Medicare Reimbursement for CPT 22103

CPT 22103 is a procedure code used for physician billing under Medicare; the specific clinical descriptor is not shown here due to AMA licensing restrictions. This page displays the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code at the national level and, where available, by locality, comparing non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$115.90	$115.90
ALASKA* (AK)	$147.98	$147.98
ALABAMA (AL)	$105.77	$105.77
ARKANSAS (AR)	$104.55	$104.55
ARIZONA (AZ)	$112.78	$112.78
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$122.98	$122.98
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$124.39	$124.39
OXNARD-THOUSAND OAKS-VENTURA (CA)	$115.93	$115.93
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$117.63	$117.63
NAPA (CA)	$119.81	$119.81
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$123.55	$123.55
VALLEJO (CA)	$118.99	$118.99
BAKERSFIELD (CA)	$113.03	$113.03
CHICO (CA)	$111.66	$111.66
FRESNO (CA)	$111.66	$111.66
HANFORD-CORCORAN (CA)	$111.66	$111.66
MADERA (CA)	$111.66	$111.66
MERCED (CA)	$111.66	$111.66
MODESTO (CA)	$111.66	$111.66
REDDING (CA)	$111.66	$111.66
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$117.03	$117.03
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$114.65	$114.65
SALINAS (CA)	$114.18	$114.18
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$126.72	$126.72
SANTA CRUZ-WATSONVILLE (CA)	$114.71	$114.71
SANTA ROSA-PETALUMA (CA)	$115.69	$115.69
STOCKTON (CA)	$111.66	$111.66
VISALIA (CA)	$111.66	$111.66
YUBA CITY (CA)	$111.66	$111.66
EL CENTRO (CA)	$111.74	$111.74
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$115.05	$115.05
SAN LUIS OBISPO-PASO ROBLES (CA)	$112.65	$112.65
SANTA MARIA-SANTA BARBARA (CA)	$114.11	$114.11
REST OF CALIFORNIA (CA)	$111.66	$111.66
COLORADO (CO)	$114.63	$114.63
CONNECTICUT (CT)	$122.71	$122.71
DC + MD/VA SUBURBS (DC)	$126.00	$126.00
DELAWARE (DE)	$114.32	$114.32
FORT LAUDERDALE (FL)	$129.69	$129.69
MIAMI (FL)	$142.38	$142.38
REST OF FLORIDA (FL)	$123.29	$123.29
ATLANTA (GA)	$119.86	$119.86
REST OF GEORGIA (GA)	$116.62	$116.62
HAWAII, GUAM (HI)	$112.03	$112.03
IOWA (IA)	$103.87	$103.87
IDAHO (ID)	$105.26	$105.26
EAST ST. LOUIS (IL)	$130.99	$130.99
SUBURBAN CHICAGO (IL)	$129.95	$129.95
CHICAGO (IL)	$138.18	$138.18
REST OF ILLINOIS (IL)	$123.30	$123.30
INDIANA (IN)	$105.63	$105.63
KANSAS (KS)	$105.41	$105.41
KENTUCKY (KY)	$111.92	$111.92
NEW ORLEANS (LA)	$116.81	$116.81
REST OF LOUISIANA (LA)	$112.55	$112.55
METROPOLITAN BOSTON (MA)	$121.66	$121.66
REST OF MASSACHUSETTS (MA)	$114.95	$114.95
BALTIMORE/SURR. CNTYS (MD)	$122.76	$122.76
REST OF MARYLAND (MD)	$115.57	$115.57
SOUTHERN MAINE (ME)	$109.53	$109.53
REST OF MAINE (ME)	$107.74	$107.74
DETROIT (MI)	$126.55	$126.55
REST OF MICHIGAN (MI)	$116.05	$116.05
MINNESOTA (MN)	$104.81	$104.81
METROPOLITAN ST. LOUIS (MO)	$114.83	$114.83
METROPOLITAN KANSAS CITY (MO)	$114.11	$114.11
REST OF MISSOURI (MO)	$112.29	$112.29
MISSISSIPPI (MS)	$108.34	$108.34
MONTANA** (MT)	$115.87	$115.87
NORTH CAROLINA (NC)	$108.33	$108.33
NORTH DAKOTA** (ND)	$105.98	$105.98
NEBRASKA (NE)	$103.74	$103.74
NEW HAMPSHIRE (NH)	$114.76	$114.76
NORTHERN NJ (NJ)	$125.52	$125.52
REST OF NEW JERSEY (NJ)	$122.69	$122.69
NEW MEXICO (NM)	$117.35	$117.35
NEVADA** (NV)	$113.14	$113.14
MANHATTAN (NY)	$134.29	$134.29
NYC SUBURBS/LONG ISLAND (NY)	$139.44	$139.44
POUGHKPSIE/N NYC SUBURBS (NY)	$125.02	$125.02
QUEENS (NY)	$132.35	$132.35
REST OF NEW YORK (NY)	$109.79	$109.79
OHIO (OH)	$114.03	$114.03
OKLAHOMA (OK)	$109.71	$109.71
PORTLAND (OR)	$115.40	$115.40
REST OF OREGON (OR)	$110.85	$110.85
METROPOLITAN PHILADELPHIA (PA)	$121.44	$121.44
REST OF PENNSYLVANIA (PA)	$113.09	$113.09
PUERTO RICO (PR)	$115.90	$115.90
RHODE ISLAND (RI)	$116.30	$116.30
SOUTH CAROLINA (SC)	$111.64	$111.64
SOUTH DAKOTA** (SD)	$104.81	$104.81
TENNESSEE (TN)	$106.07	$106.07
BRAZORIA (TX)	$112.63	$112.63
DALLAS (TX)	$114.12	$114.12
GALVESTON (TX)	$113.48	$113.48
HOUSTON (TX)	$122.63	$122.63
BEAUMONT (TX)	$112.64	$112.64
FORT WORTH (TX)	$114.11	$114.11
AUSTIN (TX)	$115.49	$115.49
REST OF TEXAS (TX)	$113.11	$113.11
UTAH (UT)	$112.81	$112.81
VIRGINIA (VA)	$110.60	$110.60
VIRGIN ISLANDS (VI)	$115.90	$115.90
VERMONT (VT)	$107.42	$107.42
SEATTLE (KING CNTY) (WA)	$121.88	$121.88
REST OF WASHINGTON (WA)	$114.12	$114.12
WISCONSIN (WI)	$103.38	$103.38
WEST VIRGINIA (WV)	$120.08	$120.08
WYOMING** (WY)	$111.56	$111.56

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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 PFS amounts are calculated from three Relative Value Units (RVUs) assigned to a code: 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 amount. Practice expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the same code can have two different allowed amounts depending on place of service. For this code, the non-facility and facility practice expense RVUs are the same, so the national amounts shown are identical in both settings.

RVUs — work 2.28, practice expense 0.69 (non-facility) / 0.69 (facility), malpractice 0.5 — × 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 payer is responsible for the remainder.
Actual payment can vary by locality GPCIs, applicable modifiers, multiple-procedure or bilateral adjustments, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

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

When the practice expense RVUs for non-facility and facility settings are identical, as they are for this code, the resulting allowed amounts are the same regardless of place of service.

Why can't you show the CPT code description?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page cannot reproduce the official language and instead refers to it generically.

Will my locality's payment differ from the national amount shown?

Yes. The national amount is a baseline; actual payment is adjusted using locality-specific GPCIs that reflect regional cost differences for work, practice expense, and malpractice.

Does this amount reflect what Medicare will actually pay?

No. It is an estimate of the allowed amount before the standard 80/20 split, deductible, and any modifier- or policy-based adjustments are applied.

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.