Medicare Reimbursement for CPT 22208
This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code (CPT descriptors are not reproduced here due to AMA licensing). Amounts are shown nationally and can vary by locality, as well as by non-facility versus facility place of service.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $528.07 | $528.07 |
| ALASKA* (AK) | $644.32 | $644.32 |
| ALABAMA (AL) | $468.36 | $468.36 |
| ARKANSAS (AR) | $461.21 | $461.21 |
| ARIZONA (AZ) | $509.37 | $509.37 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $540.19 | $540.19 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $545.32 | $545.32 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $515.98 | $515.98 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $524.55 | $524.55 |
| NAPA (CA) | $529.19 | $529.19 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $543.82 | $543.82 |
| VALLEJO (CA) | $523.95 | $523.95 |
| BAKERSFIELD (CA) | $502.48 | $502.48 |
| CHICO (CA) | $494.05 | $494.05 |
| FRESNO (CA) | $494.05 | $494.05 |
| HANFORD-CORCORAN (CA) | $494.05 | $494.05 |
| MADERA (CA) | $494.05 | $494.05 |
| MERCED (CA) | $494.05 | $494.05 |
| MODESTO (CA) | $494.05 | $494.05 |
| REDDING (CA) | $494.05 | $494.05 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $528.25 | $528.25 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $507.17 | $507.17 |
| SALINAS (CA) | $505.17 | $505.17 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $560.18 | $560.18 |
| SANTA CRUZ-WATSONVILLE (CA) | $507.99 | $507.99 |
| SANTA ROSA-PETALUMA (CA) | $512.21 | $512.21 |
| STOCKTON (CA) | $494.05 | $494.05 |
| VISALIA (CA) | $494.05 | $494.05 |
| YUBA CITY (CA) | $494.05 | $494.05 |
| EL CENTRO (CA) | $494.59 | $494.59 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $509.44 | $509.44 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $498.63 | $498.63 |
| SANTA MARIA-SANTA BARBARA (CA) | $504.97 | $504.97 |
| REST OF CALIFORNIA (CA) | $494.05 | $494.05 |
| COLORADO (CO) | $515.26 | $515.26 |
| CONNECTICUT (CT) | $565.01 | $565.01 |
| DC + MD/VA SUBURBS (DC) | $576.10 | $576.10 |
| DELAWARE (DE) | $517.57 | $517.57 |
| FORT LAUDERDALE (FL) | $615.81 | $615.81 |
| MIAMI (FL) | $695.86 | $695.86 |
| REST OF FLORIDA (FL) | $577.14 | $577.14 |
| ATLANTA (GA) | $552.20 | $552.20 |
| REST OF GEORGIA (GA) | $537.08 | $537.08 |
| HAWAII, GUAM (HI) | $497.67 | $497.67 |
| IOWA (IA) | $454.56 | $454.56 |
| IDAHO (ID) | $463.22 | $463.22 |
| EAST ST. LOUIS (IL) | $627.92 | $627.92 |
| SUBURBAN CHICAGO (IL) | $615.66 | $615.66 |
| CHICAGO (IL) | $669.22 | $669.22 |
| REST OF ILLINOIS (IL) | $578.97 | $578.97 |
| INDIANA (IN) | $465.35 | $465.35 |
| KANSAS (KS) | $464.83 | $464.83 |
| KENTUCKY (KY) | $507.16 | $507.16 |
| NEW ORLEANS (LA) | $536.32 | $536.32 |
| REST OF LOUISIANA (LA) | $511.33 | $511.33 |
| METROPOLITAN BOSTON (MA) | $549.88 | $549.88 |
| REST OF MASSACHUSETTS (MA) | $517.05 | $517.05 |
| BALTIMORE/SURR. CNTYS (MD) | $566.21 | $566.21 |
| REST OF MARYLAND (MD) | $523.73 | $523.73 |
| SOUTHERN MAINE (ME) | $487.67 | $487.67 |
| REST OF MAINE (ME) | $479.14 | $479.14 |
| DETROIT (MI) | $597.66 | $597.66 |
| REST OF MICHIGAN (MI) | $532.59 | $532.59 |
| MINNESOTA (MN) | $455.91 | $455.91 |
| METROPOLITAN ST. LOUIS (MO) | $523.17 | $523.17 |
| METROPOLITAN KANSAS CITY (MO) | $519.11 | $519.11 |
| REST OF MISSOURI (MO) | $510.59 | $510.59 |
| MISSISSIPPI (MS) | $485.36 | $485.36 |
| MONTANA** (MT) | $527.85 | $527.85 |
| NORTH CAROLINA (NC) | $482.34 | $482.34 |
| NORTH DAKOTA** (ND) | $464.58 | $464.58 |
| NEBRASKA (NE) | $453.38 | $453.38 |
| NEW HAMPSHIRE (NH) | $519.08 | $519.08 |
| NORTHERN NJ (NJ) | $572.21 | $572.21 |
| REST OF NEW JERSEY (NJ) | $560.82 | $560.82 |
| NEW MEXICO (NM) | $540.71 | $540.71 |
| NEVADA** (NV) | $510.33 | $510.33 |
| MANHATTAN (NY) | $628.10 | $628.10 |
| NYC SUBURBS/LONG ISLAND (NY) | $659.94 | $659.94 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $574.79 | $574.79 |
| QUEENS (NY) | $614.84 | $614.84 |
| REST OF NEW YORK (NY) | $491.00 | $491.00 |
| OHIO (OH) | $519.65 | $519.65 |
| OKLAHOMA (OK) | $492.83 | $492.83 |
| PORTLAND (OR) | $517.57 | $517.57 |
| REST OF OREGON (OR) | $495.90 | $495.90 |
| METROPOLITAN PHILADELPHIA (PA) | $558.73 | $558.73 |
| REST OF PENNSYLVANIA (PA) | $513.45 | $513.45 |
| PUERTO RICO (PR) | $527.64 | $527.64 |
| RHODE ISLAND (RI) | $526.02 | $526.02 |
| SOUTH CAROLINA (SC) | $503.94 | $503.94 |
| SOUTH DAKOTA** (SD) | $457.10 | $457.10 |
| TENNESSEE (TN) | $468.89 | $468.89 |
| BRAZORIA (TX) | $506.11 | $506.11 |
| DALLAS (TX) | $515.30 | $515.30 |
| GALVESTON (TX) | $511.46 | $511.46 |
| HOUSTON (TX) | $570.03 | $570.03 |
| BEAUMONT (TX) | $510.89 | $510.89 |
| FORT WORTH (TX) | $515.62 | $515.62 |
| AUSTIN (TX) | $522.69 | $522.69 |
| REST OF TEXAS (TX) | $512.27 | $512.27 |
| UTAH (UT) | $510.77 | $510.77 |
| VIRGINIA (VA) | $494.83 | $494.83 |
| VIRGIN ISLANDS (VI) | $527.64 | $527.64 |
| VERMONT (VT) | $474.20 | $474.20 |
| SEATTLE (KING CNTY) (WA) | $548.43 | $548.43 |
| REST OF WASHINGTON (WA) | $512.26 | $512.26 |
| WISCONSIN (WI) | $449.63 | $449.63 |
| WEST VIRGINIA (WV) | $560.18 | $560.18 |
| WYOMING** (WY) | $500.28 | $500.28 |
Look up another code or locality →
Maximum units per day (MUE)
Medicare’s Medically Unlikely Edit caps this code at 5 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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. The adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Practice expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts can differ. The conversion factor and RVU values are updated annually by CMS and may be affected by budget-neutrality adjustments.
RVUs — work 9.42, practice expense 3.19 (non-facility) / 3.19 (facility), malpractice 3.2 — × 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 rules, sequestration, and annual budget-neutrality changes.
- Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.
Frequently asked
Why does the facility amount differ from the non-facility amount?
Facility and non-facility settings often use different practice expense RVUs, reflecting differences in overhead costs borne by the provider versus the facility.
Does this amount reflect what I will actually be paid?
No. It's a national or locality-adjusted estimate before modifiers, sequestration, secondary payer rules, or claim-specific adjustments are applied.
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.
How often do these rates change?
CMS updates RVUs, GPCIs, and the conversion factor annually, and mid-year adjustments can occur due to legislation or budget-neutrality requirements.
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.
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