Medicare Reimbursement for CPT 22867

CPT 22867 is a surgical procedure code; because CPT descriptors are proprietary to the AMA, this page refers to it generically as 'this procedure code.' The page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and reflects how it can vary by locality and by site of service (non-facility vs. facility).

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1012.05	$1012.05
ALASKA* (AK)	$1216.06	$1216.06
ALABAMA (AL)	$901.93	$901.93
ARKANSAS (AR)	$888.50	$888.50
ARIZONA (AZ)	$979.48	$979.48
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1130.60	$1130.60
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1146.00	$1146.00
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1040.14	$1040.14
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1052.80	$1052.80
NAPA (CA)	$1092.12	$1092.12
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1135.52	$1135.52
VALLEJO (CA)	$1085.04	$1085.04
BAKERSFIELD (CA)	$1001.14	$1001.14
CHICO (CA)	$989.61	$989.61
FRESNO (CA)	$989.61	$989.61
HANFORD-CORCORAN (CA)	$989.61	$989.61
MADERA (CA)	$989.61	$989.61
MERCED (CA)	$989.61	$989.61
MODESTO (CA)	$989.61	$989.61
REDDING (CA)	$989.61	$989.61
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1035.94	$1035.94
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1024.27	$1024.27
SALINAS (CA)	$1020.31	$1020.31
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1166.11	$1166.11
SANTA CRUZ-WATSONVILLE (CA)	$1036.64	$1036.64
SANTA ROSA-PETALUMA (CA)	$1045.96	$1045.96
STOCKTON (CA)	$989.61	$989.61
VISALIA (CA)	$989.61	$989.61
YUBA CITY (CA)	$989.61	$989.61
EL CENTRO (CA)	$990.33	$990.33
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1034.71	$1034.71
SAN LUIS OBISPO-PASO ROBLES (CA)	$1005.90	$1005.90
SANTA MARIA-SANTA BARBARA (CA)	$1021.50	$1021.50
REST OF CALIFORNIA (CA)	$989.61	$989.61
COLORADO (CO)	$1010.48	$1010.48
CONNECTICUT (CT)	$1081.36	$1081.36
DC + MD/VA SUBURBS (DC)	$1122.20	$1122.20
DELAWARE (DE)	$995.34	$995.34
FORT LAUDERDALE (FL)	$1133.83	$1133.83
MIAMI (FL)	$1248.71	$1248.71
REST OF FLORIDA (FL)	$1068.13	$1068.13
ATLANTA (GA)	$1048.64	$1048.64
REST OF GEORGIA (GA)	$998.91	$998.91
HAWAII, GUAM (HI)	$1003.05	$1003.05
IOWA (IA)	$892.64	$892.64
IDAHO (ID)	$905.53	$905.53
EAST ST. LOUIS (IL)	$1128.40	$1128.40
SUBURBAN CHICAGO (IL)	$1137.35	$1137.35
CHICAGO (IL)	$1204.65	$1204.65
REST OF ILLINOIS (IL)	$1060.52	$1060.52
INDIANA (IN)	$910.06	$910.06
KANSAS (KS)	$903.95	$903.95
KENTUCKY (KY)	$957.71	$957.71
NEW ORLEANS (LA)	$1009.37	$1009.37
REST OF LOUISIANA (LA)	$962.41	$962.41
METROPOLITAN BOSTON (MA)	$1089.65	$1089.65
REST OF MASSACHUSETTS (MA)	$1010.58	$1010.58
BALTIMORE/SURR. CNTYS (MD)	$1081.79	$1081.79
REST OF MARYLAND (MD)	$1009.62	$1009.62
SOUTHERN MAINE (ME)	$955.27	$955.27
REST OF MAINE (ME)	$927.08	$927.08
DETROIT (MI)	$1098.00	$1098.00
REST OF MICHIGAN (MI)	$997.75	$997.75
MINNESOTA (MN)	$921.21	$921.21
METROPOLITAN ST. LOUIS (MO)	$994.16	$994.16
METROPOLITAN KANSAS CITY (MO)	$985.62	$985.62
REST OF MISSOURI (MO)	$956.02	$956.02
MISSISSIPPI (MS)	$921.65	$921.65
MONTANA** (MT)	$1011.76	$1011.76
NORTH CAROLINA (NC)	$934.46	$934.46
NORTH DAKOTA** (ND)	$926.14	$926.14
NEBRASKA (NE)	$892.92	$892.92
NEW HAMPSHIRE (NH)	$1009.50	$1009.50
NORTHERN NJ (NJ)	$1113.27	$1113.27
REST OF NEW JERSEY (NJ)	$1080.47	$1080.47
NEW MEXICO (NM)	$1009.68	$1009.68
NEVADA** (NV)	$988.27	$988.27
MANHATTAN (NY)	$1189.43	$1189.43
NYC SUBURBS/LONG ISLAND (NY)	$1238.85	$1238.85
POUGHKPSIE/N NYC SUBURBS (NY)	$1100.39	$1100.39
QUEENS (NY)	$1176.18	$1176.18
REST OF NEW YORK (NY)	$950.16	$950.16
OHIO (OH)	$980.25	$980.25
OKLAHOMA (OK)	$939.27	$939.27
PORTLAND (OR)	$1024.88	$1024.88
REST OF OREGON (OR)	$967.58	$967.58
METROPOLITAN PHILADELPHIA (PA)	$1064.29	$1064.29
REST OF PENNSYLVANIA (PA)	$973.03	$973.03
PUERTO RICO (PR)	$1014.04	$1014.04
RHODE ISLAND (RI)	$1018.21	$1018.21
SOUTH CAROLINA (SC)	$961.57	$961.57
SOUTH DAKOTA** (SD)	$916.02	$916.02
TENNESSEE (TN)	$910.62	$910.62
BRAZORIA (TX)	$980.73	$980.73
DALLAS (TX)	$994.39	$994.39
GALVESTON (TX)	$988.43	$988.43
HOUSTON (TX)	$1067.68	$1067.68
BEAUMONT (TX)	$967.69	$967.69
FORT WORTH (TX)	$992.49	$992.49
AUSTIN (TX)	$1018.51	$1018.51
REST OF TEXAS (TX)	$978.70	$978.70
UTAH (UT)	$974.57	$974.57
VIRGINIA (VA)	$963.09	$963.09
VIRGIN ISLANDS (VI)	$1014.04	$1014.04
VERMONT (VT)	$936.81	$936.81
SEATTLE (KING CNTY) (WA)	$1095.99	$1095.99
REST OF WASHINGTON (WA)	$1003.91	$1003.91
WISCONSIN (WI)	$896.06	$896.06
WEST VIRGINIA (WV)	$1024.76	$1024.76
WYOMING** (WY)	$974.44	$974.44

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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 payment 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 Indices (GPCIs) for the specific 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. The practice-expense RVU often differs between non-facility (e.g., physician office) and facility (e.g., hospital) settings because overhead costs differ, which is why the two amounts shown here may not match. The resulting allowed amount is the Medicare-approved rate before any cost-sharing, modifiers, or adjustments are applied.

RVUs — work 14.63, practice expense 11.34 (non-facility) / 11.34 (facility), malpractice 4.33 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on national RVUs and the standard conversion factor — not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets the annual Part B deductible; the remainder is patient or secondary-payer responsibility.
Actual payment varies by locality GPCI, applicable modifiers, site-of-service differentials, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the allowed amount differ by locality?

Medicare adjusts the work, practice expense, and malpractice RVUs using locality-specific GPCIs to account for regional differences in cost of living and practice costs, which changes the final payment amount.

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

When the practice expense RVU is identical in both settings, as shown here, the non-facility and facility allowed amounts will be equal; this can occur for procedures where site-of-service overhead costs don't differ.

Does this amount reflect what the patient will owe?

No. The PFS amount is the Medicare-allowed rate; the patient's actual responsibility depends on deductible status, coinsurance, secondary coverage, and any applicable modifiers.

Will this amount change during the year?

The conversion factor and RVUs are typically set annually, but mid-year adjustments, correction notices, or budget-neutrality changes can occur, so amounts should be periodically re-verified.

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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.