Medicare Reimbursement for CPT 22112

CPT 22112 is a surgical procedure code; because CPT descriptors are proprietary to the AMA, we refer to it generically here as 'this procedure code.' This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount nationally and lets you see how it is adjusted by locality, and separately for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1171.04	$1171.04
ALASKA* (AK)	$1347.44	$1347.44
ALABAMA (AL)	$1022.39	$1022.39
ARKANSAS (AR)	$1004.24	$1004.24
ARIZONA (AZ)	$1127.16	$1127.16
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1316.98	$1316.98
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1335.10	$1335.10
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1205.86	$1205.86
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1220.24	$1220.24
NAPA (CA)	$1270.46	$1270.46
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1323.53	$1323.53
VALLEJO (CA)	$1261.02	$1261.02
BAKERSFIELD (CA)	$1154.31	$1154.31
CHICO (CA)	$1139.33	$1139.33
FRESNO (CA)	$1139.33	$1139.33
HANFORD-CORCORAN (CA)	$1139.33	$1139.33
MADERA (CA)	$1139.33	$1139.33
MERCED (CA)	$1139.33	$1139.33
MODESTO (CA)	$1139.33	$1139.33
REDDING (CA)	$1139.33	$1139.33
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1200.88	$1200.88
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1182.88	$1182.88
SALINAS (CA)	$1178.51	$1178.51
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1361.88	$1361.88
SANTA CRUZ-WATSONVILLE (CA)	$1203.05	$1203.05
SANTA ROSA-PETALUMA (CA)	$1213.93	$1213.93
STOCKTON (CA)	$1139.33	$1139.33
VISALIA (CA)	$1139.33	$1139.33
YUBA CITY (CA)	$1139.33	$1139.33
EL CENTRO (CA)	$1140.29	$1140.29
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1198.45	$1198.45
SAN LUIS OBISPO-PASO ROBLES (CA)	$1161.69	$1161.69
SANTA MARIA-SANTA BARBARA (CA)	$1180.77	$1180.77
REST OF CALIFORNIA (CA)	$1139.33	$1139.33
COLORADO (CO)	$1167.61	$1167.61
CONNECTICUT (CT)	$1260.72	$1260.72
DC + MD/VA SUBURBS (DC)	$1310.13	$1310.13
DELAWARE (DE)	$1147.62	$1147.62
FORT LAUDERDALE (FL)	$1333.52	$1333.52
MIAMI (FL)	$1487.03	$1487.03
REST OF FLORIDA (FL)	$1245.09	$1245.09
ATLANTA (GA)	$1219.47	$1219.47
REST OF GEORGIA (GA)	$1151.87	$1151.87
HAWAII, GUAM (HI)	$1161.15	$1161.15
IOWA (IA)	$1010.62	$1010.62
IDAHO (ID)	$1027.87	$1027.87
EAST ST. LOUIS (IL)	$1324.85	$1324.85
SUBURBAN CHICAGO (IL)	$1337.07	$1337.07
CHICAGO (IL)	$1426.42	$1426.42
REST OF ILLINOIS (IL)	$1234.29	$1234.29
INDIANA (IN)	$1034.01	$1034.01
KANSAS (KS)	$1025.52	$1025.52
KENTUCKY (KY)	$1096.93	$1096.93
NEW ORLEANS (LA)	$1166.56	$1166.56
REST OF LOUISIANA (LA)	$1103.14	$1103.14
METROPOLITAN BOSTON (MA)	$1269.51	$1269.51
REST OF MASSACHUSETTS (MA)	$1166.81	$1166.81
BALTIMORE/SURR. CNTYS (MD)	$1262.01	$1262.01
REST OF MARYLAND (MD)	$1166.06	$1166.06
SOUTHERN MAINE (ME)	$1095.24	$1095.24
REST OF MAINE (ME)	$1056.58	$1056.58
DETROIT (MI)	$1285.04	$1285.04
REST OF MICHIGAN (MI)	$1150.65	$1150.65
MINNESOTA (MN)	$1050.44	$1050.44
METROPOLITAN ST. LOUIS (MO)	$1146.46	$1146.46
METROPOLITAN KANSAS CITY (MO)	$1134.88	$1134.88
REST OF MISSOURI (MO)	$1094.26	$1094.26
MISSISSIPPI (MS)	$1048.45	$1048.45
MONTANA** (MT)	$1170.65	$1170.65
NORTH CAROLINA (NC)	$1066.62	$1066.62
NORTH DAKOTA** (ND)	$1056.56	$1056.56
NEBRASKA (NE)	$1011.12	$1011.12
NEW HAMPSHIRE (NH)	$1168.27	$1168.27
NORTHERN NJ (NJ)	$1296.22	$1296.22
REST OF NEW JERSEY (NJ)	$1255.90	$1255.90
NEW MEXICO (NM)	$1166.61	$1166.61
NEVADA** (NV)	$1139.37	$1139.37
MANHATTAN (NY)	$1397.55	$1397.55
NYC SUBURBS/LONG ISLAND (NY)	$1463.82	$1463.82
POUGHKPSIE/N NYC SUBURBS (NY)	$1281.53	$1281.53
QUEENS (NY)	$1380.20	$1380.20
REST OF NEW YORK (NY)	$1087.79	$1087.79
OHIO (OH)	$1127.33	$1127.33
OKLAHOMA (OK)	$1072.41	$1072.41
PORTLAND (OR)	$1186.76	$1186.76
REST OF OREGON (OR)	$1111.72	$1111.72
METROPOLITAN PHILADELPHIA (PA)	$1237.80	$1237.80
REST OF PENNSYLVANIA (PA)	$1117.79	$1117.79
PUERTO RICO (PR)	$1173.87	$1173.87
RHODE ISLAND (RI)	$1176.09	$1176.09
SOUTH CAROLINA (SC)	$1102.60	$1102.60
SOUTH DAKOTA** (SD)	$1043.07	$1043.07
TENNESSEE (TN)	$1034.48	$1034.48
BRAZORIA (TX)	$1127.62	$1127.62
DALLAS (TX)	$1145.71	$1145.71
GALVESTON (TX)	$1137.91	$1137.91
HOUSTON (TX)	$1243.53	$1243.53
BEAUMONT (TX)	$1110.55	$1110.55
FORT WORTH (TX)	$1143.02	$1143.02
AUSTIN (TX)	$1180.14	$1180.14
REST OF TEXAS (TX)	$1125.82	$1125.82
UTAH (UT)	$1120.17	$1120.17
VIRGINIA (VA)	$1105.53	$1105.53
VIRGIN ISLANDS (VI)	$1173.87	$1173.87
VERMONT (VT)	$1070.63	$1070.63
SEATTLE (KING CNTY) (WA)	$1276.73	$1276.73
REST OF WASHINGTON (WA)	$1158.49	$1158.49
WISCONSIN (WI)	$1015.83	$1015.83
WEST VIRGINIA (WV)	$1185.97	$1185.97
WYOMING** (WY)	$1120.93	$1120.93

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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) 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 furnished, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings typically use different practice-expense RVUs because the resources involved differ, which can create two distinct allowed amounts — for this code, the national non-facility and facility amounts are the same. Because GPCIs vary by region, the same code can price differently across localities even though the underlying RVUs are unchanged.

RVUs — work 13.72, practice expense 15.57 (non-facility) / 15.57 (facility), malpractice 5.77 — × 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 annual budget-neutrality adjustments can change the actual paid amount.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the amount differ by locality for the same code?

Medicare applies Geographic Practice Cost Indices (GPCIs) to the work, practice expense, and malpractice RVUs to reflect regional cost differences, which changes the final dollar amount even though the RVUs themselves stay the same.

Why might the non-facility and facility amounts be the same or different?

The practice-expense RVU component can vary between non-facility (e.g., office) and facility (e.g., hospital) settings based on the resources Medicare assumes are used; when those RVUs are equal, the resulting amounts are also equal.

Does this page reflect what Medicare will actually pay?

No — it reflects the Medicare Physician Fee Schedule allowed amount before patient responsibility, modifiers, or claim-specific adjustments are applied, so actual payment can differ.

Where can I confirm the exact payment for my claim?

Check your Medicare Administrative Contractor's (MAC) published fee schedule or remittance advice, since local rules and adjustments can affect the final amount.

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.