Medicare Reimbursement for CPT 22901

This page covers CPT code 22901, a physician procedure code used for billing purposes. It shows the Medicare Physician Fee Schedule (PFS) allowed amount for the national average and can be adjusted by locality, with separate figures shown for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$641.63	$641.63
ALASKA* (AK)	$784.19	$784.19
ALABAMA (AL)	$577.10	$577.10
ARKANSAS (AR)	$569.22	$569.22
ARIZONA (AZ)	$622.63	$622.63
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$719.70	$719.70
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$729.68	$729.68
OXNARD-THOUSAND OAKS-VENTURA (CA)	$661.57	$661.57
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$669.47	$669.47
NAPA (CA)	$694.86	$694.86
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$722.50	$722.50
VALLEJO (CA)	$690.82	$690.82
BAKERSFIELD (CA)	$637.69	$637.69
CHICO (CA)	$631.01	$631.01
FRESNO (CA)	$631.01	$631.01
HANFORD-CORCORAN (CA)	$631.01	$631.01
MADERA (CA)	$631.01	$631.01
MERCED (CA)	$631.01	$631.01
MODESTO (CA)	$631.01	$631.01
REDDING (CA)	$631.01	$631.01
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$657.49	$657.49
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$652.66	$652.66
SALINAS (CA)	$650.10	$650.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$741.15	$741.15
SANTA CRUZ-WATSONVILLE (CA)	$659.67	$659.67
SANTA ROSA-PETALUMA (CA)	$665.63	$665.63
STOCKTON (CA)	$631.01	$631.01
VISALIA (CA)	$631.01	$631.01
YUBA CITY (CA)	$631.01	$631.01
EL CENTRO (CA)	$631.42	$631.42
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$658.77	$658.77
SAN LUIS OBISPO-PASO ROBLES (CA)	$640.89	$640.89
SANTA MARIA-SANTA BARBARA (CA)	$650.72	$650.72
REST OF CALIFORNIA (CA)	$631.01	$631.01
COLORADO (CO)	$642.22	$642.22
CONNECTICUT (CT)	$683.24	$683.24
DC + MD/VA SUBURBS (DC)	$709.64	$709.64
DELAWARE (DE)	$632.19	$632.19
FORT LAUDERDALE (FL)	$711.28	$711.28
MIAMI (FL)	$777.20	$777.20
REST OF FLORIDA (FL)	$673.02	$673.02
ATLANTA (GA)	$662.88	$662.88
REST OF GEORGIA (GA)	$632.65	$632.65
HAWAII, GUAM (HI)	$638.38	$638.38
IOWA (IA)	$572.35	$572.35
IDAHO (ID)	$579.77	$579.77
EAST ST. LOUIS (IL)	$706.90	$706.90
SUBURBAN CHICAGO (IL)	$713.83	$713.83
CHICAGO (IL)	$751.92	$751.92
REST OF ILLINOIS (IL)	$668.09	$668.09
INDIANA (IN)	$582.45	$582.45
KANSAS (KS)	$578.65	$578.65
KENTUCKY (KY)	$609.11	$609.11
NEW ORLEANS (LA)	$639.29	$639.29
REST OF LOUISIANA (LA)	$611.74	$611.74
METROPOLITAN BOSTON (MA)	$690.64	$690.64
REST OF MASSACHUSETTS (MA)	$642.33	$642.33
BALTIMORE/SURR. CNTYS (MD)	$683.23	$683.23
REST OF MARYLAND (MD)	$640.92	$640.92
SOUTHERN MAINE (ME)	$609.12	$609.12
REST OF MAINE (ME)	$592.06	$592.06
DETROIT (MI)	$690.18	$690.18
REST OF MICHIGAN (MI)	$632.28	$632.28
MINNESOTA (MN)	$590.22	$590.22
METROPOLITAN ST. LOUIS (MO)	$630.77	$630.77
METROPOLITAN KANSAS CITY (MO)	$625.72	$625.72
REST OF MISSOURI (MO)	$607.77	$607.77
MISSISSIPPI (MS)	$588.16	$588.16
MONTANA** (MT)	$641.47	$641.47
NORTH CAROLINA (NC)	$596.45	$596.45
NORTH DAKOTA** (ND)	$592.63	$592.63
NEBRASKA (NE)	$572.62	$572.62
NEW HAMPSHIRE (NH)	$640.74	$640.74
NORTHERN NJ (NJ)	$704.76	$704.76
REST OF NEW JERSEY (NJ)	$683.95	$683.95
NEW MEXICO (NM)	$639.14	$639.14
NEVADA** (NV)	$628.08	$628.08
MANHATTAN (NY)	$748.28	$748.28
NYC SUBURBS/LONG ISLAND (NY)	$776.84	$776.84
POUGHKPSIE/N NYC SUBURBS (NY)	$695.61	$695.61
QUEENS (NY)	$741.00	$741.00
REST OF NEW YORK (NY)	$605.64	$605.64
OHIO (OH)	$622.30	$622.30
OKLAHOMA (OK)	$598.65	$598.65
PORTLAND (OR)	$651.29	$651.29
REST OF OREGON (OR)	$616.21	$616.21
METROPOLITAN PHILADELPHIA (PA)	$672.90	$672.90
REST OF PENNSYLVANIA (PA)	$618.25	$618.25
PUERTO RICO (PR)	$642.92	$642.92
RHODE ISLAND (RI)	$646.56	$646.56
SOUTH CAROLINA (SC)	$611.79	$611.79
SOUTH DAKOTA** (SD)	$586.85	$586.85
TENNESSEE (TN)	$582.52	$582.52
BRAZORIA (TX)	$624.05	$624.05
DALLAS (TX)	$631.96	$631.96
GALVESTON (TX)	$628.47	$628.47
HOUSTON (TX)	$673.68	$673.68
BEAUMONT (TX)	$615.09	$615.09
FORT WORTH (TX)	$630.74	$630.74
AUSTIN (TX)	$646.21	$646.21
REST OF TEXAS (TX)	$621.91	$621.91
UTAH (UT)	$619.43	$619.43
VIRGINIA (VA)	$613.47	$613.47
VIRGIN ISLANDS (VI)	$642.92	$642.92
VERMONT (VT)	$598.58	$598.58
SEATTLE (KING CNTY) (WA)	$695.16	$695.16
REST OF WASHINGTON (WA)	$638.37	$638.37
WISCONSIN (WI)	$574.89	$574.89
WEST VIRGINIA (WV)	$647.09	$647.09
WYOMING** (WY)	$620.18	$620.18

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 units 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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is billed. The adjusted RVUs are summed and then multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs because the site of service affects the overhead Medicare assumes the physician incurs; for this code, those practice-expense values are the same, so the non-facility and facility amounts align. These RVU, GPCI, and conversion factor values are updated annually and are set by CMS rulemaking.

RVUs — work 9.86, practice expense 6.88 (non-facility) / 6.88 (facility), malpractice 2.47 — × 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 annual Part B deductible is met; the patient or secondary payer is responsible for the remainder.
Actual payment can vary by locality GPCI, applicable modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Always verify current, locality-specific amounts with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why do non-facility and facility amounts sometimes differ for this code?

The difference comes from the practice-expense RVU, which reflects the overhead costs (staff, supplies, equipment) assumed for each setting. When those RVUs match, as they do here, the calculated amounts are the same.

Is this the amount my practice will actually be paid?

No. It's a PFS-based estimate. Actual payment depends on your specific locality, any modifiers applied, your MAC's processing rules, sequestration, and other claim-specific factors.

Why does the conversion factor matter?

The conversion factor is a single annual dollar figure that CMS applies to the total adjusted RVUs for every code. Because it changes each year, PFS amounts can shift annually even if the RVUs for a code stay the same.

Where can I find the exact RVUs and GPCIs used for my locality?

CMS publishes the PFS Relative Value File and GPCI tables each year, and your MAC can confirm the specific locality values applicable to your practice.

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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.