Medicare Reimbursement for CPT 22857

CPT 22857 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) estimated allowed amount for this code, both at the national level and adjusted for locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1568.84	$1568.84
ALASKA* (AK)	$1958.46	$1958.46
ALABAMA (AL)	$1425.06	$1425.06
ARKANSAS (AR)	$1407.51	$1407.51
ARIZONA (AZ)	$1526.34	$1526.34
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1748.55	$1748.55
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1772.45	$1772.45
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1613.20	$1613.20
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1632.89	$1632.89
NAPA (CA)	$1690.13	$1690.13
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1754.94	$1754.94
VALLEJO (CA)	$1680.92	$1680.92
BAKERSFIELD (CA)	$1559.84	$1559.84
CHICO (CA)	$1544.35	$1544.35
FRESNO (CA)	$1544.35	$1544.35
HANFORD-CORCORAN (CA)	$1544.35	$1544.35
MADERA (CA)	$1544.35	$1544.35
MERCED (CA)	$1544.35	$1544.35
MODESTO (CA)	$1544.35	$1544.35
REDDING (CA)	$1544.35	$1544.35
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1604.84	$1604.84
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1594.46	$1594.46
SALINAS (CA)	$1588.05	$1588.05
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1798.59	$1798.59
SANTA CRUZ-WATSONVILLE (CA)	$1607.07	$1607.07
SANTA ROSA-PETALUMA (CA)	$1621.48	$1621.48
STOCKTON (CA)	$1544.35	$1544.35
VISALIA (CA)	$1544.35	$1544.35
YUBA CITY (CA)	$1544.35	$1544.35
EL CENTRO (CA)	$1545.29	$1545.29
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1606.70	$1606.70
SAN LUIS OBISPO-PASO ROBLES (CA)	$1565.74	$1565.74
SANTA MARIA-SANTA BARBARA (CA)	$1588.88	$1588.88
REST OF CALIFORNIA (CA)	$1544.35	$1544.35
COLORADO (CO)	$1570.09	$1570.09
CONNECTICUT (CT)	$1664.29	$1664.29
DC + MD/VA SUBURBS (DC)	$1726.32	$1726.32
DELAWARE (DE)	$1548.30	$1548.30
FORT LAUDERDALE (FL)	$1727.25	$1727.25
MIAMI (FL)	$1876.76	$1876.76
REST OF FLORIDA (FL)	$1641.55	$1641.55
ATLANTA (GA)	$1617.25	$1617.25
REST OF GEORGIA (GA)	$1551.23	$1551.23
HAWAII, GUAM (HI)	$1557.81	$1557.81
IOWA (IA)	$1413.17	$1413.17
IDAHO (ID)	$1429.95	$1429.95
EAST ST. LOUIS (IL)	$1719.73	$1719.73
SUBURBAN CHICAGO (IL)	$1733.62	$1733.62
CHICAGO (IL)	$1821.03	$1821.03
REST OF ILLINOIS (IL)	$1631.44	$1631.44
INDIANA (IN)	$1435.88	$1435.88
KANSAS (KS)	$1427.82	$1427.82
KENTUCKY (KY)	$1497.65	$1497.65
NEW ORLEANS (LA)	$1565.07	$1565.07
REST OF LOUISIANA (LA)	$1503.75	$1503.75
METROPOLITAN BOSTON (MA)	$1680.86	$1680.86
REST OF MASSACHUSETTS (MA)	$1571.16	$1571.16
BALTIMORE/SURR. CNTYS (MD)	$1663.85	$1663.85
REST OF MARYLAND (MD)	$1568.22	$1568.22
SOUTHERN MAINE (ME)	$1494.97	$1494.97
REST OF MAINE (ME)	$1457.97	$1457.97
DETROIT (MI)	$1680.43	$1680.43
REST OF MICHIGAN (MI)	$1549.83	$1549.83
MINNESOTA (MN)	$1450.88	$1450.88
METROPOLITAN ST. LOUIS (MO)	$1545.34	$1545.34
METROPOLITAN KANSAS CITY (MO)	$1534.18	$1534.18
REST OF MISSOURI (MO)	$1495.32	$1495.32
MISSISSIPPI (MS)	$1450.63	$1450.63
MONTANA** (MT)	$1568.46	$1568.46
NORTH CAROLINA (NC)	$1467.63	$1467.63
NORTH DAKOTA** (ND)	$1457.14	$1457.14
NEBRASKA (NE)	$1413.58	$1413.58
NEW HAMPSHIRE (NH)	$1565.73	$1565.73
NORTHERN NJ (NJ)	$1716.86	$1716.86
REST OF NEW JERSEY (NJ)	$1668.17	$1668.17
NEW MEXICO (NM)	$1565.36	$1565.36
NEVADA** (NV)	$1537.93	$1537.93
MANHATTAN (NY)	$1816.15	$1816.15
NYC SUBURBS/LONG ISLAND (NY)	$1880.53	$1880.53
POUGHKPSIE/N NYC SUBURBS (NY)	$1695.33	$1695.33
QUEENS (NY)	$1799.01	$1799.01
REST OF NEW YORK (NY)	$1488.12	$1488.12
OHIO (OH)	$1527.08	$1527.08
OKLAHOMA (OK)	$1473.69	$1473.69
PORTLAND (OR)	$1590.04	$1590.04
REST OF OREGON (OR)	$1511.00	$1511.00
METROPOLITAN PHILADELPHIA (PA)	$1641.43	$1641.43
REST OF PENNSYLVANIA (PA)	$1517.72	$1517.72
PUERTO RICO (PR)	$1571.49	$1571.49
RHODE ISLAND (RI)	$1581.73	$1581.73
SOUTH CAROLINA (SC)	$1502.84	$1502.84
SOUTH DAKOTA** (SD)	$1443.98	$1443.98
TENNESSEE (TN)	$1436.52	$1436.52
BRAZORIA (TX)	$1530.06	$1530.06
DALLAS (TX)	$1548.10	$1548.10
GALVESTON (TX)	$1540.08	$1540.08
HOUSTON (TX)	$1643.13	$1643.13
BEAUMONT (TX)	$1510.73	$1510.73
FORT WORTH (TX)	$1545.57	$1545.57
AUSTIN (TX)	$1578.02	$1578.02
REST OF TEXAS (TX)	$1525.24	$1525.24
UTAH (UT)	$1519.82	$1519.82
VIRGINIA (VA)	$1505.10	$1505.10
VIRGIN ISLANDS (VI)	$1571.49	$1571.49
VERMONT (VT)	$1470.97	$1470.97
SEATTLE (KING CNTY) (WA)	$1691.50	$1691.50
REST OF WASHINGTON (WA)	$1561.74	$1561.74
WISCONSIN (WI)	$1417.82	$1417.82
WEST VIRGINIA (WV)	$1584.74	$1584.74
WYOMING** (WY)	$1519.95	$1519.95

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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 — assigned to each code. Each RVU component is adjusted by 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 rates generally apply when a service is performed in a physician's office, while facility rates apply in hospitals or ambulatory surgical centers, reflecting different practice-expense assumptions; for some codes, including this one, the practice-expense RVU is the same in both settings, so the resulting amounts are identical.

RVUs — work 26.45, practice expense 14.89 (non-facility) / 14.89 (facility), malpractice 5.63 — × 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 approved amount after the patient meets the annual deductible; the beneficiary or secondary payer covers the remainder.
Actual payment can vary due to modifiers, place of service, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why isn't the CPT code description shown?

CPT codes and their descriptors are copyrighted by the American Medical Association, so licensed descriptive text cannot be republished here. Refer to your CPT codebook or practice management system for the official descriptor.

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

When the practice-expense RVU is identical for both settings, the calculated PFS amount ends up the same regardless of where the service is performed.

Will my actual payment match the national amount shown?

Not necessarily. The GPCI-adjusted, locality-specific amount is a closer estimate, but modifiers, secondary payers, and annual fee schedule updates can still change the final payment.

How often does the conversion factor change?

CMS updates the national conversion factor annually, and it can also be affected by legislative or budget-neutrality adjustments during the year.

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.