Medicare Reimbursement for CPT 22310

CPT 22310 is a procedure code reported to Medicare and other payers; this page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted by locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$341.36	$291.59
ALASKA* (AK)	$398.80	$345.80
ALABAMA (AL)	$304.56	$261.02
ARKANSAS (AR)	$299.97	$257.22
ARIZONA (AZ)	$331.27	$283.05
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$419.97	$349.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$427.40	$355.64
OXNARD-THOUSAND OAKS-VENTURA (CA)	$371.45	$312.63
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$374.19	$315.32
NAPA (CA)	$399.92	$334.32
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$420.87	$350.70
VALLEJO (CA)	$398.62	$333.03
BAKERSFIELD (CA)	$352.64	$298.09
CHICO (CA)	$350.48	$295.94
FRESNO (CA)	$350.48	$295.94
HANFORD-CORCORAN (CA)	$350.48	$295.94
MADERA (CA)	$350.48	$295.94
MERCED (CA)	$350.48	$295.94
MODESTO (CA)	$350.48	$295.94
REDDING (CA)	$350.48	$295.94
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$358.96	$304.42
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$366.20	$308.32
SALINAS (CA)	$364.83	$307.15
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$431.07	$359.31
SANTA CRUZ-WATSONVILLE (CA)	$375.06	$314.59
SANTA ROSA-PETALUMA (CA)	$378.71	$317.59
STOCKTON (CA)	$350.48	$295.94
VISALIA (CA)	$350.48	$295.94
YUBA CITY (CA)	$350.48	$295.94
EL CENTRO (CA)	$350.62	$296.07
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$372.38	$312.85
SAN LUIS OBISPO-PASO ROBLES (CA)	$359.20	$302.52
SANTA MARIA-SANTA BARBARA (CA)	$365.91	$307.88
REST OF CALIFORNIA (CA)	$350.48	$295.94
COLORADO (CO)	$349.90	$296.95
CONNECTICUT (CT)	$364.75	$311.15
DC + MD/VA SUBURBS (DC)	$386.49	$327.86
DELAWARE (DE)	$336.82	$287.65
FORT LAUDERDALE (FL)	$365.31	$314.90
MIAMI (FL)	$390.01	$338.21
REST OF FLORIDA (FL)	$345.71	$298.13
ATLANTA (GA)	$350.24	$299.68
REST OF GEORGIA (GA)	$324.53	$280.13
HAWAII, GUAM (HI)	$358.02	$301.44
IOWA (IA)	$308.21	$262.68
IDAHO (ID)	$311.23	$265.45
EAST ST. LOUIS (IL)	$351.89	$306.11
SUBURBAN CHICAGO (IL)	$367.99	$316.88
CHICAGO (IL)	$377.33	$327.31
REST OF ILLINOIS (IL)	$338.57	$293.14
INDIANA (IN)	$312.99	$266.86
KANSAS (KS)	$308.81	$263.82
KENTUCKY (KY)	$316.61	$272.37
NEW ORLEANS (LA)	$332.98	$286.15
REST OF LOUISIANA (LA)	$316.93	$272.89
METROPOLITAN BOSTON (MA)	$382.39	$322.97
REST OF MASSACHUSETTS (MA)	$348.54	$296.14
BALTIMORE/SURR. CNTYS (MD)	$364.21	$310.81
REST OF MARYLAND (MD)	$342.75	$292.38
SOUTHERN MAINE (ME)	$329.80	$280.48
REST OF MAINE (ME)	$315.16	$269.38
DETROIT (MI)	$352.36	$304.34
REST OF MICHIGAN (MI)	$327.12	$281.68
MINNESOTA (MN)	$328.66	$277.45
METROPOLITAN ST. LOUIS (MO)	$331.68	$284.30
METROPOLITAN KANSAS CITY (MO)	$328.38	$281.65
REST OF MISSOURI (MO)	$312.69	$269.79
MISSISSIPPI (MS)	$306.29	$263.44
MONTANA** (MT)	$341.30	$291.54
NORTH CAROLINA (NC)	$318.25	$271.81
NORTH DAKOTA** (ND)	$325.68	$275.92
NEBRASKA (NE)	$309.33	$263.40
NEW HAMPSHIRE (NH)	$346.37	$294.56
NORTHERN NJ (NJ)	$382.66	$324.93
REST OF NEW JERSEY (NJ)	$367.06	$312.71
NEW MEXICO (NM)	$329.83	$284.20
NEVADA** (NV)	$337.15	$287.34
MANHATTAN (NY)	$396.85	$339.02
NYC SUBURBS/LONG ISLAND (NY)	$409.47	$350.30
POUGHKPSIE/N NYC SUBURBS (NY)	$371.21	$316.71
QUEENS (NY)	$397.10	$338.28
REST OF NEW YORK (NY)	$323.38	$276.10
OHIO (OH)	$323.93	$278.49
OKLAHOMA (OK)	$313.78	$269.34
PORTLAND (OR)	$358.90	$303.61
REST OF OREGON (OR)	$332.71	$283.14
METROPOLITAN PHILADELPHIA (PA)	$356.78	$304.97
REST OF PENNSYLVANIA (PA)	$323.28	$277.59
PUERTO RICO (PR)	$343.19	$292.88
RHODE ISLAND (RI)	$347.33	$295.92
SOUTH CAROLINA (SC)	$321.99	$276.01
SOUTH DAKOTA** (SD)	$323.84	$274.07
TENNESSEE (TN)	$310.69	$265.45
BRAZORIA (TX)	$334.63	$285.31
DALLAS (TX)	$337.81	$288.24
GALVESTON (TX)	$336.30	$286.88
HOUSTON (TX)	$350.76	$301.34
BEAUMONT (TX)	$321.24	$275.95
FORT WORTH (TX)	$336.12	$287.05
AUSTIN (TX)	$350.33	$297.68
REST OF TEXAS (TX)	$328.46	$281.23
UTAH (UT)	$326.50	$279.72
VIRGINIA (VA)	$330.15	$281.23
VIRGIN ISLANDS (VI)	$343.19	$292.88
VERMONT (VT)	$326.29	$277.03
SEATTLE (KING CNTY) (WA)	$388.16	$327.10
REST OF WASHINGTON (WA)	$347.26	$294.85
WISCONSIN (WI)	$314.58	$266.91
WEST VIRGINIA (WV)	$326.17	$282.92
WYOMING** (WY)	$334.50	$284.73

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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 fee schedule 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. Practice-expense RVUs differ between non-facility and facility settings because overhead costs (equipment, supplies, staff time) are typically higher when a service is performed in a physician's office versus a facility that already bears some of those costs. The resulting allowed amount represents what Medicare recognizes as payment in full for the service, before cost-sharing is applied.

RVUs — work 3.36, practice expense 6.07 (non-facility) / 4.58 (facility), malpractice 0.79 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment for any specific claim.
Medicare typically pays 80% of the allowed amount after the patient's Part B deductible is met; the beneficiary or secondary payer is responsible for the remainder.
Actual payment can vary due to modifiers, multiple-procedure reductions, sequestration, site-of-service differences, and annual budget-neutrality adjustments.
Locality-adjusted amounts depend on the GPCI values for the specific Medicare locality and may differ from the national average shown here.
Always confirm final allowed amounts and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why is the facility amount different from the non-facility amount for this code?

The facility amount uses lower practice-expense RVUs because overhead costs like equipment and staff time are assumed to be borne by the facility rather than the billing physician's office.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare-allowed amount before cost-sharing. Medicare generally pays 80% of this amount after the deductible, with other adjustments possible based on modifiers or policy edits.

Why might my locality's amount differ from the national figure shown?

The national amount uses a GPCI value of 1.0 for all cost components, while locality-specific amounts apply that area's actual GPCI adjustments for work, practice expense, and malpractice, which can raise or lower the total.

Can this amount change during the year?

Yes. CMS can issue mid-year corrections, and factors like sequestration or claim-specific modifiers can alter the amount actually paid on a given claim.

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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.