Medicare Reimbursement for CPT 22558

This page covers Medicare Physician Fee Schedule (PFS) estimates for CPT code 22558, a procedure code billed under Medicare Part B. Because the CPT descriptor itself is licensed by the AMA, we refer to it generically here. The figures shown reflect the national PFS allowed amount as well as locality-adjusted amounts, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1423.88	$1423.88
ALASKA* (AK)	$1738.32	$1738.32
ALABAMA (AL)	$1274.69	$1274.69
ARKANSAS (AR)	$1256.58	$1256.58
ARIZONA (AZ)	$1379.00	$1379.00
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1552.79	$1552.79
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1572.32	$1572.32
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1443.85	$1443.85
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1463.14	$1463.14
NAPA (CA)	$1505.70	$1505.70
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1560.16	$1560.16
VALLEJO (CA)	$1495.08	$1495.08
BAKERSFIELD (CA)	$1396.01	$1396.01
CHICO (CA)	$1378.65	$1378.65
FRESNO (CA)	$1378.65	$1378.65
HANFORD-CORCORAN (CA)	$1378.65	$1378.65
MADERA (CA)	$1378.65	$1378.65
MERCED (CA)	$1378.65	$1378.65
MODESTO (CA)	$1378.65	$1378.65
REDDING (CA)	$1378.65	$1378.65
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1448.13	$1448.13
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1422.75	$1422.75
SALINAS (CA)	$1417.15	$1417.15
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1602.46	$1602.46
SANTA CRUZ-WATSONVILLE (CA)	$1434.18	$1434.18
SANTA ROSA-PETALUMA (CA)	$1446.81	$1446.81
STOCKTON (CA)	$1378.65	$1378.65
VISALIA (CA)	$1378.65	$1378.65
YUBA CITY (CA)	$1378.65	$1378.65
EL CENTRO (CA)	$1379.73	$1379.73
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1434.00	$1434.00
SAN LUIS OBISPO-PASO ROBLES (CA)	$1397.61	$1397.61
SANTA MARIA-SANTA BARBARA (CA)	$1417.94	$1417.94
REST OF CALIFORNIA (CA)	$1378.65	$1378.65
COLORADO (CO)	$1413.82	$1413.82
CONNECTICUT (CT)	$1518.68	$1518.68
DC + MD/VA SUBURBS (DC)	$1568.23	$1568.23
DELAWARE (DE)	$1400.53	$1400.53
FORT LAUDERDALE (FL)	$1604.76	$1604.76
MIAMI (FL)	$1773.40	$1773.40
REST OF FLORIDA (FL)	$1513.52	$1513.52
ATLANTA (GA)	$1476.80	$1476.80
REST OF GEORGIA (GA)	$1417.88	$1417.88
HAWAII, GUAM (HI)	$1393.02	$1393.02
IOWA (IA)	$1255.69	$1255.69
IDAHO (ID)	$1274.37	$1274.37
EAST ST. LOUIS (IL)	$1608.42	$1608.42
SUBURBAN CHICAGO (IL)	$1608.50	$1608.50
CHICAGO (IL)	$1712.17	$1712.17
REST OF ILLINOIS (IL)	$1507.57	$1507.57
INDIANA (IN)	$1280.27	$1280.27
KANSAS (KS)	$1274.04	$1274.04
KENTUCKY (KY)	$1356.52	$1356.52
NEW ORLEANS (LA)	$1427.35	$1427.35
REST OF LOUISIANA (LA)	$1364.07	$1364.07
METROPOLITAN BOSTON (MA)	$1516.98	$1516.98
REST OF MASSACHUSETTS (MA)	$1415.50	$1415.50
BALTIMORE/SURR. CNTYS (MD)	$1519.70	$1519.70
REST OF MARYLAND (MD)	$1419.06	$1419.06
SOUTHERN MAINE (ME)	$1339.92	$1339.92
REST OF MAINE (ME)	$1306.67	$1306.67
DETROIT (MI)	$1557.15	$1557.15
REST OF MICHIGAN (MI)	$1413.49	$1413.49
MINNESOTA (MN)	$1284.06	$1284.06
METROPOLITAN ST. LOUIS (MO)	$1403.15	$1403.15
METROPOLITAN KANSAS CITY (MO)	$1392.00	$1392.00
REST OF MISSOURI (MO)	$1357.40	$1357.40
MISSISSIPPI (MS)	$1306.02	$1306.02
MONTANA** (MT)	$1423.45	$1423.45
NORTH CAROLINA (NC)	$1316.09	$1316.09
NORTH DAKOTA** (ND)	$1295.12	$1295.12
NEBRASKA (NE)	$1255.10	$1255.10
NEW HAMPSHIRE (NH)	$1414.86	$1414.86
NORTHERN NJ (NJ)	$1557.44	$1557.44
REST OF NEW JERSEY (NJ)	$1516.12	$1516.12
NEW MEXICO (NM)	$1430.86	$1430.86
NEVADA** (NV)	$1388.12	$1388.12
MANHATTAN (NY)	$1671.37	$1671.37
NYC SUBURBS/LONG ISLAND (NY)	$1742.02	$1742.02
POUGHKPSIE/N NYC SUBURBS (NY)	$1545.77	$1545.77
QUEENS (NY)	$1648.97	$1648.97
REST OF NEW YORK (NY)	$1337.45	$1337.45
OHIO (OH)	$1387.26	$1387.26
OKLAHOMA (OK)	$1328.36	$1328.36
PORTLAND (OR)	$1429.59	$1429.59
REST OF OREGON (OR)	$1357.74	$1357.74
METROPOLITAN PHILADELPHIA (PA)	$1497.59	$1497.59
REST OF PENNSYLVANIA (PA)	$1375.80	$1375.80
PUERTO RICO (PR)	$1425.48	$1425.48
RHODE ISLAND (RI)	$1429.58	$1429.58
SOUTH CAROLINA (SC)	$1357.86	$1357.86
SOUTH DAKOTA** (SD)	$1279.94	$1279.94
TENNESSEE (TN)	$1283.39	$1283.39
BRAZORIA (TX)	$1378.35	$1378.35
DALLAS (TX)	$1398.23	$1398.23
GALVESTON (TX)	$1389.64	$1389.64
HOUSTON (TX)	$1508.43	$1508.43
BEAUMONT (TX)	$1368.81	$1368.81
FORT WORTH (TX)	$1396.64	$1396.64
AUSTIN (TX)	$1426.27	$1426.27
REST OF TEXAS (TX)	$1380.37	$1380.37
UTAH (UT)	$1375.32	$1375.32
VIRGINIA (VA)	$1352.65	$1352.65
VIRGIN ISLANDS (VI)	$1425.48	$1425.48
VERMONT (VT)	$1312.39	$1312.39
SEATTLE (KING CNTY) (WA)	$1522.60	$1522.60
REST OF WASHINGTON (WA)	$1405.40	$1405.40
WISCONSIN (WI)	$1255.36	$1255.36
WEST VIRGINIA (WV)	$1459.55	$1459.55
WYOMING** (WY)	$1367.52	$1367.52

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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 billed. The GPCI-adjusted RVUs are summed and multiplied by the annual conversion factor (a national dollar-per-RVU rate set by CMS) to produce the allowed amount. Non-facility and facility settings can have different practice-expense RVUs because facility settings assume some costs are borne by the facility rather than the billing physician; for this code, those practice-expense RVUs happen to be the same, so the national non-facility and facility amounts shown are equal. Locality-specific GPCIs mean the final payable amount can differ from the national figure depending on where the service was furnished.

RVUs — work 22.94, practice expense 13.2 (non-facility) / 13.2 (facility), malpractice 6.49 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on the national conversion factor and standard RVUs — actual payment may differ.
Medicare typically pays 80% of the approved amount after the patient's Part B deductible is met; the beneficiary or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the final paid amount.
Locality-specific GPCIs may shift the payable amount above or below the national figure shown here.
Always confirm current rates and edits with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why might the amount I was paid differ from the national figure shown here?

The national amount uses average GPCIs; your actual payment depends on the GPCIs for your specific Medicare locality, any applicable modifiers, and other claim-specific adjustments.

Does this amount represent what the practice actually collects?

No. It represents the Medicare-approved amount before the 80/20 split; after the deductible is met, Medicare pays 80% and the remaining 20% is owed by the patient or a secondary payer.

Why are the non-facility and facility amounts the same for this code?

The practice-expense RVUs for this code are identical in both settings, which can happen when CMS determines the resource costs don't differ materially between a facility and non-facility setting.

Can this code's fee change during the year?

The conversion factor and RVUs are generally set annually, but CMS can make mid-year adjustments, and budget-neutrality rules or legislative action can affect the final amount.

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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.