Medicare Reimbursement for CPT 22512

CPT 22512 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 by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$739.83	$181.37
ALASKA* (AK)	$832.22	$237.46
ALABAMA (AL)	$656.20	$167.55
ARKANSAS (AR)	$645.61	$165.89
ARIZONA (AZ)	$718.22	$177.07
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$978.44	$191.01
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$998.46	$193.15
OXNARD-THOUSAND OAKS-VENTURA (CA)	$840.98	$180.87
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$844.24	$183.58
NAPA (CA)	$922.40	$186.34
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$979.26	$191.82
VALLEJO (CA)	$921.22	$185.17
BAKERSFIELD (CA)	$789.11	$177.04
CHICO (CA)	$787.10	$175.02
FRESNO (CA)	$787.10	$175.02
HANFORD-CORCORAN (CA)	$787.10	$175.02
MADERA (CA)	$787.10	$175.02
MERCED (CA)	$787.10	$175.02
MODESTO (CA)	$787.10	$175.02
REDDING (CA)	$787.10	$175.02
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$794.85	$182.77
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$828.80	$179.31
SALINAS (CA)	$825.81	$178.55
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1001.80	$196.50
SANTA CRUZ-WATSONVILLE (CA)	$857.29	$178.76
SANTA ROSA-PETALUMA (CA)	$866.08	$180.28
STOCKTON (CA)	$787.10	$175.02
VISALIA (CA)	$787.10	$175.02
YUBA CITY (CA)	$787.10	$175.02
EL CENTRO (CA)	$787.22	$175.14
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$847.49	$179.56
SAN LUIS OBISPO-PASO ROBLES (CA)	$812.27	$176.18
SANTA MARIA-SANTA BARBARA (CA)	$829.51	$178.35
REST OF CALIFORNIA (CA)	$787.10	$175.02
COLORADO (CO)	$773.60	$179.39
CONNECTICUT (CT)	$792.57	$191.11
DC + MD/VA SUBURBS (DC)	$853.80	$195.93
DELAWARE (DE)	$731.03	$179.26
FORT LAUDERDALE (FL)	$766.87	$201.15
MIAMI (FL)	$800.61	$219.25
REST OF FLORIDA (FL)	$726.16	$192.27
ATLANTA (GA)	$754.42	$187.02
REST OF GEORGIA (GA)	$681.21	$183.06
HAWAII, GUAM (HI)	$809.92	$174.95
IOWA (IA)	$675.56	$164.57
IDAHO (ID)	$680.31	$166.53
EAST ST. LOUIS (IL)	$717.37	$203.59
SUBURBAN CHICAGO (IL)	$775.12	$201.57
CHICAGO (IL)	$774.81	$213.56
REST OF ILLINOIS (IL)	$702.43	$192.55
INDIANA (IN)	$684.73	$167.03
KANSAS (KS)	$671.69	$166.84
KENTUCKY (KY)	$672.79	$176.32
NEW ORLEANS (LA)	$708.56	$183.04
REST OF LOUISIANA (LA)	$671.49	$177.25
METROPOLITAN BOSTON (MA)	$856.12	$189.31
REST OF MASSACHUSETTS (MA)	$768.06	$180.00
BALTIMORE/SURR. CNTYS (MD)	$790.36	$191.13
REST OF MARYLAND (MD)	$746.19	$181.02
SOUTHERN MAINE (ME)	$725.69	$172.25
REST OF MAINE (ME)	$683.90	$170.11
DETROIT (MI)	$735.83	$196.92
REST OF MICHIGAN (MI)	$691.99	$182.12
MINNESOTA (MN)	$739.88	$165.22
METROPOLITAN ST. LOUIS (MO)	$711.77	$180.12
METROPOLITAN KANSAS CITY (MO)	$703.56	$179.16
REST OF MISSOURI (MO)	$658.40	$177.01
MISSISSIPPI (MS)	$652.17	$171.33
MONTANA** (MT)	$739.78	$181.32
NORTH CAROLINA (NC)	$691.92	$170.87
NORTH DAKOTA** (ND)	$725.55	$167.08
NEBRASKA (NE)	$679.79	$164.33
NEW HAMPSHIRE (NH)	$760.83	$179.47
NORTHERN NJ (NJ)	$843.35	$195.54
REST OF NEW JERSEY (NJ)	$801.24	$191.40
NEW MEXICO (NM)	$696.07	$183.96
NEVADA** (NV)	$736.40	$177.38
MANHATTAN (NY)	$857.11	$208.18
NYC SUBURBS/LONG ISLAND (NY)	$879.44	$215.43
POUGHKPSIE/N NYC SUBURBS (NY)	$806.37	$194.85
QUEENS (NY)	$865.36	$205.26
REST OF NEW YORK (NY)	$703.41	$172.87
OHIO (OH)	$689.08	$179.21
OKLAHOMA (OK)	$671.82	$173.11
PORTLAND (OR)	$800.75	$180.30
REST OF OREGON (OR)	$730.35	$174.12
METROPOLITAN PHILADELPHIA (PA)	$770.82	$189.46
REST OF PENNSYLVANIA (PA)	$690.49	$177.83
PUERTO RICO (PR)	$745.91	$181.30
RHODE ISLAND (RI)	$759.03	$182.14
SOUTH CAROLINA (SC)	$691.72	$175.70
SOUTH DAKOTA** (SD)	$723.86	$165.40
TENNESSEE (TN)	$675.41	$167.77
BRAZORIA (TX)	$730.31	$176.87
DALLAS (TX)	$735.25	$179.02
GALVESTON (TX)	$732.64	$178.08
HOUSTON (TX)	$745.82	$191.26
BEAUMONT (TX)	$685.43	$177.22
FORT WORTH (TX)	$729.70	$179.06
AUSTIN (TX)	$771.31	$180.46
REST OF TEXAS (TX)	$707.64	$177.65
UTAH (UT)	$702.25	$177.29
VIRGINIA (VA)	$722.81	$173.84
VIRGIN ISLANDS (VI)	$745.91	$181.30
VERMONT (VT)	$722.09	$169.22
SEATTLE (KING CNTY) (WA)	$874.85	$189.62
REST OF WASHINGTON (WA)	$766.81	$178.75
WISCONSIN (WI)	$698.60	$163.59
WEST VIRGINIA (WV)	$673.49	$188.19
WYOMING** (WY)	$733.58	$175.11

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 3 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

The Medicare PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality to reflect local cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because overhead costs differ between settings, which is why two separate allowed amounts are shown. These figures represent the Medicare-approved amount before patient cost-sharing is applied.

RVUs — work 3.9, practice expense 17.53 (non-facility) / 0.81 (facility), malpractice 0.72 — × 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 approved amount after the patient's Part B deductible is met; the patient or secondary payer is responsible for the remainder.
Actual payment can vary due to modifiers, place-of-service coding, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Rates shown reflect a specific year's conversion factor and may change with new rulemaking.
Always confirm final payment with your Medicare Administrative Contractor (MAC) or remittance advice.

Frequently asked

Why is the facility amount lower than the non-facility amount for this code?

In the facility setting, Medicare assumes the hospital or facility absorbs most overhead costs (equipment, supplies, staff), so the practice-expense RVU assigned to the physician's service is lower, reducing the total allowed amount.

Does this amount include anesthesia, supplies, or modifiers?

No. The base PFS amount reflects the standard RVUs for the code only; add-on codes, modifiers (e.g., bilateral, multiple procedure), and supply charges can change the final paid amount.

Why do amounts differ by locality?

Medicare applies Geographic Practice Cost Indices (GPCIs) to the work, practice expense, and malpractice RVUs to account for regional differences in wages, rent, and liability insurance costs, which changes the final payment in each locality.

Is this the amount my practice will actually be paid?

Not necessarily. This is a PFS-based estimate; the actual payment depends on the patient's plan, deductible status, secondary coverage, and any applicable adjustments from your MAC.

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.