Medicare Reimbursement for CPT 22870

This page explains the Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code (CPT descriptors are proprietary to the AMA and not reproduced here). It shows the estimated national allowed amount as well as how the amount can vary by locality, and separately for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$100.87	$100.87
ALASKA* (AK)	$136.95	$136.95
ALABAMA (AL)	$95.61	$95.61
ARKANSAS (AR)	$94.97	$94.97
ARIZONA (AZ)	$99.31	$99.31
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$111.33	$111.33
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$112.84	$112.84
OXNARD-THOUSAND OAKS-VENTURA (CA)	$103.58	$103.58
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$104.88	$104.88
NAPA (CA)	$107.85	$107.85
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$111.57	$111.57
VALLEJO (CA)	$107.50	$107.50
BAKERSFIELD (CA)	$101.27	$101.27
CHICO (CA)	$100.61	$100.61
FRESNO (CA)	$100.61	$100.61
HANFORD-CORCORAN (CA)	$100.61	$100.61
MADERA (CA)	$100.61	$100.61
MERCED (CA)	$100.61	$100.61
MODESTO (CA)	$100.61	$100.61
REDDING (CA)	$100.61	$100.61
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$102.91	$102.91
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$103.24	$103.24
SALINAS (CA)	$102.79	$102.79
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$113.82	$113.82
SANTA CRUZ-WATSONVILLE (CA)	$103.02	$103.02
SANTA ROSA-PETALUMA (CA)	$103.94	$103.94
STOCKTON (CA)	$100.61	$100.61
VISALIA (CA)	$100.61	$100.61
YUBA CITY (CA)	$100.61	$100.61
EL CENTRO (CA)	$100.65	$100.65
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$103.41	$103.41
SAN LUIS OBISPO-PASO ROBLES (CA)	$101.37	$101.37
SANTA MARIA-SANTA BARBARA (CA)	$102.69	$102.69
REST OF CALIFORNIA (CA)	$100.61	$100.61
COLORADO (CO)	$101.38	$101.38
CONNECTICUT (CT)	$105.23	$105.23
DC + MD/VA SUBURBS (DC)	$108.93	$108.93
DELAWARE (DE)	$100.33	$100.33
FORT LAUDERDALE (FL)	$106.77	$106.77
MIAMI (FL)	$112.32	$112.32
REST OF FLORIDA (FL)	$103.62	$103.62
ATLANTA (GA)	$102.79	$102.79
REST OF GEORGIA (GA)	$100.31	$100.31
HAWAII, GUAM (HI)	$100.34	$100.34
IOWA (IA)	$95.14	$95.14
IDAHO (ID)	$95.76	$95.76
EAST ST. LOUIS (IL)	$106.57	$106.57
SUBURBAN CHICAGO (IL)	$107.30	$107.30
CHICAGO (IL)	$110.58	$110.58
REST OF ILLINOIS (IL)	$103.28	$103.28
INDIANA (IN)	$95.97	$95.97
KANSAS (KS)	$95.69	$95.69
KENTUCKY (KY)	$98.31	$98.31
NEW ORLEANS (LA)	$100.78	$100.78
REST OF LOUISIANA (LA)	$98.54	$98.54
METROPOLITAN BOSTON (MA)	$106.66	$106.66
REST OF MASSACHUSETTS (MA)	$101.60	$101.60
BALTIMORE/SURR. CNTYS (MD)	$105.04	$105.04
REST OF MARYLAND (MD)	$101.27	$101.27
SOUTHERN MAINE (ME)	$98.12	$98.12
REST OF MAINE (ME)	$96.80	$96.80
DETROIT (MI)	$105.06	$105.06
REST OF MICHIGAN (MI)	$100.24	$100.24
MINNESOTA (MN)	$96.45	$96.45
METROPOLITAN ST. LOUIS (MO)	$100.04	$100.04
METROPOLITAN KANSAS CITY (MO)	$99.63	$99.63
REST OF MISSOURI (MO)	$98.25	$98.25
MISSISSIPPI (MS)	$96.58	$96.58
MONTANA** (MT)	$100.86	$100.86
NORTH CAROLINA (NC)	$97.15	$97.15
NORTH DAKOTA** (ND)	$96.70	$96.70
NEBRASKA (NE)	$95.14	$95.14
NEW HAMPSHIRE (NH)	$100.72	$100.72
NORTHERN NJ (NJ)	$108.98	$108.98
REST OF NEW JERSEY (NJ)	$106.23	$106.23
NEW MEXICO (NM)	$100.81	$100.81
NEVADA** (NV)	$99.72	$99.72
MANHATTAN (NY)	$112.72	$112.72
NYC SUBURBS/LONG ISLAND (NY)	$115.10	$115.10
POUGHKPSIE/N NYC SUBURBS (NY)	$107.45	$107.45
QUEENS (NY)	$112.07	$112.07
REST OF NEW YORK (NY)	$97.90	$97.90
OHIO (OH)	$99.39	$99.39
OKLAHOMA (OK)	$97.41	$97.41
PORTLAND (OR)	$102.26	$102.26
REST OF OREGON (OR)	$98.72	$98.72
METROPOLITAN PHILADELPHIA (PA)	$104.32	$104.32
REST OF PENNSYLVANIA (PA)	$99.03	$99.03
PUERTO RICO (PR)	$100.96	$100.96
RHODE ISLAND (RI)	$102.14	$102.14
SOUTH CAROLINA (SC)	$98.47	$98.47
SOUTH DAKOTA** (SD)	$96.21	$96.21
TENNESSEE (TN)	$96.01	$96.01
BRAZORIA (TX)	$99.78	$99.78
DALLAS (TX)	$100.49	$100.49
GALVESTON (TX)	$100.15	$100.15
HOUSTON (TX)	$103.99	$103.99
BEAUMONT (TX)	$98.78	$98.78
FORT WORTH (TX)	$100.40	$100.40
AUSTIN (TX)	$101.25	$101.25
REST OF TEXAS (TX)	$99.29	$99.29
UTAH (UT)	$99.09	$99.09
VIRGINIA (VA)	$98.51	$98.51
VIRGIN ISLANDS (VI)	$100.96	$100.96
VERMONT (VT)	$97.23	$97.23
SEATTLE (KING CNTY) (WA)	$107.41	$107.41
REST OF WASHINGTON (WA)	$101.12	$101.12
WISCONSIN (WI)	$95.27	$95.27
WEST VIRGINIA (WV)	$101.57	$101.57
WYOMING** (WY)	$99.05	$99.05

Look up another code or locality →

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) assigned to the code — physician work, practice expense, and malpractice — each of which is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed. The GPCI-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar allowed amount. Practice-expense RVUs (and therefore the resulting payment) can differ between non-facility settings, such as a physician's office, and facility settings, like a hospital outpatient department, because overhead costs differ between them. The conversion factor is updated each year, so allowed amounts generally change annually even if the RVUs stay the same.

RVUs — work 2.28, practice expense 0.53 (non-facility) / 0.53 (facility), malpractice 0.21 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment — actual claims processing may differ.
Medicare typically pays 80% of the allowed amount after the patient meets the Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the final paid amount.
Locality-specific GPCIs mean the amount shown nationally will differ from what a specific Medicare Administrative Contractor (MAC) pays in a given area.
Always verify current rates and coverage policy with your MAC before billing or appealing a claim.

Frequently asked

Why does the facility amount differ from the non-facility amount for some codes?

Facility and non-facility payments differ because the practice-expense RVU component accounts for overhead differently depending on where the service is furnished — the practice absorbs less overhead when a facility (such as a hospital) provides the space, staff, and equipment.

Why does the Medicare allowed amount change every year?

CMS updates the conversion factor and can revise RVUs annually, and GPCIs are periodically recalculated, so the allowed amount for the same code can rise or fall from year to year even without any coding change.

Is the amount shown what Medicare will actually pay?

No — the figure shown is the total allowed amount before the beneficiary's deductible and coinsurance are applied, and it does not account for modifiers, secondary payer adjustments, or local contractor variations.

Why isn't a plain-English description of this code shown?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page cannot reproduce the official descriptor text for CPT codes.

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.