Medicare Reimbursement for CPT 22819

This page covers Medicare Physician Fee Schedule (PFS) estimates for CPT code 22819, a procedure code whose official descriptor is licensed by the AMA and not reproduced here. It shows the national PFS allowed amount as well as how that amount can vary by locality, and distinguishes non-facility and facility payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$2201.79	$2201.79
ALASKA* (AK)	$2762.40	$2762.40
ALABAMA (AL)	$2002.46	$2002.46
ARKANSAS (AR)	$1978.19	$1978.19
ARIZONA (AZ)	$2142.42	$2142.42
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2431.38	$2431.38
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2463.64	$2463.64
OXNARD-THOUSAND OAKS-VENTURA (CA)	$2252.26	$2252.26
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$2280.79	$2280.79
NAPA (CA)	$2353.59	$2353.59
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2440.67	$2440.67
VALLEJO (CA)	$2340.20	$2340.20
BAKERSFIELD (CA)	$2181.34	$2181.34
CHICO (CA)	$2158.83	$2158.83
FRESNO (CA)	$2158.83	$2158.83
HANFORD-CORCORAN (CA)	$2158.83	$2158.83
MADERA (CA)	$2158.83	$2158.83
MERCED (CA)	$2158.83	$2158.83
MODESTO (CA)	$2158.83	$2158.83
REDDING (CA)	$2158.83	$2158.83
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$2246.72	$2246.72
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$2226.48	$2226.48
SALINAS (CA)	$2217.48	$2217.48
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2501.62	$2501.62
SANTA CRUZ-WATSONVILLE (CA)	$2240.83	$2240.83
SANTA ROSA-PETALUMA (CA)	$2260.77	$2260.77
STOCKTON (CA)	$2158.83	$2158.83
VISALIA (CA)	$2158.83	$2158.83
YUBA CITY (CA)	$2158.83	$2158.83
EL CENTRO (CA)	$2160.20	$2160.20
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$2241.74	$2241.74
SAN LUIS OBISPO-PASO ROBLES (CA)	$2186.61	$2186.61
SANTA MARIA-SANTA BARBARA (CA)	$2218.16	$2218.16
REST OF CALIFORNIA (CA)	$2158.83	$2158.83
COLORADO (CO)	$2198.69	$2198.69
CONNECTICUT (CT)	$2334.56	$2334.56
DC + MD/VA SUBURBS (DC)	$2416.90	$2416.90
DELAWARE (DE)	$2172.85	$2172.85
FORT LAUDERDALE (FL)	$2430.95	$2430.95
MIAMI (FL)	$2646.02	$2646.02
REST OF FLORIDA (FL)	$2310.79	$2310.79
ATLANTA (GA)	$2270.89	$2270.89
REST OF GEORGIA (GA)	$2184.48	$2184.48
HAWAII, GUAM (HI)	$2175.26	$2175.26
IOWA (IA)	$1982.13	$1982.13
IDAHO (ID)	$2006.12	$2006.12
EAST ST. LOUIS (IL)	$2427.15	$2427.15
SUBURBAN CHICAGO (IL)	$2439.13	$2439.13
CHICAGO (IL)	$2567.81	$2567.81
REST OF ILLINOIS (IL)	$2299.41	$2299.41
INDIANA (IN)	$2014.20	$2014.20
KANSAS (KS)	$2004.26	$2004.26
KENTUCKY (KY)	$2106.86	$2106.86
NEW ORLEANS (LA)	$2200.83	$2200.83
REST OF LOUISIANA (LA)	$2116.03	$2116.03
METROPOLITAN BOSTON (MA)	$2349.64	$2349.64
REST OF MASSACHUSETTS (MA)	$2201.08	$2201.08
BALTIMORE/SURR. CNTYS (MD)	$2334.22	$2334.22
REST OF MARYLAND (MD)	$2199.96	$2199.96
SOUTHERN MAINE (ME)	$2095.16	$2095.16
REST OF MAINE (ME)	$2046.83	$2046.83
DETROIT (MI)	$2366.61	$2366.61
REST OF MICHIGAN (MI)	$2180.83	$2180.83
MINNESOTA (MN)	$2028.17	$2028.17
METROPOLITAN ST. LOUIS (MO)	$2171.33	$2171.33
METROPOLITAN KANSAS CITY (MO)	$2156.10	$2156.10
REST OF MISSOURI (MO)	$2105.54	$2105.54
MISSISSIPPI (MS)	$2040.69	$2040.69
MONTANA** (MT)	$2201.24	$2201.24
NORTH CAROLINA (NC)	$2059.87	$2059.87
NORTH DAKOTA** (ND)	$2039.50	$2039.50
NEBRASKA (NE)	$1982.10	$1982.10
NEW HAMPSHIRE (NH)	$2194.12	$2194.12
NORTHERN NJ (NJ)	$2404.53	$2404.53
REST OF NEW JERSEY (NJ)	$2339.02	$2339.02
NEW MEXICO (NM)	$2203.09	$2203.09
NEVADA** (NV)	$2156.81	$2156.81
MANHATTAN (NY)	$2548.63	$2548.63
NYC SUBURBS/LONG ISLAND (NY)	$2640.11	$2640.11
POUGHKPSIE/N NYC SUBURBS (NY)	$2378.25	$2378.25
QUEENS (NY)	$2522.20	$2522.20
REST OF NEW YORK (NY)	$2088.34	$2088.34
OHIO (OH)	$2147.77	$2147.77
OKLAHOMA (OK)	$2071.74	$2071.74
PORTLAND (OR)	$2224.07	$2224.07
REST OF OREGON (OR)	$2118.06	$2118.06
METROPOLITAN PHILADELPHIA (PA)	$2304.09	$2304.09
REST OF PENNSYLVANIA (PA)	$2133.79	$2133.79
PUERTO RICO (PR)	$2204.79	$2204.79
RHODE ISLAND (RI)	$2217.97	$2217.97
SOUTH CAROLINA (SC)	$2111.71	$2111.71
SOUTH DAKOTA** (SD)	$2020.37	$2020.37
TENNESSEE (TN)	$2016.50	$2016.50
BRAZORIA (TX)	$2146.13	$2146.13
DALLAS (TX)	$2171.95	$2171.95
GALVESTON (TX)	$2160.53	$2160.53
HOUSTON (TX)	$2310.26	$2310.26
BEAUMONT (TX)	$2124.25	$2124.25
FORT WORTH (TX)	$2169.04	$2169.04
AUSTIN (TX)	$2210.67	$2210.67
REST OF TEXAS (TX)	$2142.34	$2142.34
UTAH (UT)	$2135.16	$2135.16
VIRGINIA (VA)	$2110.48	$2110.48
VIRGIN ISLANDS (VI)	$2204.79	$2204.79
VERMONT (VT)	$2060.36	$2060.36
SEATTLE (KING CNTY) (WA)	$2362.55	$2362.55
REST OF WASHINGTON (WA)	$2187.40	$2187.40
WISCONSIN (WI)	$1985.59	$1985.59
WEST VIRGINIA (WV)	$2234.92	$2234.92
WYOMING** (WY)	$2130.75	$2130.75

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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 — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed. The GPCI-adjusted RVUs are summed and multiplied by the annual conversion factor (a national dollar-per-RVU rate set by CMS) to produce the allowed amount. Non-facility and facility settings typically use different practice-expense RVUs to reflect whether the physician's office or a facility bears the overhead costs; for this code, the practice-expense RVU is the same in both settings, so the non-facility and facility amounts shown are identical. Because GPCIs differ across localities, the final dollar amount can vary meaningfully depending on where the service is performed.

RVUs — work 38.4, practice expense 19.34 (non-facility) / 19.34 (facility), malpractice 8.18 — × 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, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Amounts shown are based on the national conversion factor and may not reflect your specific locality's GPCIs unless selected.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the amount for CPT 22819 differ by locality?

The PFS formula applies locality-specific GPCIs to the work, practice-expense, and malpractice RVUs before multiplying by the conversion factor, so areas with higher cost indices produce higher allowed amounts.

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

The practice-expense RVU used in this calculation is identical for both settings, so the resulting PFS amounts match. This isn't the case for every code.

Does this amount reflect what Medicare will actually pay?

No. It reflects the full PFS allowed amount before patient responsibility, deductible status, modifiers, and other adjustments that affect the final payment.

Where can I find the official descriptor for CPT 22819?

CPT code descriptors are copyrighted by the AMA; consult your CPT codebook, encoder software, or AMA licensing source for the official language.

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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.