Medicare Reimbursement for CPT 22328

This page covers a CPT procedure code (descriptor not shown due to AMA licensing restrictions) and shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for 2026, 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)	$252.51	$252.51
ALASKA* (AK)	$307.38	$307.38
ALABAMA (AL)	$223.59	$223.59
ARKANSAS (AR)	$220.13	$220.13
ARIZONA (AZ)	$243.44	$243.44
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$257.48	$257.48
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$259.88	$259.88
OXNARD-THOUSAND OAKS-VENTURA (CA)	$246.25	$246.25
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$250.38	$250.38
NAPA (CA)	$252.36	$252.36
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$259.25	$259.25
VALLEJO (CA)	$249.81	$249.81
BAKERSFIELD (CA)	$239.83	$239.83
CHICO (CA)	$235.73	$235.73
FRESNO (CA)	$235.73	$235.73
HANFORD-CORCORAN (CA)	$235.73	$235.73
MADERA (CA)	$235.73	$235.73
MERCED (CA)	$235.73	$235.73
MODESTO (CA)	$235.73	$235.73
REDDING (CA)	$235.73	$235.73
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$252.39	$252.39
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$241.95	$241.95
SALINAS (CA)	$241.00	$241.00
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$267.12	$267.12
SANTA CRUZ-WATSONVILLE (CA)	$242.33	$242.33
SANTA ROSA-PETALUMA (CA)	$244.33	$244.33
STOCKTON (CA)	$235.73	$235.73
VISALIA (CA)	$235.73	$235.73
YUBA CITY (CA)	$235.73	$235.73
EL CENTRO (CA)	$235.99	$235.99
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$243.03	$243.03
SAN LUIS OBISPO-PASO ROBLES (CA)	$237.89	$237.89
SANTA MARIA-SANTA BARBARA (CA)	$240.91	$240.91
REST OF CALIFORNIA (CA)	$235.73	$235.73
COLORADO (CO)	$246.13	$246.13
CONNECTICUT (CT)	$270.34	$270.34
DC + MD/VA SUBURBS (DC)	$275.47	$275.47
DELAWARE (DE)	$247.39	$247.39
FORT LAUDERDALE (FL)	$295.27	$295.27
MIAMI (FL)	$334.25	$334.25
REST OF FLORIDA (FL)	$276.50	$276.50
ATLANTA (GA)	$264.24	$264.24
REST OF GEORGIA (GA)	$257.07	$257.07
HAWAII, GUAM (HI)	$237.48	$237.48
IOWA (IA)	$216.80	$216.80
IDAHO (ID)	$221.02	$221.02
EAST ST. LOUIS (IL)	$301.31	$301.31
SUBURBAN CHICAGO (IL)	$295.15	$295.15
CHICAGO (IL)	$321.29	$321.29
REST OF ILLINOIS (IL)	$277.46	$277.46
INDIANA (IN)	$222.05	$222.05
KANSAS (KS)	$221.82	$221.82
KENTUCKY (KY)	$242.48	$242.48
NEW ORLEANS (LA)	$256.62	$256.62
REST OF LOUISIANA (LA)	$244.52	$244.52
METROPOLITAN BOSTON (MA)	$262.71	$262.71
REST OF MASSACHUSETTS (MA)	$247.01	$247.01
BALTIMORE/SURR. CNTYS (MD)	$270.94	$270.94
REST OF MARYLAND (MD)	$250.34	$250.34
SOUTHERN MAINE (ME)	$232.83	$232.83
REST OF MAINE (ME)	$228.78	$228.78
DETROIT (MI)	$286.49	$286.49
REST OF MICHIGAN (MI)	$254.84	$254.84
MINNESOTA (MN)	$217.29	$217.29
METROPOLITAN ST. LOUIS (MO)	$250.19	$250.19
METROPOLITAN KANSAS CITY (MO)	$248.24	$248.24
REST OF MISSOURI (MO)	$244.20	$244.20
MISSISSIPPI (MS)	$231.90	$231.90
MONTANA** (MT)	$252.41	$252.41
NORTH CAROLINA (NC)	$230.32	$230.32
NORTH DAKOTA** (ND)	$221.56	$221.56
NEBRASKA (NE)	$216.22	$216.22
NEW HAMPSHIRE (NH)	$248.07	$248.07
NORTHERN NJ (NJ)	$273.57	$273.57
REST OF NEW JERSEY (NJ)	$268.20	$268.20
NEW MEXICO (NM)	$258.80	$258.80
NEVADA** (NV)	$243.86	$243.86
MANHATTAN (NY)	$300.81	$300.81
NYC SUBURBS/LONG ISLAND (NY)	$316.30	$316.30
POUGHKPSIE/N NYC SUBURBS (NY)	$274.99	$274.99
QUEENS (NY)	$294.32	$294.32
REST OF NEW YORK (NY)	$234.51	$234.51
OHIO (OH)	$248.54	$248.54
OKLAHOMA (OK)	$235.49	$235.49
PORTLAND (OR)	$247.17	$247.17
REST OF OREGON (OR)	$236.83	$236.83
METROPOLITAN PHILADELPHIA (PA)	$267.33	$267.33
REST OF PENNSYLVANIA (PA)	$245.51	$245.51
PUERTO RICO (PR)	$252.28	$252.28
RHODE ISLAND (RI)	$251.40	$251.40
SOUTH CAROLINA (SC)	$240.86	$240.86
SOUTH DAKOTA** (SD)	$217.91	$217.91
TENNESSEE (TN)	$223.80	$223.80
BRAZORIA (TX)	$241.79	$241.79
DALLAS (TX)	$246.26	$246.26
GALVESTON (TX)	$244.40	$244.40
HOUSTON (TX)	$272.95	$272.95
BEAUMONT (TX)	$244.27	$244.27
FORT WORTH (TX)	$246.43	$246.43
AUSTIN (TX)	$249.80	$249.80
REST OF TEXAS (TX)	$244.88	$244.88
UTAH (UT)	$244.17	$244.17
VIRGINIA (VA)	$236.33	$236.33
VIRGIN ISLANDS (VI)	$252.28	$252.28
VERMONT (VT)	$226.27	$226.27
SEATTLE (KING CNTY) (WA)	$261.92	$261.92
REST OF WASHINGTON (WA)	$244.68	$244.68
WISCONSIN (WI)	$214.34	$214.34
WEST VIRGINIA (WV)	$268.36	$268.36
WYOMING** (WY)	$238.96	$238.96

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 6 units per patient per day — Date of Service Edit: Clinical. 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 the code — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar allowance. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs, reflecting the fact that overhead costs are handled differently when a facility bills separately for its own costs. The resulting national and locality-adjusted amounts shown on this page reflect that calculation for the given year.

RVUs — work 4.49, practice expense 1.51 (non-facility) / 1.51 (facility), malpractice 1.56 — × 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 payer is responsible for the remainder.
Actual payment can vary based on locality, applicable modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (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 (equipment, supplies, staff time) are allocated differently depending on whether the procedure is performed in a facility that bills its own costs separately or in a non-facility setting like a physician's office.

Why might my local payment differ from the national amount shown?

Locality-specific GPCIs adjust the work, practice-expense, and malpractice RVUs to reflect regional cost differences, so the final allowed amount can be higher or lower than the national average.

Does this amount include the deductible or patient coinsurance?

No. The figure shown is the Medicare-allowed amount before deductible and coinsurance; Medicare generally pays 80% of this amount after the deductible is satisfied.

Can modifiers change this amount?

Yes. Modifiers (such as those indicating bilateral procedures, reduced services, or multiple-procedure reductions) can increase or decrease the final payment relative to the base PFS amount shown here.

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.