Medicare Reimbursement for CPT 22590

This page covers CPT code 22590, a procedure code defined by the American Medical Association. It shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and adjusted for locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1559.15	$1559.15
ALASKA* (AK)	$1830.61	$1830.61
ALABAMA (AL)	$1369.77	$1369.77
ARKANSAS (AR)	$1346.76	$1346.76
ARIZONA (AZ)	$1502.41	$1502.41
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1710.30	$1710.30
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1732.01	$1732.01
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1583.47	$1583.47
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1604.29	$1604.29
NAPA (CA)	$1656.44	$1656.44
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1719.44	$1719.44
VALLEJO (CA)	$1643.26	$1643.26
BAKERSFIELD (CA)	$1523.31	$1523.31
CHICO (CA)	$1502.27	$1502.27
FRESNO (CA)	$1502.27	$1502.27
HANFORD-CORCORAN (CA)	$1502.27	$1502.27
MADERA (CA)	$1502.27	$1502.27
MERCED (CA)	$1502.27	$1502.27
MODESTO (CA)	$1502.27	$1502.27
REDDING (CA)	$1502.27	$1502.27
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1588.21	$1588.21
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1554.70	$1554.70
SALINAS (CA)	$1548.83	$1548.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1769.39	$1769.39
SANTA CRUZ-WATSONVILLE (CA)	$1574.30	$1574.30
SANTA ROSA-PETALUMA (CA)	$1588.24	$1588.24
STOCKTON (CA)	$1502.27	$1502.27
VISALIA (CA)	$1502.27	$1502.27
YUBA CITY (CA)	$1502.27	$1502.27
EL CENTRO (CA)	$1503.61	$1503.61
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1571.25	$1571.25
SAN LUIS OBISPO-PASO ROBLES (CA)	$1527.27	$1527.27
SANTA MARIA-SANTA BARBARA (CA)	$1550.77	$1550.77
REST OF CALIFORNIA (CA)	$1502.27	$1502.27
COLORADO (CO)	$1545.99	$1545.99
CONNECTICUT (CT)	$1674.57	$1674.57
DC + MD/VA SUBURBS (DC)	$1731.32	$1731.32
DELAWARE (DE)	$1528.56	$1528.56
FORT LAUDERDALE (FL)	$1783.97	$1783.97
MIAMI (FL)	$1994.11	$1994.11
REST OF FLORIDA (FL)	$1668.81	$1668.81
ATLANTA (GA)	$1624.63	$1624.63
REST OF GEORGIA (GA)	$1547.98	$1547.98
HAWAII, GUAM (HI)	$1525.62	$1525.62
IOWA (IA)	$1347.59	$1347.59
IDAHO (ID)	$1370.93	$1370.93
EAST ST. LOUIS (IL)	$1785.27	$1785.27
SUBURBAN CHICAGO (IL)	$1787.39	$1787.39
CHICAGO (IL)	$1915.22	$1915.22
REST OF ILLINOIS (IL)	$1659.94	$1659.94
INDIANA (IN)	$1378.50	$1378.50
KANSAS (KS)	$1369.97	$1369.97
KENTUCKY (KY)	$1471.75	$1471.75
NEW ORLEANS (LA)	$1561.41	$1561.41
REST OF LOUISIANA (LA)	$1480.99	$1480.99
METROPOLITAN BOSTON (MA)	$1671.45	$1671.45
REST OF MASSACHUSETTS (MA)	$1546.73	$1546.73
BALTIMORE/SURR. CNTYS (MD)	$1676.67	$1676.67
REST OF MARYLAND (MD)	$1551.17	$1551.17
SOUTHERN MAINE (ME)	$1454.70	$1454.70
REST OF MAINE (ME)	$1411.00	$1411.00
DETROIT (MI)	$1723.25	$1723.25
REST OF MICHIGAN (MI)	$1543.25	$1543.25
MINNESOTA (MN)	$1386.73	$1386.73
METROPOLITAN ST. LOUIS (MO)	$1531.78	$1531.78
METROPOLITAN KANSAS CITY (MO)	$1517.50	$1517.50
REST OF MISSOURI (MO)	$1471.91	$1471.91
MISSISSIPPI (MS)	$1408.15	$1408.15
MONTANA** (MT)	$1558.62	$1558.62
NORTH CAROLINA (NC)	$1423.13	$1423.13
NORTH DAKOTA** (ND)	$1399.44	$1399.44
NEBRASKA (NE)	$1347.14	$1347.14
NEW HAMPSHIRE (NH)	$1549.39	$1549.39
NORTHERN NJ (NJ)	$1715.13	$1715.13
REST OF NEW JERSEY (NJ)	$1667.08	$1667.08
NEW MEXICO (NM)	$1564.93	$1564.93
NEVADA** (NV)	$1514.83	$1514.83
MANHATTAN (NY)	$1856.28	$1856.28
NYC SUBURBS/LONG ISLAND (NY)	$1944.85	$1944.85
POUGHKPSIE/N NYC SUBURBS (NY)	$1702.76	$1702.76
QUEENS (NY)	$1829.19	$1829.19
REST OF NEW YORK (NY)	$1450.22	$1450.22
OHIO (OH)	$1510.71	$1510.71
OKLAHOMA (OK)	$1436.97	$1436.97
PORTLAND (OR)	$1566.21	$1566.21
REST OF OREGON (OR)	$1476.97	$1476.97
METROPOLITAN PHILADELPHIA (PA)	$1647.65	$1647.65
REST OF PENNSYLVANIA (PA)	$1496.68	$1496.68
PUERTO RICO (PR)	$1561.52	$1561.52
RHODE ISLAND (RI)	$1562.77	$1562.77
SOUTH CAROLINA (SC)	$1474.63	$1474.63
SOUTH DAKOTA** (SD)	$1380.62	$1380.62
TENNESSEE (TN)	$1381.75	$1381.75
BRAZORIA (TX)	$1500.44	$1500.44
DALLAS (TX)	$1525.03	$1525.03
GALVESTON (TX)	$1514.51	$1514.51
HOUSTON (TX)	$1661.85	$1661.85
BEAUMONT (TX)	$1487.73	$1487.73
FORT WORTH (TX)	$1522.71	$1522.71
AUSTIN (TX)	$1563.65	$1563.65
REST OF TEXAS (TX)	$1503.42	$1503.42
UTAH (UT)	$1496.84	$1496.84
VIRGINIA (VA)	$1470.22	$1470.22
VIRGIN ISLANDS (VI)	$1561.52	$1561.52
VERMONT (VT)	$1420.51	$1420.51
SEATTLE (KING CNTY) (WA)	$1677.39	$1677.39
REST OF WASHINGTON (WA)	$1534.93	$1534.93
WISCONSIN (WI)	$1348.67	$1348.67
WEST VIRGINIA (WV)	$1598.86	$1598.86
WYOMING** (WY)	$1489.25	$1489.25

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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) — work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts may differ for some codes.

RVUs — work 21.22, practice expense 17.41 (non-facility) / 17.41 (facility), malpractice 8.05 — × 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.
Modifiers, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCI values and the conversion factor are updated annually and can shift amounts year to year.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why do the non-facility and facility amounts differ?

They differ when the practice-expense RVU assigned to the code varies by setting, since non-facility (e.g., office) settings often include overhead costs that are billed separately when the service is performed in a facility.

Why does the amount change by locality?

Each locality has its own Geographic Practice Cost Indices (GPCIs) for work, practice expense, and malpractice, which adjust the RVUs to reflect local cost-of-living and practice cost differences before the conversion factor is applied.

Is this the amount my practice will actually be paid?

No — this is an estimated allowed amount based on the standard PFS formula. Actual payment can be affected by your specific MAC, applicable modifiers, patient deductible status, sequestration, and other claim-specific factors.

Why isn't the CPT code description shown here?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page refers to the code generically rather than reproducing the official descriptor.

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.