Medicare Reimbursement for CPT 22610

This page covers CPT code 22610, a physician procedure code valued under the Medicare Physician Fee Schedule (PFS). It shows the estimated national Medicare allowed amount, along with how the amount may be adjusted by locality, and compares non-facility (office) versus facility (hospital/ASC) payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1255.54	$1255.54
ALASKA* (AK)	$1482.74	$1482.74
ALABAMA (AL)	$1109.29	$1109.29
ARKANSAS (AR)	$1091.45	$1091.45
ARIZONA (AZ)	$1212.25	$1212.25
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1402.87	$1402.87
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1421.89	$1421.89
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1289.46	$1289.46
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1305.19	$1305.19
NAPA (CA)	$1354.91	$1354.91
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1409.43	$1409.43
VALLEJO (CA)	$1345.45	$1345.45
BAKERSFIELD (CA)	$1238.72	$1238.72
CHICO (CA)	$1223.50	$1223.50
FRESNO (CA)	$1223.50	$1223.50
HANFORD-CORCORAN (CA)	$1223.50	$1223.50
MADERA (CA)	$1223.50	$1223.50
MERCED (CA)	$1223.50	$1223.50
MODESTO (CA)	$1223.50	$1223.50
REDDING (CA)	$1223.50	$1223.50
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1285.26	$1285.26
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1267.67	$1267.67
SALINAS (CA)	$1262.86	$1262.86
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1448.73	$1448.73
SANTA CRUZ-WATSONVILLE (CA)	$1285.21	$1285.21
SANTA ROSA-PETALUMA (CA)	$1296.77	$1296.77
STOCKTON (CA)	$1223.50	$1223.50
VISALIA (CA)	$1223.50	$1223.50
YUBA CITY (CA)	$1223.50	$1223.50
EL CENTRO (CA)	$1224.46	$1224.46
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1281.94	$1281.94
SAN LUIS OBISPO-PASO ROBLES (CA)	$1244.98	$1244.98
SANTA MARIA-SANTA BARBARA (CA)	$1264.67	$1264.67
REST OF CALIFORNIA (CA)	$1223.50	$1223.50
COLORADO (CO)	$1251.99	$1251.99
CONNECTICUT (CT)	$1345.81	$1345.81
DC + MD/VA SUBURBS (DC)	$1396.69	$1396.69
DELAWARE (DE)	$1232.86	$1232.86
FORT LAUDERDALE (FL)	$1418.03	$1418.03
MIAMI (FL)	$1571.21	$1571.21
REST OF FLORIDA (FL)	$1330.66	$1330.66
ATLANTA (GA)	$1304.03	$1304.03
REST OF GEORGIA (GA)	$1238.64	$1238.64
HAWAII, GUAM (HI)	$1242.72	$1242.72
IOWA (IA)	$1096.65	$1096.65
IDAHO (ID)	$1113.82	$1113.82
EAST ST. LOUIS (IL)	$1411.33	$1411.33
SUBURBAN CHICAGO (IL)	$1422.01	$1422.01
CHICAGO (IL)	$1511.99	$1511.99
REST OF ILLINOIS (IL)	$1320.76	$1320.76
INDIANA (IN)	$1119.83	$1119.83
KANSAS (KS)	$1111.81	$1111.81
KENTUCKY (KY)	$1183.67	$1183.67
NEW ORLEANS (LA)	$1252.31	$1252.31
REST OF LOUISIANA (LA)	$1189.97	$1189.97
METROPOLITAN BOSTON (MA)	$1354.32	$1354.32
REST OF MASSACHUSETTS (MA)	$1251.84	$1251.84
BALTIMORE/SURR. CNTYS (MD)	$1346.78	$1346.78
REST OF MARYLAND (MD)	$1251.33	$1251.33
SOUTHERN MAINE (ME)	$1179.80	$1179.80
REST OF MAINE (ME)	$1142.59	$1142.59
DETROIT (MI)	$1370.49	$1370.49
REST OF MICHIGAN (MI)	$1236.97	$1236.97
MINNESOTA (MN)	$1134.12	$1134.12
METROPOLITAN ST. LOUIS (MO)	$1231.94	$1231.94
METROPOLITAN KANSAS CITY (MO)	$1220.62	$1220.62
REST OF MISSOURI (MO)	$1181.56	$1181.56
MISSISSIPPI (MS)	$1135.70	$1135.70
MONTANA** (MT)	$1255.15	$1255.15
NORTH CAROLINA (NC)	$1152.37	$1152.37
NORTH DAKOTA** (ND)	$1140.86	$1140.86
NEBRASKA (NE)	$1096.98	$1096.98
NEW HAMPSHIRE (NH)	$1251.89	$1251.89
NORTHERN NJ (NJ)	$1384.07	$1384.07
REST OF NEW JERSEY (NJ)	$1342.75	$1342.75
NEW MEXICO (NM)	$1252.87	$1252.87
NEVADA** (NV)	$1223.80	$1223.80
MANHATTAN (NY)	$1485.64	$1485.64
NYC SUBURBS/LONG ISLAND (NY)	$1551.45	$1551.45
POUGHKPSIE/N NYC SUBURBS (NY)	$1368.88	$1368.88
QUEENS (NY)	$1467.83	$1467.83
REST OF NEW YORK (NY)	$1173.22	$1173.22
OHIO (OH)	$1213.61	$1213.61
OKLAHOMA (OK)	$1159.02	$1159.02
PORTLAND (OR)	$1270.59	$1270.59
REST OF OREGON (OR)	$1196.20	$1196.20
METROPOLITAN PHILADELPHIA (PA)	$1323.42	$1323.42
REST OF PENNSYLVANIA (PA)	$1203.95	$1203.95
PUERTO RICO (PR)	$1258.14	$1258.14
RHODE ISLAND (RI)	$1261.87	$1261.87
SOUTH CAROLINA (SC)	$1188.61	$1188.61
SOUTH DAKOTA** (SD)	$1127.35	$1127.35
TENNESSEE (TN)	$1120.68	$1120.68
BRAZORIA (TX)	$1213.07	$1213.07
DALLAS (TX)	$1231.19	$1231.19
GALVESTON (TX)	$1223.34	$1223.34
HOUSTON (TX)	$1329.13	$1329.13
BEAUMONT (TX)	$1196.86	$1196.86
FORT WORTH (TX)	$1228.71	$1228.71
AUSTIN (TX)	$1263.64	$1263.64
REST OF TEXAS (TX)	$1211.33	$1211.33
UTAH (UT)	$1205.87	$1205.87
VIRGINIA (VA)	$1190.29	$1190.29
VIRGIN ISLANDS (VI)	$1258.14	$1258.14
VERMONT (VT)	$1155.17	$1155.17
SEATTLE (KING CNTY) (WA)	$1361.78	$1361.78
REST OF WASHINGTON (WA)	$1243.20	$1243.20
WISCONSIN (WI)	$1100.96	$1100.96
WEST VIRGINIA (WV)	$1273.29	$1273.29
WYOMING** (WY)	$1205.34	$1205.34

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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 pricing starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice risk. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, to reflect regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility settings can differ because the practice-expense RVU often reflects different overhead assumptions depending on where the service is furnished.

RVUs — work 16.85, practice expense 14.96 (non-facility) / 14.96 (facility), malpractice 5.78 — × 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 insurer is responsible for the remainder.
Actual payment can vary by locality GPCI values, applicable modifiers, claims-level adjustments, sequestration, and annual budget-neutrality changes to the conversion factor.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the Medicare amount for this code change by locality?

Medicare applies Geographic Practice Cost Indices (GPCIs) to the work, practice expense, and malpractice RVUs to account for regional differences in costs, so the same code can have different allowed amounts across localities.

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

When the practice-expense RVUs are identical for both settings, as shown here, the resulting allowed amounts are equal; this reflects how CMS values the overhead costs for this particular service.

Does this amount reflect what the patient will owe?

No. This figure is the Medicare-allowed amount before cost-sharing. After the deductible is met, Medicare generally pays 80%, leaving the patient responsible for the remaining 20% unless other coverage applies.

Will this amount change next year?

Yes. CMS updates RVUs, GPCIs, and the conversion factor annually, and may apply budget-neutrality adjustments, so allowed amounts can change from year to year.

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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.