Medicare Reimbursement for CPT 22585

CPT 22585 is a procedure code defined by the American Medical Association (AMA); the descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and by locality, with both non-facility and facility rates where they apply.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$287.58	$287.58
ALASKA* (AK)	$356.80	$356.80
ALABAMA (AL)	$257.48	$257.48
ARKANSAS (AR)	$253.87	$253.87
ARIZONA (AZ)	$278.16	$278.16
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$295.92	$295.92
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$298.84	$298.84
OXNARD-THOUSAND OAKS-VENTURA (CA)	$282.19	$282.19
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$286.78	$286.78
NAPA (CA)	$289.65	$289.65
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$297.75	$297.75
VALLEJO (CA)	$287.02	$287.02
BAKERSFIELD (CA)	$275.16	$275.16
CHICO (CA)	$270.88	$270.88
FRESNO (CA)	$270.88	$270.88
HANFORD-CORCORAN (CA)	$270.88	$270.88
MADERA (CA)	$270.88	$270.88
MERCED (CA)	$270.88	$270.88
MODESTO (CA)	$270.88	$270.88
REDDING (CA)	$270.88	$270.88
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$288.11	$288.11
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$277.92	$277.92
SALINAS (CA)	$276.80	$276.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$306.31	$306.31
SANTA CRUZ-WATSONVILLE (CA)	$278.04	$278.04
SANTA ROSA-PETALUMA (CA)	$280.36	$280.36
STOCKTON (CA)	$270.88	$270.88
VISALIA (CA)	$270.88	$270.88
YUBA CITY (CA)	$270.88	$270.88
EL CENTRO (CA)	$271.15	$271.15
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$278.95	$278.95
SAN LUIS OBISPO-PASO ROBLES (CA)	$273.21	$273.21
SANTA MARIA-SANTA BARBARA (CA)	$276.64	$276.64
REST OF CALIFORNIA (CA)	$270.88	$270.88
COLORADO (CO)	$281.42	$281.42
CONNECTICUT (CT)	$306.63	$306.63
DC + MD/VA SUBURBS (DC)	$312.99	$312.99
DELAWARE (DE)	$282.40	$282.40
FORT LAUDERDALE (FL)	$331.74	$331.74
MIAMI (FL)	$372.02	$372.02
REST OF FLORIDA (FL)	$312.25	$312.25
ATLANTA (GA)	$299.80	$299.80
REST OF GEORGIA (GA)	$292.06	$292.06
HAWAII, GUAM (HI)	$272.36	$272.36
IOWA (IA)	$250.56	$250.56
IDAHO (ID)	$254.91	$254.91
EAST ST. LOUIS (IL)	$337.78	$337.78
SUBURBAN CHICAGO (IL)	$331.82	$331.82
CHICAGO (IL)	$358.75	$358.75
REST OF ILLINOIS (IL)	$313.15	$313.15
INDIANA (IN)	$255.99	$255.99
KANSAS (KS)	$255.71	$255.71
KENTUCKY (KY)	$277.00	$277.00
NEW ORLEANS (LA)	$291.70	$291.70
REST OF LOUISIANA (LA)	$279.10	$279.10
METROPOLITAN BOSTON (MA)	$299.53	$299.53
REST OF MASSACHUSETTS (MA)	$282.41	$282.41
BALTIMORE/SURR. CNTYS (MD)	$307.15	$307.15
REST OF MARYLAND (MD)	$285.62	$285.62
SOUTHERN MAINE (ME)	$267.25	$267.25
REST OF MAINE (ME)	$262.93	$262.93
DETROIT (MI)	$322.58	$322.58
REST OF MICHIGAN (MI)	$289.81	$289.81
MINNESOTA (MN)	$251.29	$251.29
METROPOLITAN ST. LOUIS (MO)	$285.09	$285.09
METROPOLITAN KANSAS CITY (MO)	$283.04	$283.04
REST OF MISSOURI (MO)	$278.72	$278.72
MISSISSIPPI (MS)	$266.03	$266.03
MONTANA** (MT)	$287.47	$287.47
NORTH CAROLINA (NC)	$264.54	$264.54
NORTH DAKOTA** (ND)	$255.64	$255.64
NEBRASKA (NE)	$249.97	$249.97
NEW HAMPSHIRE (NH)	$283.08	$283.08
NORTHERN NJ (NJ)	$311.22	$311.22
REST OF NEW JERSEY (NJ)	$304.96	$304.96
NEW MEXICO (NM)	$293.90	$293.90
NEVADA** (NV)	$278.66	$278.66
MANHATTAN (NY)	$339.36	$339.36
NYC SUBURBS/LONG ISLAND (NY)	$355.39	$355.39
POUGHKPSIE/N NYC SUBURBS (NY)	$312.10	$312.10
QUEENS (NY)	$332.70	$332.70
REST OF NEW YORK (NY)	$268.90	$268.90
OHIO (OH)	$283.30	$283.30
OKLAHOMA (OK)	$269.80	$269.80
PORTLAND (OR)	$282.70	$282.70
REST OF OREGON (OR)	$271.39	$271.39
METROPOLITAN PHILADELPHIA (PA)	$303.41	$303.41
REST OF PENNSYLVANIA (PA)	$280.19	$280.19
PUERTO RICO (PR)	$287.37	$287.37
RHODE ISLAND (RI)	$286.97	$286.97
SOUTH CAROLINA (SC)	$275.40	$275.40
SOUTH DAKOTA** (SD)	$251.87	$251.87
TENNESSEE (TN)	$257.76	$257.76
BRAZORIA (TX)	$276.70	$276.70
DALLAS (TX)	$281.35	$281.35
GALVESTON (TX)	$279.39	$279.39
HOUSTON (TX)	$308.86	$308.86
BEAUMONT (TX)	$278.89	$278.89
FORT WORTH (TX)	$281.50	$281.50
AUSTIN (TX)	$284.95	$284.95
REST OF TEXAS (TX)	$279.61	$279.61
UTAH (UT)	$278.85	$278.85
VIRGINIA (VA)	$270.85	$270.85
VIRGIN ISLANDS (VI)	$287.37	$287.37
VERMONT (VT)	$260.48	$260.48
SEATTLE (KING CNTY) (WA)	$299.01	$299.01
REST OF WASHINGTON (WA)	$279.93	$279.93
WISCONSIN (WI)	$248.10	$248.10
WEST VIRGINIA (WV)	$303.67	$303.67
WYOMING** (WY)	$273.60	$273.60

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 5 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) — 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 the allowed amount. Practice expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why two allowed amounts may be shown. These values are recalculated each year as RVUs, GPCIs, and the conversion factor are updated.

RVUs — work 5.38, practice expense 1.62 (non-facility) / 1.62 (facility), malpractice 1.61 — × 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 their annual deductible; the patient or secondary payer is responsible for the remainder.
Actual payment can vary with locality, applicable modifiers, claim-specific adjustments, sequestration, and annual budget-neutrality changes to the conversion factor.
Always confirm current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why do I see different amounts for non-facility and facility settings?

Practice expense RVUs are typically lower in a facility setting (e.g., hospital) because the facility, not the physician's practice, absorbs certain overhead costs. This can result in a lower facility-based allowed amount compared to non-facility.

Does this amount reflect what my practice will actually be paid?

No. It's an estimate based on national RVUs, locality GPCIs, and the current conversion factor. Actual reimbursement depends on the specific claim, modifiers used, the patient's deductible status, and any applicable sequestration or adjustments.

Why can't you show the CPT code description?

CPT code descriptors are copyrighted and licensed by the American Medical Association. We display the code number but cannot reproduce the official descriptor text.

Will this rate change next year?

Yes. CMS updates RVUs, GPCIs, and the conversion factor annually, and budget-neutrality adjustments can shift allowed amounts even if a code's RVUs stay the same.

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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.