Medicare Reimbursement for CPT 22326

CPT 22326 is a surgical procedure code defined by the American Medical Association; the descriptor itself is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted for locality, under the non-facility and facility settings. All figures are estimates based on current Medicare payment formulas.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1473.65	$1473.65
ALASKA* (AK)	$1737.11	$1737.11
ALABAMA (AL)	$1297.60	$1297.60
ARKANSAS (AR)	$1276.19	$1276.19
ARIZONA (AZ)	$1420.96	$1420.96
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1619.60	$1619.60
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1640.33	$1640.33
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1498.60	$1498.60
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1518.15	$1518.15
NAPA (CA)	$1568.18	$1568.18
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1628.04	$1628.04
VALLEJO (CA)	$1556.02	$1556.02
BAKERSFIELD (CA)	$1442.00	$1442.00
CHICO (CA)	$1422.53	$1422.53
FRESNO (CA)	$1422.53	$1422.53
HANFORD-CORCORAN (CA)	$1422.53	$1422.53
MADERA (CA)	$1422.53	$1422.53
MERCED (CA)	$1422.53	$1422.53
MODESTO (CA)	$1422.53	$1422.53
REDDING (CA)	$1422.53	$1422.53
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1501.87	$1501.87
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1472.05	$1472.05
SALINAS (CA)	$1466.47	$1466.47
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1674.83	$1674.83
SANTA CRUZ-WATSONVILLE (CA)	$1490.31	$1490.31
SANTA ROSA-PETALUMA (CA)	$1503.52	$1503.52
STOCKTON (CA)	$1422.53	$1422.53
VISALIA (CA)	$1422.53	$1422.53
YUBA CITY (CA)	$1422.53	$1422.53
EL CENTRO (CA)	$1423.77	$1423.77
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1487.52	$1487.52
SAN LUIS OBISPO-PASO ROBLES (CA)	$1446.04	$1446.04
SANTA MARIA-SANTA BARBARA (CA)	$1468.27	$1468.27
REST OF CALIFORNIA (CA)	$1422.53	$1422.53
COLORADO (CO)	$1462.44	$1462.44
CONNECTICUT (CT)	$1581.44	$1581.44
DC + MD/VA SUBURBS (DC)	$1635.67	$1635.67
DELAWARE (DE)	$1445.41	$1445.41
FORT LAUDERDALE (FL)	$1681.28	$1681.28
MIAMI (FL)	$1875.52	$1875.52
REST OF FLORIDA (FL)	$1574.42	$1574.42
ATLANTA (GA)	$1534.31	$1534.31
REST OF GEORGIA (GA)	$1462.24	$1462.24
HAWAII, GUAM (HI)	$1444.08	$1444.08
IOWA (IA)	$1277.53	$1277.53
IDAHO (ID)	$1299.12	$1299.12
EAST ST. LOUIS (IL)	$1681.55	$1681.55
SUBURBAN CHICAGO (IL)	$1684.75	$1684.75
CHICAGO (IL)	$1802.51	$1802.51
REST OF ILLINOIS (IL)	$1565.80	$1565.80
INDIANA (IN)	$1306.17	$1306.17
KANSAS (KS)	$1298.07	$1298.07
KENTUCKY (KY)	$1391.86	$1391.86
NEW ORLEANS (LA)	$1475.14	$1475.14
REST OF LOUISIANA (LA)	$1400.35	$1400.35
METROPOLITAN BOSTON (MA)	$1580.25	$1580.25
REST OF MASSACHUSETTS (MA)	$1463.11	$1463.11
BALTIMORE/SURR. CNTYS (MD)	$1583.24	$1583.24
REST OF MARYLAND (MD)	$1466.65	$1466.65
SOUTHERN MAINE (ME)	$1377.15	$1377.15
REST OF MAINE (ME)	$1336.10	$1336.10
DETROIT (MI)	$1624.75	$1624.75
REST OF MICHIGAN (MI)	$1458.09	$1458.09
MINNESOTA (MN)	$1314.79	$1314.79
METROPOLITAN ST. LOUIS (MO)	$1447.90	$1447.90
METROPOLITAN KANSAS CITY (MO)	$1434.59	$1434.59
REST OF MISSOURI (MO)	$1391.74	$1391.74
MISSISSIPPI (MS)	$1332.87	$1332.87
MONTANA** (MT)	$1473.15	$1473.15
NORTH CAROLINA (NC)	$1347.43	$1347.43
NORTH DAKOTA** (ND)	$1326.24	$1326.24
NEBRASKA (NE)	$1277.19	$1277.19
NEW HAMPSHIRE (NH)	$1465.04	$1465.04
NORTHERN NJ (NJ)	$1620.77	$1620.77
REST OF NEW JERSEY (NJ)	$1575.17	$1575.17
NEW MEXICO (NM)	$1478.15	$1478.15
NEVADA** (NV)	$1432.75	$1432.75
MANHATTAN (NY)	$1751.09	$1751.09
NYC SUBURBS/LONG ISLAND (NY)	$1833.11	$1833.11
POUGHKPSIE/N NYC SUBURBS (NY)	$1608.25	$1608.25
QUEENS (NY)	$1726.29	$1726.29
REST OF NEW YORK (NY)	$1372.60	$1372.60
OHIO (OH)	$1428.06	$1428.06
OKLAHOMA (OK)	$1359.80	$1359.80
PORTLAND (OR)	$1481.67	$1481.67
REST OF OREGON (OR)	$1397.75	$1397.75
METROPOLITAN PHILADELPHIA (PA)	$1556.18	$1556.18
REST OF PENNSYLVANIA (PA)	$1415.16	$1415.16
PUERTO RICO (PR)	$1475.94	$1475.94
RHODE ISLAND (RI)	$1477.78	$1477.78
SOUTH CAROLINA (SC)	$1394.87	$1394.87
SOUTH DAKOTA** (SD)	$1308.86	$1308.86
TENNESSEE (TN)	$1308.99	$1308.99
BRAZORIA (TX)	$1419.56	$1419.56
DALLAS (TX)	$1442.33	$1442.33
GALVESTON (TX)	$1432.56	$1432.56
HOUSTON (TX)	$1568.56	$1568.56
BEAUMONT (TX)	$1406.82	$1406.82
FORT WORTH (TX)	$1440.09	$1440.09
AUSTIN (TX)	$1478.43	$1478.43
REST OF TEXAS (TX)	$1421.69	$1421.69
UTAH (UT)	$1415.53	$1415.53
VIRGINIA (VA)	$1391.39	$1391.39
VIRGIN ISLANDS (VI)	$1475.94	$1475.94
VERMONT (VT)	$1345.58	$1345.58
SEATTLE (KING CNTY) (WA)	$1586.29	$1586.29
REST OF WASHINGTON (WA)	$1452.14	$1452.14
WISCONSIN (WI)	$1278.95	$1278.95
WEST VIRGINIA (WV)	$1508.98	$1508.98
WYOMING** (WY)	$1409.12	$1409.12

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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 furnished. The geographically adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which is why this code may show two different allowed amounts. Work and malpractice RVUs generally stay the same across settings, while practice expense RVU adjusts based on where the service is performed.

RVUs — work 20.32, practice expense 16.37 (non-facility) / 16.37 (facility), malpractice 7.43 — × 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 insurer is generally responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Local Medicare Administrative Contractor (MAC) policies and coverage determinations may affect whether and how this code is reimbursed.
Rates shown are based on the national conversion factor and may not reflect final locality-adjusted payment for every jurisdiction.

Frequently asked

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

When the practice expense RVU is identical in both settings, as shown here, the calculated allowed amounts will match. In other codes, non-facility and facility amounts often differ because of different overhead cost assumptions.

Will I be paid exactly this amount for CPT 22326?

No. This figure is a national or locality-adjusted estimate. Actual payment depends on your specific locality GPCIs, any applicable modifiers, secondary payer rules, and annual adjustments like sequestration.

Why do Medicare rates change each year?

RVUs, GPCIs, and the conversion factor are updated annually (and sometimes mid-year) by CMS to reflect changes in costs, budget-neutrality requirements, and legislative adjustments.

Where can I confirm the exact payment for my claim?

Check with your Medicare Administrative Contractor (MAC) or use CMS's official PFS lookup tool, since local adjustments and claim-specific modifiers are not reflected in a general reference like this one.

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.