Medicare Reimbursement for CPT 22843

CPT 22843 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and, where available, adjusted for your locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$728.47	$728.47
ALASKA* (AK)	$892.17	$892.17
ALABAMA (AL)	$647.63	$647.63
ARKANSAS (AR)	$637.93	$637.93
ARIZONA (AZ)	$703.19	$703.19
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$747.52	$747.52
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$754.76	$754.76
OXNARD-THOUSAND OAKS-VENTURA (CA)	$713.20	$713.20
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$724.94	$724.94
NAPA (CA)	$731.95	$731.95
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$752.42	$752.42
VALLEJO (CA)	$724.89	$724.89
BAKERSFIELD (CA)	$694.61	$694.61
CHICO (CA)	$683.22	$683.22
FRESNO (CA)	$683.22	$683.22
HANFORD-CORCORAN (CA)	$683.22	$683.22
MADERA (CA)	$683.22	$683.22
MERCED (CA)	$683.22	$683.22
MODESTO (CA)	$683.22	$683.22
REDDING (CA)	$683.22	$683.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$729.30	$729.30
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$701.38	$701.38
SALINAS (CA)	$698.61	$698.61
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$774.77	$774.77
SANTA CRUZ-WATSONVILLE (CA)	$702.46	$702.46
SANTA ROSA-PETALUMA (CA)	$708.31	$708.31
STOCKTON (CA)	$683.22	$683.22
VISALIA (CA)	$683.22	$683.22
YUBA CITY (CA)	$683.22	$683.22
EL CENTRO (CA)	$683.94	$683.94
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$704.47	$704.47
SAN LUIS OBISPO-PASO ROBLES (CA)	$689.54	$689.54
SANTA MARIA-SANTA BARBARA (CA)	$698.32	$698.32
REST OF CALIFORNIA (CA)	$683.22	$683.22
COLORADO (CO)	$711.60	$711.60
CONNECTICUT (CT)	$778.77	$778.77
DC + MD/VA SUBURBS (DC)	$794.53	$794.53
DELAWARE (DE)	$714.36	$714.36
FORT LAUDERDALE (FL)	$846.70	$846.70
MIAMI (FL)	$954.61	$954.61
REST OF FLORIDA (FL)	$794.42	$794.42
ATLANTA (GA)	$761.07	$761.07
REST OF GEORGIA (GA)	$740.24	$740.24
HAWAII, GUAM (HI)	$688.00	$688.00
IOWA (IA)	$629.18	$629.18
IDAHO (ID)	$640.85	$640.85
EAST ST. LOUIS (IL)	$862.69	$862.69
SUBURBAN CHICAGO (IL)	$846.64	$846.64
CHICAGO (IL)	$918.70	$918.70
REST OF ILLINOIS (IL)	$796.74	$796.74
INDIANA (IN)	$643.75	$643.75
KANSAS (KS)	$642.96	$642.96
KENTUCKY (KY)	$699.92	$699.92
NEW ORLEANS (LA)	$739.38	$739.38
REST OF LOUISIANA (LA)	$705.53	$705.53
METROPOLITAN BOSTON (MA)	$759.09	$759.09
REST OF MASSACHUSETTS (MA)	$714.04	$714.04
BALTIMORE/SURR. CNTYS (MD)	$780.32	$780.32
REST OF MARYLAND (MD)	$722.81	$722.81
SOUTHERN MAINE (ME)	$674.03	$674.03
REST OF MAINE (ME)	$662.30	$662.30
DETROIT (MI)	$822.08	$822.08
REST OF MICHIGAN (MI)	$734.26	$734.26
MINNESOTA (MN)	$631.39	$631.39
METROPOLITAN ST. LOUIS (MO)	$721.71	$721.71
METROPOLITAN KANSAS CITY (MO)	$716.20	$716.20
REST OF MISSOURI (MO)	$704.45	$704.45
MISSISSIPPI (MS)	$670.47	$670.47
MONTANA** (MT)	$728.19	$728.19
NORTH CAROLINA (NC)	$666.66	$666.66
NORTH DAKOTA** (ND)	$642.96	$642.96
NEBRASKA (NE)	$627.62	$627.62
NEW HAMPSHIRE (NH)	$716.50	$716.50
NORTHERN NJ (NJ)	$789.34	$789.34
REST OF NEW JERSEY (NJ)	$773.46	$773.46
NEW MEXICO (NM)	$745.21	$745.21
NEVADA** (NV)	$704.58	$704.58
MANHATTAN (NY)	$864.64	$864.64
NYC SUBURBS/LONG ISLAND (NY)	$907.63	$907.63
POUGHKPSIE/N NYC SUBURBS (NY)	$792.36	$792.36
QUEENS (NY)	$846.85	$846.85
REST OF NEW YORK (NY)	$678.37	$678.37
OHIO (OH)	$716.84	$716.84
OKLAHOMA (OK)	$680.65	$680.65
PORTLAND (OR)	$714.93	$714.93
REST OF OREGON (OR)	$685.13	$685.13
METROPOLITAN PHILADELPHIA (PA)	$770.16	$770.16
REST OF PENNSYLVANIA (PA)	$708.50	$708.50
PUERTO RICO (PR)	$727.93	$727.93
RHODE ISLAND (RI)	$726.09	$726.09
SOUTH CAROLINA (SC)	$695.71	$695.71
SOUTH DAKOTA** (SD)	$632.89	$632.89
TENNESSEE (TN)	$648.45	$648.45
BRAZORIA (TX)	$698.98	$698.98
DALLAS (TX)	$711.38	$711.38
GALVESTON (TX)	$706.18	$706.18
HOUSTON (TX)	$785.07	$785.07
BEAUMONT (TX)	$705.03	$705.03
FORT WORTH (TX)	$711.78	$711.78
AUSTIN (TX)	$721.46	$721.46
REST OF TEXAS (TX)	$707.01	$707.01
UTAH (UT)	$704.97	$704.97
VIRGINIA (VA)	$683.65	$683.65
VIRGIN ISLANDS (VI)	$727.93	$727.93
VERMONT (VT)	$655.89	$655.89
SEATTLE (KING CNTY) (WA)	$757.37	$757.37
REST OF WASHINGTON (WA)	$707.54	$707.54
WISCONSIN (WI)	$622.68	$622.68
WEST VIRGINIA (WV)	$771.27	$771.27
WYOMING** (WY)	$691.04	$691.04

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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 Physician Fee Schedule amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to the 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 geographically adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital, ASC) settings often have different practice-expense RVUs because overhead costs differ, which can make the allowed amount vary by place of service.

RVUs — work 13.1, practice expense 4.4 (non-facility) / 4.4 (facility), malpractice 4.31 — × 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 the annual Part B deductible; the patient or secondary insurer is generally responsible for the remainder.
Modifiers, multiple-procedure reductions, bilateral billing, and other claim-specific factors can change the final payment.
Annual budget-neutrality adjustments, legislative changes, and sequestration can alter the conversion factor or payment amount year to year.
Figures shown use national averages or standard locality GPCIs and may not match your specific Medicare Administrative Contractor (MAC) locality exactly.
Always verify the final allowed amount and any local coverage determinations with your MAC before billing or appealing a denial.

Frequently asked

Why is the facility amount different from the non-facility amount for this code?

The two settings use different practice-expense RVUs because the resources and overhead a physician's practice must supply differ from those already covered by a facility (hospital or ASC) fee. When the practice-expense RVUs are the same, as shown here, the resulting allowed amounts will match.

Does this page show what Medicare will actually pay?

No. It shows the Medicare Physician Fee Schedule allowed amount before adjustments like deductible, coinsurance, modifiers, or sequestration. Actual reimbursement may be lower.

Why might my locality's amount differ from the national figure?

Medicare adjusts each RVU component using locality-specific Geographic Practice Cost Indices (GPCIs) to reflect regional differences in wages, rents, and malpractice costs, so the same code can be reimbursed at different rates in different areas.

Can this amount change during the year?

The conversion factor and RVUs are generally set annually, but CMS can issue mid-year corrections, and claim-level adjustments (modifiers, sequestration, MAC-specific policies) can still change the amount actually paid.

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.