Medicare Reimbursement for CPT 22840

CPT 22840 is a surgical procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare PFS allowed amount for this code, both nationally and adjusted by locality, with a comparison of non-facility and facility payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$668.35	$668.35
ALASKA* (AK)	$824.65	$824.65
ALABAMA (AL)	$596.98	$596.98
ARKANSAS (AR)	$588.42	$588.42
ARIZONA (AZ)	$646.08	$646.08
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$690.21	$690.21
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$697.13	$697.13
OXNARD-THOUSAND OAKS-VENTURA (CA)	$656.98	$656.98
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$667.57	$667.57
NAPA (CA)	$675.17	$675.17
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$694.48	$694.48
VALLEJO (CA)	$669.01	$669.01
BAKERSFIELD (CA)	$639.95	$639.95
CHICO (CA)	$629.97	$629.97
FRESNO (CA)	$629.97	$629.97
HANFORD-CORCORAN (CA)	$629.97	$629.97
MADERA (CA)	$629.97	$629.97
MERCED (CA)	$629.97	$629.97
MODESTO (CA)	$629.97	$629.97
REDDING (CA)	$629.97	$629.97
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$670.19	$670.19
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$646.76	$646.76
SALINAS (CA)	$644.18	$644.18
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$714.58	$714.58
SANTA CRUZ-WATSONVILLE (CA)	$647.66	$647.66
SANTA ROSA-PETALUMA (CA)	$653.08	$653.08
STOCKTON (CA)	$629.97	$629.97
VISALIA (CA)	$629.97	$629.97
YUBA CITY (CA)	$629.97	$629.97
EL CENTRO (CA)	$630.59	$630.59
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$649.52	$649.52
SAN LUIS OBISPO-PASO ROBLES (CA)	$635.77	$635.77
SANTA MARIA-SANTA BARBARA (CA)	$643.90	$643.90
REST OF CALIFORNIA (CA)	$629.97	$629.97
COLORADO (CO)	$654.38	$654.38
CONNECTICUT (CT)	$713.27	$713.27
DC + MD/VA SUBURBS (DC)	$728.59	$728.59
DELAWARE (DE)	$656.09	$656.09
FORT LAUDERDALE (FL)	$771.58	$771.58
MIAMI (FL)	$865.91	$865.91
REST OF FLORIDA (FL)	$725.59	$725.59
ATLANTA (GA)	$696.98	$696.98
REST OF GEORGIA (GA)	$677.89	$677.89
HAWAII, GUAM (HI)	$633.97	$633.97
IOWA (IA)	$581.15	$581.15
IDAHO (ID)	$591.37	$591.37
EAST ST. LOUIS (IL)	$784.90	$784.90
SUBURBAN CHICAGO (IL)	$771.80	$771.80
CHICAGO (IL)	$834.52	$834.52
REST OF ILLINOIS (IL)	$727.32	$727.32
INDIANA (IN)	$593.95	$593.95
KANSAS (KS)	$593.11	$593.11
KENTUCKY (KY)	$642.70	$642.70
NEW ORLEANS (LA)	$677.47	$677.47
REST OF LOUISIANA (LA)	$647.56	$647.56
METROPOLITAN BOSTON (MA)	$697.44	$697.44
REST OF MASSACHUSETTS (MA)	$656.53	$656.53
BALTIMORE/SURR. CNTYS (MD)	$714.49	$714.49
REST OF MARYLAND (MD)	$663.75	$663.75
SOUTHERN MAINE (ME)	$620.80	$620.80
REST OF MAINE (ME)	$610.08	$610.08
DETROIT (MI)	$749.78	$749.78
REST OF MICHIGAN (MI)	$672.81	$672.81
MINNESOTA (MN)	$583.85	$583.85
METROPOLITAN ST. LOUIS (MO)	$662.13	$662.13
METROPOLITAN KANSAS CITY (MO)	$657.23	$657.23
REST OF MISSOURI (MO)	$646.47	$646.47
MISSISSIPPI (MS)	$616.82	$616.82
MONTANA** (MT)	$668.10	$668.10
NORTH CAROLINA (NC)	$613.97	$613.97
NORTH DAKOTA** (ND)	$593.75	$593.75
NEBRASKA (NE)	$579.85	$579.85
NEW HAMPSHIRE (NH)	$658.19	$658.19
NORTHERN NJ (NJ)	$724.18	$724.18
REST OF NEW JERSEY (NJ)	$709.26	$709.26
NEW MEXICO (NM)	$682.40	$682.40
NEVADA** (NV)	$647.51	$647.51
MANHATTAN (NY)	$789.91	$789.91
NYC SUBURBS/LONG ISLAND (NY)	$827.58	$827.58
POUGHKPSIE/N NYC SUBURBS (NY)	$725.90	$725.90
QUEENS (NY)	$774.52	$774.52
REST OF NEW YORK (NY)	$624.31	$624.31
OHIO (OH)	$657.62	$657.62
OKLAHOMA (OK)	$625.91	$625.91
PORTLAND (OR)	$657.71	$657.71
REST OF OREGON (OR)	$630.51	$630.51
METROPOLITAN PHILADELPHIA (PA)	$705.46	$705.46
REST OF PENNSYLVANIA (PA)	$650.38	$650.38
PUERTO RICO (PR)	$667.95	$667.95
RHODE ISLAND (RI)	$666.99	$666.99
SOUTH CAROLINA (SC)	$639.26	$639.26
SOUTH DAKOTA** (SD)	$584.96	$584.96
TENNESSEE (TN)	$597.93	$597.93
BRAZORIA (TX)	$642.77	$642.77
DALLAS (TX)	$653.65	$653.65
GALVESTON (TX)	$649.07	$649.07
HOUSTON (TX)	$717.89	$717.89
BEAUMONT (TX)	$647.29	$647.29
FORT WORTH (TX)	$653.93	$653.93
AUSTIN (TX)	$662.68	$662.68
REST OF TEXAS (TX)	$649.29	$649.29
UTAH (UT)	$647.45	$647.45
VIRGINIA (VA)	$629.14	$629.14
VIRGIN ISLANDS (VI)	$667.95	$667.95
VERMONT (VT)	$604.96	$604.96
SEATTLE (KING CNTY) (WA)	$696.39	$696.39
REST OF WASHINGTON (WA)	$650.79	$650.79
WISCONSIN (WI)	$575.78	$575.78
WEST VIRGINIA (WV)	$704.80	$704.80
WYOMING** (WY)	$635.70	$635.70

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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: Clinical. 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 allowed amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to the procedure code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs, since the site of service affects overhead costs borne by the billing provider.

RVUs — work 12.21, practice expense 4.04 (non-facility) / 4.04 (facility), malpractice 3.76 — × 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 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 final paid amount.
Locality-specific GPCIs mean actual payment varies by where the service is rendered.
Always confirm current rates and edits with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount for this code?

The two settings use different practice-expense RVUs because overhead costs (equipment, staff, supplies) are allocated differently when a service is performed in a facility versus a non-facility setting like an office.

Does this fee schedule amount reflect what I'll actually be paid?

No. It's a national/locality-adjusted estimate based on standard RVUs and the conversion factor. Actual payment depends on your specific MAC, contract terms, modifiers used, and any claim-specific adjustments.

Why might my MAC's posted rate differ slightly from this figure?

Differences can arise from locality GPCI updates, mid-year corrections, sequestration, or budget-neutrality adjustments applied after the initial fee schedule publication.

Can modifiers change the Medicare payment for CPT 22840?

Yes. Modifiers such as those indicating bilateral procedures, reduced services, or assistant-at-surgery can increase or decrease the allowed amount relative to the base fee shown here.

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.