (VI)	$704.32	$704.32
VERMONT (VT)	$670.38	$670.38
SEATTLE (KING CNTY) (WA)	$773.65	$773.65
REST OF WASHINGTON (WA)	$707.80	$707.80
WISCONSIN (WI)	$649.76	$649.76
WEST VIRGINIA (WV)	$690.22	$690.22
WYOMING** (WY)	$686.89	$686.89

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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 amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed. The geographically adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings because the resources a physician must supply differ by setting; for this code, the practice-expense RVU happens to be the same in both settings, so the resulting national amounts shown are equal. Amounts are recalculated annually based on CMS rulemaking and are subject to budget-neutrality adjustments.

RVUs — work 10.8, practice expense 8.47 (non-facility) / 8.47 (facility), malpractice 1.75 — × 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.
Modifiers, multiple-procedure reductions, sequestration, and locality-specific GPCIs can all change the final paid amount.
Conversion factors and RVUs are updated annually and may be revised mid-year by CMS.
Confirm current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

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

Because the practice-expense RVU used in the formula is identical for both settings for this particular code, so the geographically adjusted totals come out the same. This is not true for every code.

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

The national amount uses a GPCI value of 1.0 for each cost component, while locality-specific amounts apply that area's actual work, practice-expense, and malpractice GPCIs, which can raise or lower the total.

Does this amount include the Medicare deductible or coinsurance?

No. The figure shown is the full PFS allowed amount; Medicare generally pays 80% of this after the deductible is met, with the remaining 20% billed to the patient or secondary insurer.

Why can the conversion factor change from year to year?

CMS updates the conversion factor annually through rulemaking, often reflecting legislative adjustments, budget-neutrality requirements, and updates to RVUs across the fee schedule.

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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.