Medicare Reimbursement for CPT 22325

CPT 22325 is a physician procedure code reported under Medicare Part B. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code at the national level and, where available, by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1444.25	$1444.25
ALASKA* (AK)	$1702.82	$1702.82
ALABAMA (AL)	$1274.41	$1274.41
ARKANSAS (AR)	$1253.71	$1253.71
ARIZONA (AZ)	$1393.87	$1393.87
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1608.88	$1608.88
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1630.47	$1630.47
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1480.51	$1480.51
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1498.80	$1498.80
NAPA (CA)	$1554.58	$1554.58
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1616.61	$1616.61
VALLEJO (CA)	$1543.45	$1543.45
BAKERSFIELD (CA)	$1422.48	$1422.48
CHICO (CA)	$1404.60	$1404.60
FRESNO (CA)	$1404.60	$1404.60
HANFORD-CORCORAN (CA)	$1404.60	$1404.60
MADERA (CA)	$1404.60	$1404.60
MERCED (CA)	$1404.60	$1404.60
MODESTO (CA)	$1404.60	$1404.60
REDDING (CA)	$1404.60	$1404.60
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1477.25	$1477.25
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1455.09	$1455.09
SALINAS (CA)	$1449.58	$1449.58
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1662.04	$1662.04
SANTA CRUZ-WATSONVILLE (CA)	$1475.04	$1475.04
SANTA ROSA-PETALUMA (CA)	$1488.27	$1488.27
STOCKTON (CA)	$1404.60	$1404.60
VISALIA (CA)	$1404.60	$1404.60
YUBA CITY (CA)	$1404.60	$1404.60
EL CENTRO (CA)	$1405.74	$1405.74
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1471.39	$1471.39
SAN LUIS OBISPO-PASO ROBLES (CA)	$1429.12	$1429.12
SANTA MARIA-SANTA BARBARA (CA)	$1451.63	$1451.63
REST OF CALIFORNIA (CA)	$1404.60	$1404.60
COLORADO (CO)	$1438.77	$1438.77
CONNECTICUT (CT)	$1548.79	$1548.79
DC + MD/VA SUBURBS (DC)	$1606.34	$1606.34
DELAWARE (DE)	$1417.71	$1417.71
FORT LAUDERDALE (FL)	$1635.18	$1635.18
MIAMI (FL)	$1814.91	$1814.91
REST OF FLORIDA (FL)	$1533.41	$1533.41
ATLANTA (GA)	$1500.97	$1500.97
REST OF GEORGIA (GA)	$1426.29	$1426.29
HAWAII, GUAM (HI)	$1426.75	$1426.75
IOWA (IA)	$1258.83	$1258.83
IDAHO (ID)	$1278.95	$1278.95
EAST ST. LOUIS (IL)	$1628.95	$1628.95
SUBURBAN CHICAGO (IL)	$1639.52	$1639.52
CHICAGO (IL)	$1745.76	$1745.76
REST OF ILLINOIS (IL)	$1522.52	$1522.52
INDIANA (IN)	$1285.89	$1285.89
KANSAS (KS)	$1276.87	$1276.87
KENTUCKY (KY)	$1361.66	$1361.66
NEW ORLEANS (LA)	$1441.51	$1441.51
REST OF LOUISIANA (LA)	$1369.15	$1369.15
METROPOLITAN BOSTON (MA)	$1556.41	$1556.41
REST OF MASSACHUSETTS (MA)	$1438.72	$1438.72
BALTIMORE/SURR. CNTYS (MD)	$1550.06	$1550.06
REST OF MARYLAND (MD)	$1438.94	$1438.94
SOUTHERN MAINE (ME)	$1355.31	$1355.31
REST OF MAINE (ME)	$1312.79	$1312.79
DETROIT (MI)	$1580.11	$1580.11
REST OF MICHIGAN (MI)	$1423.95	$1423.95
MINNESOTA (MN)	$1300.89	$1300.89
METROPOLITAN ST. LOUIS (MO)	$1417.34	$1417.34
METROPOLITAN KANSAS CITY (MO)	$1404.25	$1404.25
REST OF MISSOURI (MO)	$1359.67	$1359.67
MISSISSIPPI (MS)	$1305.72	$1305.72
MONTANA** (MT)	$1443.80	$1443.80
NORTH CAROLINA (NC)	$1324.06	$1324.06
NORTH DAKOTA** (ND)	$1309.34	$1309.34
NEBRASKA (NE)	$1259.08	$1259.08
NEW HAMPSHIRE (NH)	$1439.24	$1439.24
NORTHERN NJ (NJ)	$1591.68	$1591.68
REST OF NEW JERSEY (NJ)	$1544.62	$1544.62
NEW MEXICO (NM)	$1442.58	$1442.58
NEVADA** (NV)	$1406.90	$1406.90
MANHATTAN (NY)	$1711.12	$1711.12
NYC SUBURBS/LONG ISLAND (NY)	$1788.07	$1788.07
POUGHKPSIE/N NYC SUBURBS (NY)	$1575.23	$1575.23
QUEENS (NY)	$1689.82	$1689.82
REST OF NEW YORK (NY)	$1348.29	$1348.29
OHIO (OH)	$1396.47	$1396.47
OKLAHOMA (OK)	$1332.60	$1332.60
PORTLAND (OR)	$1459.75	$1459.75
REST OF OREGON (OR)	$1374.52	$1374.52
METROPOLITAN PHILADELPHIA (PA)	$1523.11	$1523.11
REST OF PENNSYLVANIA (PA)	$1385.01	$1385.01
PUERTO RICO (PR)	$1447.12	$1447.12
RHODE ISLAND (RI)	$1450.83	$1450.83
SOUTH CAROLINA (SC)	$1366.85	$1366.85
SOUTH DAKOTA** (SD)	$1293.44	$1293.44
TENNESSEE (TN)	$1287.21	$1287.21
BRAZORIA (TX)	$1394.33	$1394.33
DALLAS (TX)	$1415.55	$1415.55
GALVESTON (TX)	$1406.37	$1406.37
HOUSTON (TX)	$1530.84	$1530.84
BEAUMONT (TX)	$1376.82	$1376.82
FORT WORTH (TX)	$1412.80	$1412.80
AUSTIN (TX)	$1452.73	$1452.73
REST OF TEXAS (TX)	$1393.15	$1393.15
UTAH (UT)	$1386.88	$1386.88
VIRGINIA (VA)	$1367.79	$1367.79
VIRGIN ISLANDS (VI)	$1447.12	$1447.12
VERMONT (VT)	$1326.35	$1326.35
SEATTLE (KING CNTY) (WA)	$1564.46	$1564.46
REST OF WASHINGTON (WA)	$1428.60	$1428.60
WISCONSIN (WI)	$1263.14	$1263.14
WEST VIRGINIA (WV)	$1467.46	$1467.46
WYOMING** (WY)	$1385.20	$1385.20

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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 the 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 the dollar allowed amount. Non-facility and facility rates can differ because the practice-expense RVU is typically lower in facility settings, where the facility itself bears more of the overhead cost.

RVUs — work 19.37, practice expense 17.07 (non-facility) / 17.07 (facility), malpractice 6.8 — × 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 Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, bilateral billing, and other claim-specific factors can change the actual paid amount.
Sequestration and annual budget-neutrality adjustments can alter the effective payment from year to year.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility rate differ from the non-facility rate for this code?

The two rates can differ because the practice-expense RVU component is calculated differently depending on where the service is furnished. In a facility setting, the facility (such as a hospital) bears more of the overhead, so the physician's practice-expense RVU is generally lower than when the service is performed in a non-facility setting like a physician's office.

Does this amount reflect what Medicare will actually pay?

No. The figure shown is the Medicare Physician Fee Schedule allowed amount, which represents the maximum Medicare generally recognizes for the service. Actual payment depends on factors like the patient's deductible status, applicable modifiers, secondary insurance, and MAC-specific adjustments.

Why do amounts vary by locality?

Medicare adjusts payment using Geographic Practice Cost Indices (GPCIs) that account for differences in local labor, rent, and malpractice insurance costs. As a result, the same code can have different allowed amounts depending on where the service is rendered.

Will this rate change next year?

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

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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.