Medicare Reimbursement for CPT 22318

This page covers the Medicare Physician Fee Schedule (PFS) allowed amount for CPT code 22318, a procedure code defined by the American Medical Association. It shows the national estimate as well as how the amount can vary by locality, and compares non-facility and facility payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1624.62	$1624.62
ALASKA* (AK)	$1898.05	$1898.05
ALABAMA (AL)	$1421.44	$1421.44
ARKANSAS (AR)	$1396.80	$1396.80
ARIZONA (AZ)	$1563.34	$1563.34
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1762.56	$1762.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1783.99	$1783.99
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1638.89	$1638.89
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1661.37	$1661.37
NAPA (CA)	$1709.91	$1709.91
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1772.74	$1772.74
VALLEJO (CA)	$1695.23	$1695.23
BAKERSFIELD (CA)	$1577.71	$1577.71
CHICO (CA)	$1554.36	$1554.36
FRESNO (CA)	$1554.36	$1554.36
HANFORD-CORCORAN (CA)	$1554.36	$1554.36
MADERA (CA)	$1554.36	$1554.36
MERCED (CA)	$1554.36	$1554.36
MODESTO (CA)	$1554.36	$1554.36
REDDING (CA)	$1554.36	$1554.36
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1650.07	$1650.07
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1607.62	$1607.62
SALINAS (CA)	$1601.58	$1601.58
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1825.64	$1825.64
SANTA CRUZ-WATSONVILLE (CA)	$1626.95	$1626.95
SANTA ROSA-PETALUMA (CA)	$1641.22	$1641.22
STOCKTON (CA)	$1554.36	$1554.36
VISALIA (CA)	$1554.36	$1554.36
YUBA CITY (CA)	$1554.36	$1554.36
EL CENTRO (CA)	$1555.86	$1555.86
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1624.29	$1624.29
SAN LUIS OBISPO-PASO ROBLES (CA)	$1579.52	$1579.52
SANTA MARIA-SANTA BARBARA (CA)	$1603.46	$1603.46
REST OF CALIFORNIA (CA)	$1554.36	$1554.36
COLORADO (CO)	$1605.34	$1605.34
CONNECTICUT (CT)	$1747.39	$1747.39
DC + MD/VA SUBURBS (DC)	$1802.59	$1802.59
DELAWARE (DE)	$1591.04	$1591.04
FORT LAUDERDALE (FL)	$1874.31	$1874.31
MIAMI (FL)	$2106.71	$2106.71
REST OF FLORIDA (FL)	$1749.57	$1749.57
ATLANTA (GA)	$1696.42	$1696.42
REST OF GEORGIA (GA)	$1618.94	$1618.94
HAWAII, GUAM (HI)	$1578.66	$1578.66
IOWA (IA)	$1394.22	$1394.22
IDAHO (ID)	$1419.91	$1419.91
EAST ST. LOUIS (IL)	$1881.61	$1881.61
SUBURBAN CHICAGO (IL)	$1876.89	$1876.89
CHICAGO (IL)	$2020.71	$2020.71
REST OF ILLINOIS (IL)	$1742.39	$1742.39
INDIANA (IN)	$1427.90	$1427.90
KANSAS (KS)	$1419.84	$1419.84
KENTUCKY (KY)	$1534.20	$1534.20
NEW ORLEANS (LA)	$1630.84	$1630.84
REST OF LOUISIANA (LA)	$1544.74	$1544.74
METROPOLITAN BOSTON (MA)	$1735.52	$1735.52
REST OF MASSACHUSETTS (MA)	$1606.65	$1606.65
BALTIMORE/SURR. CNTYS (MD)	$1750.18	$1750.18
REST OF MARYLAND (MD)	$1614.47	$1614.47
SOUTHERN MAINE (ME)	$1508.80	$1508.80
REST OF MAINE (ME)	$1464.55	$1464.55
DETROIT (MI)	$1809.67	$1809.67
REST OF MICHIGAN (MI)	$1612.36	$1612.36
MINNESOTA (MN)	$1430.67	$1430.67
METROPOLITAN ST. LOUIS (MO)	$1597.13	$1597.13
METROPOLITAN KANSAS CITY (MO)	$1582.03	$1582.03
REST OF MISSOURI (MO)	$1536.07	$1536.07
MISSISSIPPI (MS)	$1465.08	$1465.08
MONTANA** (MT)	$1624.02	$1624.02
NORTH CAROLINA (NC)	$1477.25	$1477.25
NORTH DAKOTA** (ND)	$1446.65	$1446.65
NEBRASKA (NE)	$1393.21	$1393.21
NEW HAMPSHIRE (NH)	$1611.16	$1611.16
NORTHERN NJ (NJ)	$1785.23	$1785.23
REST OF NEW JERSEY (NJ)	$1737.11	$1737.11
NEW MEXICO (NM)	$1636.27	$1636.27
NEVADA** (NV)	$1575.17	$1575.17
MANHATTAN (NY)	$1942.34	$1942.34
NYC SUBURBS/LONG ISLAND (NY)	$2039.33	$2039.33
POUGHKPSIE/N NYC SUBURBS (NY)	$1776.42	$1776.42
QUEENS (NY)	$1910.90	$1910.90
REST OF NEW YORK (NY)	$1506.38	$1506.38
OHIO (OH)	$1576.11	$1576.11
OKLAHOMA (OK)	$1495.19	$1495.19
PORTLAND (OR)	$1624.71	$1624.71
REST OF OREGON (OR)	$1533.30	$1533.30
METROPOLITAN PHILADELPHIA (PA)	$1719.75	$1719.75
REST OF PENNSYLVANIA (PA)	$1560.16	$1560.16
PUERTO RICO (PR)	$1626.56	$1626.56
RHODE ISLAND (RI)	$1625.63	$1625.63
SOUTH CAROLINA (SC)	$1535.20	$1535.20
SOUTH DAKOTA** (SD)	$1425.68	$1425.68
TENNESSEE (TN)	$1432.65	$1432.65
BRAZORIA (TX)	$1559.36	$1559.36
DALLAS (TX)	$1586.39	$1586.39
GALVESTON (TX)	$1574.91	$1574.91
HOUSTON (TX)	$1739.09	$1739.09
BEAUMONT (TX)	$1550.68	$1550.68
FORT WORTH (TX)	$1584.44	$1584.44
AUSTIN (TX)	$1625.89	$1625.89
REST OF TEXAS (TX)	$1565.71	$1565.71
UTAH (UT)	$1558.95	$1558.95
VIRGINIA (VA)	$1526.59	$1526.59
VIRGIN ISLANDS (VI)	$1626.56	$1626.56
VERMONT (VT)	$1470.76	$1470.76
SEATTLE (KING CNTY) (WA)	$1739.62	$1739.62
REST OF WASHINGTON (WA)	$1593.65	$1593.65
WISCONSIN (WI)	$1392.71	$1392.71
WEST VIRGINIA (WV)	$1677.09	$1677.09
WYOMING** (WY)	$1546.72	$1546.72

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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 performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which can change the final allowed amount even though work and malpractice RVUs stay the same.

RVUs — work 22.15, practice expense 17.52 (non-facility) / 17.52 (facility), malpractice 8.97 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the remainder is patient responsibility or secondary coverage.
Modifiers, place-of-service rules, sequestration, and annual budget-neutrality adjustments can all change the actual paid amount.
Locality-specific GPCIs mean the national figure shown here may differ from what your specific Medicare Administrative Contractor (MAC) pays.
Always verify current rates and coverage policy with your MAC before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The two settings use different practice expense RVUs because overhead costs (staff, supplies, equipment) are typically higher when a service is performed in a non-facility setting like a physician's office versus a facility like a hospital, where the facility itself absorbs some of those costs.

Is this the amount Medicare will actually pay?

No. This is an estimate based on national RVUs and the conversion factor. Actual payment depends on the patient's specific locality GPCIs, any applicable modifiers, deductible status, and other claim-specific factors.

Why can't you show the CPT code description?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page refers to the code generically rather than reproducing the official descriptor.

Will this amount change next year?

Yes, potentially. The conversion factor and RVUs are updated annually by CMS, and budget-neutrality adjustments or policy changes can shift the allowed amount from year to year.

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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.