Medicare Reimbursement for CPT 22836

CPT 22836 is a surgical procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount for this code nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1809.33	$1809.33
ALASKA* (AK)	$2266.25	$2266.25
ALABAMA (AL)	$1644.89	$1644.89
ARKANSAS (AR)	$1624.86	$1624.86
ARIZONA (AZ)	$1760.48	$1760.48
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2004.43	$2004.43
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2031.31	$2031.31
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1854.16	$1854.16
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1877.35	$1877.35
NAPA (CA)	$1939.31	$1939.31
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2011.97	$2011.97
VALLEJO (CA)	$1928.44	$1928.44
BAKERSFIELD (CA)	$1794.77	$1794.77
CHICO (CA)	$1776.50	$1776.50
FRESNO (CA)	$1776.50	$1776.50
HANFORD-CORCORAN (CA)	$1776.50	$1776.50
MADERA (CA)	$1776.50	$1776.50
MERCED (CA)	$1776.50	$1776.50
MODESTO (CA)	$1776.50	$1776.50
REDDING (CA)	$1776.50	$1776.50
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1847.84	$1847.84
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1832.84	$1832.84
SALINAS (CA)	$1825.45	$1825.45
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2062.13	$2062.13
SANTA CRUZ-WATSONVILLE (CA)	$1845.57	$1845.57
SANTA ROSA-PETALUMA (CA)	$1862.04	$1862.04
STOCKTON (CA)	$1776.50	$1776.50
VISALIA (CA)	$1776.50	$1776.50
YUBA CITY (CA)	$1776.50	$1776.50
EL CENTRO (CA)	$1777.61	$1777.61
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1845.92	$1845.92
SAN LUIS OBISPO-PASO ROBLES (CA)	$1799.95	$1799.95
SANTA MARIA-SANTA BARBARA (CA)	$1826.14	$1826.14
REST OF CALIFORNIA (CA)	$1776.50	$1776.50
COLORADO (CO)	$1808.17	$1808.17
CONNECTICUT (CT)	$1918.74	$1918.74
DC + MD/VA SUBURBS (DC)	$1987.75	$1987.75
DELAWARE (DE)	$1785.59	$1785.59
FORT LAUDERDALE (FL)	$1995.62	$1995.62
MIAMI (FL)	$2170.79	$2170.79
REST OF FLORIDA (FL)	$1896.88	$1896.88
ATLANTA (GA)	$1865.76	$1865.76
REST OF GEORGIA (GA)	$1793.00	$1793.00
HAWAII, GUAM (HI)	$1790.68	$1790.68
IOWA (IA)	$1629.23	$1629.23
IDAHO (ID)	$1648.81	$1648.81
EAST ST. LOUIS (IL)	$1990.58	$1990.58
SUBURBAN CHICAGO (IL)	$2002.56	$2002.56
CHICAGO (IL)	$2106.56	$2106.56
REST OF ILLINOIS (IL)	$1886.74	$1886.74
INDIANA (IN)	$1655.51	$1655.51
KANSAS (KS)	$1646.96	$1646.96
KENTUCKY (KY)	$1729.93	$1729.93
NEW ORLEANS (LA)	$1807.31	$1807.31
REST OF LOUISIANA (LA)	$1737.29	$1737.29
METROPOLITAN BOSTON (MA)	$1933.47	$1933.47
REST OF MASSACHUSETTS (MA)	$1809.89	$1809.89
BALTIMORE/SURR. CNTYS (MD)	$1918.38	$1918.38
REST OF MARYLAND (MD)	$1808.11	$1808.11
SOUTHERN MAINE (ME)	$1722.58	$1722.58
REST OF MAINE (ME)	$1681.86	$1681.86
DETROIT (MI)	$1942.38	$1942.38
REST OF MICHIGAN (MI)	$1790.48	$1790.48
MINNESOTA (MN)	$1669.01	$1669.01
METROPOLITAN ST. LOUIS (MO)	$1783.59	$1783.59
METROPOLITAN KANSAS CITY (MO)	$1770.95	$1770.95
REST OF MISSOURI (MO)	$1728.29	$1728.29
MISSISSIPPI (MS)	$1675.63	$1675.63
MONTANA** (MT)	$1808.88	$1808.88
NORTH CAROLINA (NC)	$1692.72	$1692.72
NORTH DAKOTA** (ND)	$1677.59	$1677.59
NEBRASKA (NE)	$1629.38	$1629.38
NEW HAMPSHIRE (NH)	$1803.97	$1803.97
NORTHERN NJ (NJ)	$1977.33	$1977.33
REST OF NEW JERSEY (NJ)	$1922.70	$1922.70
NEW MEXICO (NM)	$1808.63	$1808.63
NEVADA** (NV)	$1772.83	$1772.83
MANHATTAN (NY)	$2094.35	$2094.35
NYC SUBURBS/LONG ISLAND (NY)	$2169.18	$2169.18
POUGHKPSIE/N NYC SUBURBS (NY)	$1954.61	$1954.61
QUEENS (NY)	$2073.32	$2073.32
REST OF NEW YORK (NY)	$1716.19	$1716.19
OHIO (OH)	$1763.65	$1763.65
OKLAHOMA (OK)	$1701.51	$1701.51
PORTLAND (OR)	$1829.77	$1829.77
REST OF OREGON (OR)	$1741.28	$1741.28
METROPOLITAN PHILADELPHIA (PA)	$1893.25	$1893.25
REST OF PENNSYLVANIA (PA)	$1752.40	$1752.40
PUERTO RICO (PR)	$1812.00	$1812.00
RHODE ISLAND (RI)	$1823.17	$1823.17
SOUTH CAROLINA (SC)	$1734.61	$1734.61
SOUTH DAKOTA** (SD)	$1662.06	$1662.06
TENNESSEE (TN)	$1657.01	$1657.01
BRAZORIA (TX)	$1763.96	$1763.96
DALLAS (TX)	$1785.03	$1785.03
GALVESTON (TX)	$1775.70	$1775.70
HOUSTON (TX)	$1897.24	$1897.24
BEAUMONT (TX)	$1744.49	$1744.49
FORT WORTH (TX)	$1782.46	$1782.46
AUSTIN (TX)	$1817.76	$1817.76
REST OF TEXAS (TX)	$1760.00	$1760.00
UTAH (UT)	$1753.98	$1753.98
VIRGINIA (VA)	$1734.85	$1734.85
VIRGIN ISLANDS (VI)	$1812.00	$1812.00
VERMONT (VT)	$1694.31	$1694.31
SEATTLE (KING CNTY) (WA)	$1944.66	$1944.66
REST OF WASHINGTON (WA)	$1798.78	$1798.78
WISCONSIN (WI)	$1632.95	$1632.95
WEST VIRGINIA (WV)	$1833.46	$1833.46
WYOMING** (WY)	$1751.66	$1751.66

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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 Physician Fee Schedule 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 the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting local cost-of-living and practice cost differences. The locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility rates can differ because the practice-expense RVU often varies depending on whether the service is performed in a physician's office (non-facility) versus a hospital or ambulatory surgical center (facility), where Medicare assumes the facility absorbs certain overhead costs.

RVUs — work 31.2, practice expense 16.33 (non-facility) / 16.33 (facility), malpractice 6.64 — × 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 deductible; the patient or secondary payer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claim-specific circumstances, sequestration, and annual budget-neutrality adjustments.
Always verify final allowed amounts and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

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

For some codes, the practice-expense RVU is identical in both settings, which results in the same calculated allowed amount regardless of place of service. This can vary code by code.

Does this amount reflect what Medicare will actually pay?

No. The figure shown is the Medicare PFS allowed amount estimate. Medicare generally reimburses 80% of this amount after the deductible is met, and the final payment can be affected by modifiers, sequestration, and locality-specific adjustments.

Why does the amount change by locality?

Medicare applies Geographic Practice Cost Indices (GPCIs) to adjust for regional differences in labor, rent, and malpractice insurance costs, so the same code can have different allowed amounts in different parts of the country.

Where can I confirm the exact payment for my claim?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules and can confirm the final allowed amount, including any modifier or policy adjustments that apply to your specific claim.

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.