Medicare Reimbursement for CPT 22800
CPT 22800 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and, where available, by locality, broken out by non-facility and facility settings. These figures represent estimated Medicare payment amounts before patient cost-sharing is applied.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $1312.99 | $1312.99 |
| ALASKA* (AK) | $1575.65 | $1575.65 |
| ALABAMA (AL) | $1168.79 | $1168.79 |
| ARKANSAS (AR) | $1151.20 | $1151.20 |
| ARIZONA (AZ) | $1270.23 | $1270.23 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $1461.80 | $1461.80 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $1481.48 | $1481.48 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $1346.63 | $1346.63 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $1363.25 | $1363.25 |
| NAPA (CA) | $1412.77 | $1412.77 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $1468.34 | $1468.34 |
| VALLEJO (CA) | $1403.35 | $1403.35 |
| BAKERSFIELD (CA) | $1296.45 | $1296.45 |
| CHICO (CA) | $1281.14 | $1281.14 |
| FRESNO (CA) | $1281.14 | $1281.14 |
| HANFORD-CORCORAN (CA) | $1281.14 | $1281.14 |
| MADERA (CA) | $1281.14 | $1281.14 |
| MERCED (CA) | $1281.14 | $1281.14 |
| MODESTO (CA) | $1281.14 | $1281.14 |
| REDDING (CA) | $1281.14 | $1281.14 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $1342.76 | $1342.76 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $1325.74 | $1325.74 |
| SALINAS (CA) | $1320.62 | $1320.62 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $1508.22 | $1508.22 |
| SANTA CRUZ-WATSONVILLE (CA) | $1341.47 | $1341.47 |
| SANTA ROSA-PETALUMA (CA) | $1353.50 | $1353.50 |
| STOCKTON (CA) | $1281.14 | $1281.14 |
| VISALIA (CA) | $1281.14 | $1281.14 |
| YUBA CITY (CA) | $1281.14 | $1281.14 |
| EL CENTRO (CA) | $1282.10 | $1282.10 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $1339.11 | $1339.11 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $1302.02 | $1302.02 |
| SANTA MARIA-SANTA BARBARA (CA) | $1322.12 | $1322.12 |
| REST OF CALIFORNIA (CA) | $1281.14 | $1281.14 |
| COLORADO (CO) | $1309.56 | $1309.56 |
| CONNECTICUT (CT) | $1403.49 | $1403.49 |
| DC + MD/VA SUBURBS (DC) | $1455.46 | $1455.46 |
| DELAWARE (DE) | $1290.91 | $1290.91 |
| FORT LAUDERDALE (FL) | $1474.75 | $1474.75 |
| MIAMI (FL) | $1627.06 | $1627.06 |
| REST OF FLORIDA (FL) | $1388.39 | $1388.39 |
| ATLANTA (GA) | $1361.33 | $1361.33 |
| REST OF GEORGIA (GA) | $1297.48 | $1297.48 |
| HAWAII, GUAM (HI) | $1298.53 | $1298.53 |
| IOWA (IA) | $1155.70 | $1155.70 |
| IDAHO (ID) | $1172.75 | $1172.75 |
| EAST ST. LOUIS (IL) | $1469.22 | $1469.22 |
| SUBURBAN CHICAGO (IL) | $1479.07 | $1479.07 |
| CHICAGO (IL) | $1569.01 | $1569.01 |
| REST OF ILLINOIS (IL) | $1379.05 | $1379.05 |
| INDIANA (IN) | $1178.65 | $1178.65 |
| KANSAS (KS) | $1170.94 | $1170.94 |
| KENTUCKY (KY) | $1242.73 | $1242.73 |
| NEW ORLEANS (LA) | $1310.50 | $1310.50 |
| REST OF LOUISIANA (LA) | $1249.06 | $1249.06 |
| METROPOLITAN BOSTON (MA) | $1412.08 | $1412.08 |
| REST OF MASSACHUSETTS (MA) | $1309.83 | $1309.83 |
| BALTIMORE/SURR. CNTYS (MD) | $1404.20 | $1404.20 |
| REST OF MARYLAND (MD) | $1309.39 | $1309.39 |
| SOUTHERN MAINE (ME) | $1237.63 | $1237.63 |
| REST OF MAINE (ME) | $1201.41 | $1201.41 |
| DETROIT (MI) | $1427.97 | $1427.97 |
| REST OF MICHIGAN (MI) | $1295.56 | $1295.56 |
| MINNESOTA (MN) | $1191.63 | $1191.63 |
| METROPOLITAN ST. LOUIS (MO) | $1290.06 | $1290.06 |
| METROPOLITAN KANSAS CITY (MO) | $1278.94 | $1278.94 |
| REST OF MISSOURI (MO) | $1240.97 | $1240.97 |
| MISSISSIPPI (MS) | $1195.27 | $1195.27 |
| MONTANA** (MT) | $1312.60 | $1312.60 |
| NORTH CAROLINA (NC) | $1211.00 | $1211.00 |
| NORTH DAKOTA** (ND) | $1198.71 | $1198.71 |
| NEBRASKA (NE) | $1155.93 | $1155.93 |
| NEW HAMPSHIRE (NH) | $1308.85 | $1308.85 |
| NORTHERN NJ (NJ) | $1443.78 | $1443.78 |
| REST OF NEW JERSEY (NJ) | $1401.73 | $1401.73 |
| NEW MEXICO (NM) | $1311.35 | $1311.35 |
| NEVADA** (NV) | $1281.35 | $1281.35 |
| MANHATTAN (NY) | $1545.04 | $1545.04 |
| NYC SUBURBS/LONG ISLAND (NY) | $1610.29 | $1610.29 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $1428.10 | $1428.10 |
| QUEENS (NY) | $1527.05 | $1527.05 |
| REST OF NEW YORK (NY) | $1231.57 | $1231.57 |
| OHIO (OH) | $1272.28 | $1272.28 |
| OKLAHOMA (OK) | $1218.12 | $1218.12 |
| PORTLAND (OR) | $1327.80 | $1327.80 |
| REST OF OREGON (OR) | $1253.91 | $1253.91 |
| METROPOLITAN PHILADELPHIA (PA) | $1381.46 | $1381.46 |
| REST OF PENNSYLVANIA (PA) | $1262.58 | $1262.58 |
| PUERTO RICO (PR) | $1315.45 | $1315.45 |
| RHODE ISLAND (RI) | $1320.30 | $1320.30 |
| SOUTH CAROLINA (SC) | $1247.22 | $1247.22 |
| SOUTH DAKOTA** (SD) | $1185.24 | $1185.24 |
| TENNESSEE (TN) | $1179.72 | $1179.72 |
| BRAZORIA (TX) | $1271.37 | $1271.37 |
| DALLAS (TX) | $1289.44 | $1289.44 |
| GALVESTON (TX) | $1281.58 | $1281.58 |
| HOUSTON (TX) | $1387.01 | $1387.01 |
| BEAUMONT (TX) | $1255.62 | $1255.62 |
| FORT WORTH (TX) | $1287.09 | $1287.09 |
| AUSTIN (TX) | $1320.49 | $1320.49 |
| REST OF TEXAS (TX) | $1269.56 | $1269.56 |
| UTAH (UT) | $1264.23 | $1264.23 |
| VIRGINIA (VA) | $1248.17 | $1248.17 |
| VIRGIN ISLANDS (VI) | $1315.45 | $1315.45 |
| VERMONT (VT) | $1213.09 | $1213.09 |
| SEATTLE (KING CNTY) (WA) | $1419.77 | $1419.77 |
| REST OF WASHINGTON (WA) | $1301.00 | $1301.00 |
| WISCONSIN (WI) | $1159.46 | $1159.46 |
| WEST VIRGINIA (WV) | $1332.29 | $1332.29 |
| WYOMING** (WY) | $1262.97 | $1262.97 |
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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) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted using Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often use different practice-expense RVUs because overhead costs differ, which can result in different allowed amounts for the same code. The conversion factor and RVU values are updated annually and can shift due to legislative or budget-neutrality adjustments.
RVUs — work 19.01, practice expense 14.54 (non-facility) / 14.54 (facility), malpractice 5.76 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- This amount is an estimate only, not a guarantee of payment.
- Medicare typically pays 80% of the allowed amount after the patient's annual deductible is met; the patient or secondary payer is responsible for the remainder.
- Modifiers, multiple-procedure reductions, sequestration, and locality-specific adjustments can change the final paid amount.
- Annual budget-neutrality adjustments and policy changes may alter RVUs or the conversion factor from year to year.
- Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.
Frequently asked
Why does the allowed amount differ between non-facility and facility settings?
Practice-expense RVUs differ because the cost of overhead (equipment, staff, supplies) is handled differently depending on whether the service is furnished in a physician office versus a facility like a hospital, where the facility itself bills separately for overhead costs.
Does this page reflect what Medicare will actually pay?
No. It reflects the estimated PFS allowed amount. Actual payment depends on the patient's deductible status, applicable modifiers, secondary insurance, and any sequestration or local contractor adjustments.
Why do PFS amounts change each year?
CMS updates the conversion factor and RVUs annually based on legislative mandates, budget-neutrality requirements, and periodic reviews of relative value inputs.
Where can I find the official CPT descriptor for this code?
CPT code descriptors are copyrighted by the American Medical Association. Refer to your AMA CPT manual or licensed coding software for the official language.
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.
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