Medicare Reimbursement for CPT 22586

CPT 22586 is a surgical procedure code; because CPT descriptors are proprietary to the AMA, we refer to it generically here. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both at the national level and adjusted for your locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$2008.06	$2008.06
ALASKA* (AK)	$2338.00	$2338.00
ALABAMA (AL)	$1751.92	$1751.92
ARKANSAS (AR)	$1720.89	$1720.89
ARIZONA (AZ)	$1930.46	$1930.46
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2161.56	$2161.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2187.03	$2187.03
OXNARD-THOUSAND OAKS-VENTURA (CA)	$2016.09	$2016.09
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$2044.57	$2044.57
NAPA (CA)	$2099.52	$2099.52
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2174.73	$2174.73
VALLEJO (CA)	$2080.55	$2080.55
BAKERSFIELD (CA)	$1941.79	$1941.79
CHICO (CA)	$1911.70	$1911.70
FRESNO (CA)	$1911.70	$1911.70
HANFORD-CORCORAN (CA)	$1911.70	$1911.70
MADERA (CA)	$1911.70	$1911.70
MERCED (CA)	$1911.70	$1911.70
MODESTO (CA)	$1911.70	$1911.70
REDDING (CA)	$1911.70	$1911.70
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$2035.33	$2035.33
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1976.34	$1976.34
SALINAS (CA)	$1968.94	$1968.94
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2240.83	$2240.83
SANTA CRUZ-WATSONVILLE (CA)	$1999.27	$1999.27
SANTA ROSA-PETALUMA (CA)	$2016.68	$2016.68
STOCKTON (CA)	$1911.70	$1911.70
VISALIA (CA)	$1911.70	$1911.70
YUBA CITY (CA)	$1911.70	$1911.70
EL CENTRO (CA)	$1913.63	$1913.63
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1996.44	$1996.44
SAN LUIS OBISPO-PASO ROBLES (CA)	$1942.02	$1942.02
SANTA MARIA-SANTA BARBARA (CA)	$1971.13	$1971.13
REST OF CALIFORNIA (CA)	$1911.70	$1911.70
COLORADO (CO)	$1979.40	$1979.40
CONNECTICUT (CT)	$2161.97	$2161.97
DC + MD/VA SUBURBS (DC)	$2226.77	$2226.77
DELAWARE (DE)	$1965.08	$1965.08
FORT LAUDERDALE (FL)	$2330.02	$2330.02
MIAMI (FL)	$2628.87	$2628.87
REST OF FLORIDA (FL)	$2171.76	$2171.76
ATLANTA (GA)	$2099.90	$2099.90
REST OF GEORGIA (GA)	$2006.24	$2006.24
HAWAII, GUAM (HI)	$1941.68	$1941.68
IOWA (IA)	$1714.70	$1714.70
IDAHO (ID)	$1747.64	$1747.64
EAST ST. LOUIS (IL)	$2344.19	$2344.19
SUBURBAN CHICAGO (IL)	$2332.36	$2332.36
CHICAGO (IL)	$2519.31	$2519.31
REST OF ILLINOIS (IL)	$2164.67	$2164.67
INDIANA (IN)	$1757.61	$1757.61
KANSAS (KS)	$1748.36	$1748.36
KENTUCKY (KY)	$1896.89	$1896.89
NEW ORLEANS (LA)	$2019.11	$2019.11
REST OF LOUISIANA (LA)	$1910.72	$1910.72
METROPOLITAN BOSTON (MA)	$2139.82	$2139.82
REST OF MASSACHUSETTS (MA)	$1981.50	$1981.50
BALTIMORE/SURR. CNTYS (MD)	$2165.93	$2165.93
REST OF MARYLAND (MD)	$1993.94	$1993.94
SOUTHERN MAINE (ME)	$1858.87	$1858.87
REST OF MAINE (ME)	$1805.32	$1805.32
DETROIT (MI)	$2248.95	$2248.95
REST OF MICHIGAN (MI)	$1996.66	$1996.66
MINNESOTA (MN)	$1755.98	$1755.98
METROPOLITAN ST. LOUIS (MO)	$1974.99	$1974.99
METROPOLITAN KANSAS CITY (MO)	$1956.15	$1956.15
REST OF MISSOURI (MO)	$1900.69	$1900.69
MISSISSIPPI (MS)	$1809.02	$1809.02
MONTANA** (MT)	$2007.29	$2007.29
NORTH CAROLINA (NC)	$1821.07	$1821.07
NORTH DAKOTA** (ND)	$1778.11	$1778.11
NEBRASKA (NE)	$1712.98	$1712.98
NEW HAMPSHIRE (NH)	$1988.58	$1988.58
NORTHERN NJ (NJ)	$2204.90	$2204.90
REST OF NEW JERSEY (NJ)	$2147.12	$2147.12
NEW MEXICO (NM)	$2027.35	$2027.35
NEVADA** (NV)	$1944.12	$1944.12
MANHATTAN (NY)	$2407.75	$2407.75
NYC SUBURBS/LONG ISLAND (NY)	$2531.70	$2531.70
POUGHKPSIE/N NYC SUBURBS (NY)	$2197.55	$2197.55
QUEENS (NY)	$2366.11	$2366.11
REST OF NEW YORK (NY)	$1857.83	$1857.83
OHIO (OH)	$1949.82	$1949.82
OKLAHOMA (OK)	$1846.29	$1846.29
PORTLAND (OR)	$2001.88	$2001.88
REST OF OREGON (OR)	$1890.27	$1890.27
METROPOLITAN PHILADELPHIA (PA)	$2128.17	$2128.17
REST OF PENNSYLVANIA (PA)	$1928.95	$1928.95
PUERTO RICO (PR)	$2010.01	$2010.01
RHODE ISLAND (RI)	$2006.92	$2006.92
SOUTH CAROLINA (SC)	$1896.41	$1896.41
SOUTH DAKOTA** (SD)	$1751.02	$1751.02
TENNESSEE (TN)	$1764.66	$1764.66
BRAZORIA (TX)	$1923.88	$1923.88
DALLAS (TX)	$1958.51	$1958.51
GALVESTON (TX)	$1943.87	$1943.87
HOUSTON (TX)	$2156.01	$2156.01
BEAUMONT (TX)	$1917.12	$1917.12
FORT WORTH (TX)	$1956.50	$1956.50
AUSTIN (TX)	$2006.66	$2006.66
REST OF TEXAS (TX)	$1934.55	$1934.55
UTAH (UT)	$1926.27	$1926.27
VIRGINIA (VA)	$1882.26	$1882.26
VIRGIN ISLANDS (VI)	$2010.01	$2010.01
VERMONT (VT)	$1809.78	$1809.78
SEATTLE (KING CNTY) (WA)	$2143.07	$2143.07
REST OF WASHINGTON (WA)	$1964.82	$1964.82
WISCONSIN (WI)	$1710.56	$1710.56
WEST VIRGINIA (WV)	$2082.54	$2082.54
WYOMING** (WY)	$1907.41	$1907.41

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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 — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost-of-living and practice-cost differences. The adjusted RVUs are summed and multiplied by the annual national Conversion Factor to produce a dollar amount. Non-facility and facility rates differ because the practice-expense RVU is typically higher when the physician's own office bears the overhead, versus when the service is performed in a hospital or other facility that bills separately for overhead.

RVUs — work 27.42, practice expense 21.11 (non-facility) / 21.11 (facility), malpractice 11.59 — × 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 insurer is responsible for the remainder.
Actual payment can vary based on modifiers, place of service, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Always verify final allowed amounts and coverage rules with your specific Medicare Administrative Contractor (MAC).

Frequently asked

Why does the amount differ between non-facility and facility settings?

The practice-expense RVU component changes depending on where the service is performed, since overhead costs are allocated differently when a facility (rather than the physician's office) bears certain costs.

Why might my locality's amount differ from the national figure?

Geographic Practice Cost Indices (GPCIs) adjust the RVUs for regional differences in wages, rent, and malpractice costs, so the same code can price differently from one area to another.

Does this figure include any modifiers I might append?

No. The base PFS amount shown does not reflect modifier-based adjustments (e.g., bilateral, assistant surgeon, multiple procedure reductions), which can increase or decrease the final payment.

Will I be paid exactly this amount?

Not necessarily. This is a calculated estimate; actual reimbursement depends on your MAC's processing, sequestration, claim-specific modifiers, and any annual fee schedule updates.

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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.