Medicare Reimbursement for CPT 22214

This page covers a CPT procedure code (descriptor not shown due to AMA licensing restrictions) and displays its estimated Medicare Physician Fee Schedule (PFS) allowed amount. Amounts are shown nationally and can vary by locality, and are broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1444.25	$1444.25
ALASKA* (AK)	$1729.91	$1729.91
ALABAMA (AL)	$1285.59	$1285.59
ARKANSAS (AR)	$1266.22	$1266.22
ARIZONA (AZ)	$1397.41	$1397.41
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1617.83	$1617.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1640.04	$1640.04
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1486.51	$1486.51
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1504.41	$1504.41
NAPA (CA)	$1562.08	$1562.08
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1624.83	$1624.83
VALLEJO (CA)	$1551.98	$1551.98
BAKERSFIELD (CA)	$1429.84	$1429.84
CHICO (CA)	$1413.43	$1413.43
FRESNO (CA)	$1413.43	$1413.43
HANFORD-CORCORAN (CA)	$1413.43	$1413.43
MADERA (CA)	$1413.43	$1413.43
MERCED (CA)	$1413.43	$1413.43
MODESTO (CA)	$1413.43	$1413.43
REDDING (CA)	$1413.43	$1413.43
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1479.44	$1479.44
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1463.54	$1463.54
SALINAS (CA)	$1457.90	$1457.90
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1668.69	$1668.69
SANTA CRUZ-WATSONVILLE (CA)	$1482.07	$1482.07
SANTA ROSA-PETALUMA (CA)	$1495.43	$1495.43
STOCKTON (CA)	$1413.43	$1413.43
VISALIA (CA)	$1413.43	$1413.43
YUBA CITY (CA)	$1413.43	$1413.43
EL CENTRO (CA)	$1414.46	$1414.46
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1478.94	$1478.94
SAN LUIS OBISPO-PASO ROBLES (CA)	$1437.24	$1437.24
SANTA MARIA-SANTA BARBARA (CA)	$1459.72	$1459.72
REST OF CALIFORNIA (CA)	$1413.43	$1413.43
COLORADO (CO)	$1442.78	$1442.78
CONNECTICUT (CT)	$1543.86	$1543.86
DC + MD/VA SUBURBS (DC)	$1603.07	$1603.07
DELAWARE (DE)	$1420.22	$1420.22
FORT LAUDERDALE (FL)	$1617.97	$1617.97
MIAMI (FL)	$1782.06	$1782.06
REST OF FLORIDA (FL)	$1523.55	$1523.55
ATLANTA (GA)	$1496.59	$1496.59
REST OF GEORGIA (GA)	$1424.01	$1424.01
HAWAII, GUAM (HI)	$1433.36	$1433.36
IOWA (IA)	$1272.91	$1272.91
IDAHO (ID)	$1291.35	$1291.35
EAST ST. LOUIS (IL)	$1608.92	$1608.92
SUBURBAN CHICAGO (IL)	$1623.09	$1623.09
CHICAGO (IL)	$1718.69	$1718.69
REST OF ILLINOIS (IL)	$1512.10	$1512.10
INDIANA (IN)	$1297.90	$1297.90
KANSAS (KS)	$1288.87	$1288.87
KENTUCKY (KY)	$1365.27	$1365.27
NEW ORLEANS (LA)	$1439.61	$1439.61
REST OF LOUISIANA (LA)	$1371.91	$1371.91
METROPOLITAN BOSTON (MA)	$1557.08	$1557.08
REST OF MASSACHUSETTS (MA)	$1442.72	$1442.72
BALTIMORE/SURR. CNTYS (MD)	$1544.47	$1544.47
REST OF MARYLAND (MD)	$1440.85	$1440.85
SOUTHERN MAINE (ME)	$1363.23	$1363.23
REST OF MAINE (ME)	$1322.05	$1322.05
DETROIT (MI)	$1566.25	$1566.25
REST OF MICHIGAN (MI)	$1422.66	$1422.66
MINNESOTA (MN)	$1315.23	$1315.23
METROPOLITAN ST. LOUIS (MO)	$1418.09	$1418.09
METROPOLITAN KANSAS CITY (MO)	$1405.73	$1405.73
REST OF MISSOURI (MO)	$1362.47	$1362.47
MISSISSIPPI (MS)	$1313.49	$1313.49
MONTANA** (MT)	$1443.84	$1443.84
NORTH CAROLINA (NC)	$1332.76	$1332.76
NORTH DAKOTA** (ND)	$1321.84	$1321.84
NEBRASKA (NE)	$1273.43	$1273.43
NEW HAMPSHIRE (NH)	$1441.20	$1441.20
NORTHERN NJ (NJ)	$1589.99	$1589.99
REST OF NEW JERSEY (NJ)	$1542.57	$1542.57
NEW MEXICO (NM)	$1439.71	$1439.71
NEVADA** (NV)	$1410.39	$1410.39
MANHATTAN (NY)	$1698.53	$1698.53
NYC SUBURBS/LONG ISLAND (NY)	$1769.33	$1769.33
POUGHKPSIE/N NYC SUBURBS (NY)	$1570.94	$1570.94
QUEENS (NY)	$1679.93	$1679.93
REST OF NEW YORK (NY)	$1355.36	$1355.36
OHIO (OH)	$1397.72	$1397.72
OKLAHOMA (OK)	$1339.04	$1339.04
PORTLAND (OR)	$1463.92	$1463.92
REST OF OREGON (OR)	$1380.83	$1380.83
METROPOLITAN PHILADELPHIA (PA)	$1519.05	$1519.05
REST OF PENNSYLVANIA (PA)	$1387.51	$1387.51
PUERTO RICO (PR)	$1447.26	$1447.26
RHODE ISLAND (RI)	$1453.28	$1453.28
SOUTH CAROLINA (SC)	$1371.25	$1371.25
SOUTH DAKOTA** (SD)	$1307.42	$1307.42
TENNESSEE (TN)	$1298.44	$1298.44
BRAZORIA (TX)	$1399.41	$1399.41
DALLAS (TX)	$1418.94	$1418.94
GALVESTON (TX)	$1410.41	$1410.41
HOUSTON (TX)	$1523.34	$1523.34
BEAUMONT (TX)	$1379.78	$1379.78
FORT WORTH (TX)	$1416.08	$1416.08
AUSTIN (TX)	$1454.25	$1454.25
REST OF TEXAS (TX)	$1396.02	$1396.02
UTAH (UT)	$1390.01	$1390.01
VIRGINIA (VA)	$1374.25	$1374.25
VIRGIN ISLANDS (VI)	$1447.26	$1447.26
VERMONT (VT)	$1336.91	$1336.91
SEATTLE (KING CNTY) (WA)	$1566.47	$1566.47
REST OF WASHINGTON (WA)	$1433.25	$1433.25
WISCONSIN (WI)	$1278.39	$1278.39
WEST VIRGINIA (WV)	$1460.53	$1460.53
WYOMING** (WY)	$1390.67	$1390.67

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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 Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs typically 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. The conversion factor and RVU values are updated annually and can shift the final amount even when the code itself doesn't change.

RVUs — work 20.49, practice expense 16.58 (non-facility) / 16.58 (facility), malpractice 6.17 — × 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 insurance is generally responsible for the remainder.
Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Allowed amounts vary by locality due to GPCI differences — the national figure is a reference point, not a locality-specific payment.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does this code show the same amount for facility and non-facility?

When the practice-expense RVU is identical for both settings, the calculated allowed amount comes out the same, even though the underlying RVU components used in the formula are still defined separately for each setting.

Will my local Medicare payment match the national amount shown here?

Not necessarily. The national figure uses a standard set of GPCI inputs; your actual locality's GPCIs will adjust the work, practice expense, and malpractice RVUs up or down, changing the final allowed amount.

Does this amount reflect what Medicare will actually pay?

No. This is the allowed amount before cost-sharing. Medicare generally pays 80% of this figure after the deductible, with the remainder owed by the patient or secondary payer, subject to modifiers and other adjustments.

Why might this amount change next year?

The conversion factor and RVUs are updated annually through CMS rulemaking, including budget-neutrality adjustments, so the same code's allowed amount can rise or fall from one year to the next.

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.