Medicare Reimbursement for CPT 22224
CPT 22224 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted by locality, with separate figures for non-facility and facility settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $1480.33 | $1480.33 |
| ALASKA* (AK) | $1805.06 | $1805.06 |
| ALABAMA (AL) | $1330.03 | $1330.03 |
| ARKANSAS (AR) | $1311.66 | $1311.66 |
| ARIZONA (AZ) | $1436.08 | $1436.08 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $1661.58 | $1661.58 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $1684.67 | $1684.67 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $1526.79 | $1526.79 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $1544.96 | $1544.96 |
| NAPA (CA) | $1604.06 | $1604.06 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $1668.10 | $1668.10 |
| VALLEJO (CA) | $1594.66 | $1594.66 |
| BAKERSFIELD (CA) | $1471.18 | $1471.18 |
| CHICO (CA) | $1455.68 | $1455.68 |
| FRESNO (CA) | $1455.68 | $1455.68 |
| HANFORD-CORCORAN (CA) | $1455.68 | $1455.68 |
| MADERA (CA) | $1455.68 | $1455.68 |
| MERCED (CA) | $1455.68 | $1455.68 |
| MODESTO (CA) | $1455.68 | $1455.68 |
| REDDING (CA) | $1455.68 | $1455.68 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $1517.21 | $1517.21 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $1505.93 | $1505.93 |
| SALINAS (CA) | $1500.02 | $1500.02 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $1711.32 | $1711.32 |
| SANTA CRUZ-WATSONVILLE (CA) | $1522.56 | $1522.56 |
| SANTA ROSA-PETALUMA (CA) | $1536.30 | $1536.30 |
| STOCKTON (CA) | $1455.68 | $1455.68 |
| VISALIA (CA) | $1455.68 | $1455.68 |
| YUBA CITY (CA) | $1455.68 | $1455.68 |
| EL CENTRO (CA) | $1456.64 | $1456.64 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $1520.28 | $1520.28 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $1478.76 | $1478.76 |
| SANTA MARIA-SANTA BARBARA (CA) | $1501.52 | $1501.52 |
| REST OF CALIFORNIA (CA) | $1455.68 | $1455.68 |
| COLORADO (CO) | $1481.72 | $1481.72 |
| CONNECTICUT (CT) | $1576.96 | $1576.96 |
| DC + MD/VA SUBURBS (DC) | $1638.13 | $1638.13 |
| DELAWARE (DE) | $1458.28 | $1458.28 |
| FORT LAUDERDALE (FL) | $1642.22 | $1642.22 |
| MIAMI (FL) | $1795.48 | $1795.48 |
| REST OF FLORIDA (FL) | $1553.15 | $1553.15 |
| ATLANTA (GA) | $1529.71 | $1529.71 |
| REST OF GEORGIA (GA) | $1459.17 | $1459.17 |
| HAWAII, GUAM (HI) | $1473.15 | $1473.15 |
| IOWA (IA) | $1319.10 | $1319.10 |
| IDAHO (ID) | $1336.35 | $1336.35 |
| EAST ST. LOUIS (IL) | $1631.79 | $1631.79 |
| SUBURBAN CHICAGO (IL) | $1648.09 | $1648.09 |
| CHICAGO (IL) | $1736.55 | $1736.55 |
| REST OF ILLINOIS (IL) | $1541.57 | $1541.57 |
| INDIANA (IN) | $1342.60 | $1342.60 |
| KANSAS (KS) | $1333.71 | $1333.71 |
| KENTUCKY (KY) | $1404.45 | $1404.45 |
| NEW ORLEANS (LA) | $1474.73 | $1474.73 |
| REST OF LOUISIANA (LA) | $1410.55 | $1410.55 |
| METROPOLITAN BOSTON (MA) | $1594.19 | $1594.19 |
| REST OF MASSACHUSETTS (MA) | $1481.89 | $1481.89 |
| BALTIMORE/SURR. CNTYS (MD) | $1576.98 | $1576.98 |
| REST OF MARYLAND (MD) | $1478.57 | $1478.57 |
| SOUTHERN MAINE (ME) | $1404.75 | $1404.75 |
| REST OF MAINE (ME) | $1364.92 | $1364.92 |
| DETROIT (MI) | $1593.06 | $1593.06 |
| REST OF MICHIGAN (MI) | $1458.36 | $1458.36 |
| MINNESOTA (MN) | $1360.92 | $1360.92 |
| METROPOLITAN ST. LOUIS (MO) | $1454.95 | $1454.95 |
| METROPOLITAN KANSAS CITY (MO) | $1443.18 | $1443.18 |
| REST OF MISSOURI (MO) | $1401.27 | $1401.27 |
| MISSISSIPPI (MS) | $1355.68 | $1355.68 |
| MONTANA** (MT) | $1479.94 | $1479.94 |
| NORTH CAROLINA (NC) | $1375.15 | $1375.15 |
| NORTH DAKOTA** (ND) | $1366.45 | $1366.45 |
| NEBRASKA (NE) | $1319.75 | $1319.75 |
| NEW HAMPSHIRE (NH) | $1478.37 | $1478.37 |
| NORTHERN NJ (NJ) | $1626.61 | $1626.61 |
| REST OF NEW JERSEY (NJ) | $1578.38 | $1578.38 |
| NEW MEXICO (NM) | $1474.31 | $1474.31 |
| NEVADA** (NV) | $1448.85 | $1448.85 |
| MANHATTAN (NY) | $1727.75 | $1727.75 |
| NYC SUBURBS/LONG ISLAND (NY) | $1794.20 | $1794.20 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $1605.41 | $1605.41 |
| QUEENS (NY) | $1710.88 | $1710.88 |
| REST OF NEW YORK (NY) | $1396.55 | $1396.55 |
| OHIO (OH) | $1435.16 | $1435.16 |
| OKLAHOMA (OK) | $1380.14 | $1380.14 |
| PORTLAND (OR) | $1502.86 | $1502.86 |
| REST OF OREGON (OR) | $1421.24 | $1421.24 |
| METROPOLITAN PHILADELPHIA (PA) | $1552.87 | $1552.87 |
| REST OF PENNSYLVANIA (PA) | $1425.77 | $1425.77 |
| PUERTO RICO (PR) | $1483.36 | $1483.36 |
| RHODE ISLAND (RI) | $1491.62 | $1491.62 |
| SOUTH CAROLINA (SC) | $1410.78 | $1410.78 |
| SOUTH DAKOTA** (SD) | $1353.03 | $1353.03 |
| TENNESSEE (TN) | $1342.72 | $1342.72 |
| BRAZORIA (TX) | $1439.33 | $1439.33 |
| DALLAS (TX) | $1457.72 | $1457.72 |
| GALVESTON (TX) | $1449.61 | $1449.61 |
| HOUSTON (TX) | $1554.67 | $1554.67 |
| BEAUMONT (TX) | $1418.41 | $1418.41 |
| FORT WORTH (TX) | $1454.85 | $1454.85 |
| AUSTIN (TX) | $1491.11 | $1491.11 |
| REST OF TEXAS (TX) | $1434.36 | $1434.36 |
| UTAH (UT) | $1428.57 | $1428.57 |
| VIRGINIA (VA) | $1414.84 | $1414.84 |
| VIRGIN ISLANDS (VI) | $1483.36 | $1483.36 |
| VERMONT (VT) | $1380.25 | $1380.25 |
| SEATTLE (KING CNTY) (WA) | $1604.68 | $1604.68 |
| REST OF WASHINGTON (WA) | $1472.73 | $1472.73 |
| WISCONSIN (WI) | $1325.11 | $1325.11 |
| WEST VIRGINIA (WV) | $1492.65 | $1492.65 |
| WYOMING** (WY) | $1430.48 | $1430.48 |
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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 — assigned to the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, to account for regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, which is why the two amounts may differ; for this code, the practice-expense RVU is the same in both settings.
RVUs — work 22.51, practice expense 16.07 (non-facility) / 16.07 (facility), malpractice 5.74 — × 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 the annual deductible; the patient or secondary insurer is responsible for the remainder.
- Actual payment can vary due to modifiers, place-of-service rules, sequestration, and annual budget-neutrality adjustments to RVUs or the conversion factor.
- Always verify the current allowed amount and any applicable edits with your Medicare Administrative Contractor (MAC) before billing.
Frequently asked
Why does the amount differ by locality?
Medicare adjusts each RVU component using locality-specific GPCIs to reflect regional differences in wages, rents, and malpractice costs, so the same code can have different allowed amounts in different areas.
Why are the non-facility and facility amounts the same for this code?
The practice-expense RVU, which usually drives the difference between settings, is identical for non-facility and facility here, so both amounts calculate to the same figure.
Does this amount reflect what the provider will actually be paid?
No. It reflects the Medicare-allowed amount before the standard 80/20 split, deductible status, modifiers, and any sequestration or other adjustments are applied.
Where does the conversion factor come from?
The conversion factor is a dollar multiplier set annually by CMS and applied uniformly to the total adjusted RVUs to calculate the national base payment before locality adjustments.
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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