Medicare Reimbursement for CPT 22903

CPT 22903 is a procedure code billed under the Medicare Physician Fee Schedule. This page shows the estimated Medicare-allowed amount for this code nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$428.87	$428.87
ALASKA* (AK)	$520.48	$520.48
ALABAMA (AL)	$385.17	$385.17
ARKANSAS (AR)	$379.81	$379.81
ARIZONA (AZ)	$416.14	$416.14
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$487.83	$487.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$494.89	$494.89
OXNARD-THOUSAND OAKS-VENTURA (CA)	$445.75	$445.75
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$450.76	$450.76
NAPA (CA)	$469.98	$469.98
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$489.60	$489.60
VALLEJO (CA)	$467.43	$467.43
BAKERSFIELD (CA)	$428.64	$428.64
CHICO (CA)	$424.42	$424.42
FRESNO (CA)	$424.42	$424.42
HANFORD-CORCORAN (CA)	$424.42	$424.42
MADERA (CA)	$424.42	$424.42
MERCED (CA)	$424.42	$424.42
MODESTO (CA)	$424.42	$424.42
REDDING (CA)	$424.42	$424.42
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$441.15	$441.15
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$439.68	$439.68
SALINAS (CA)	$437.96	$437.96
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$502.13	$502.13
SANTA CRUZ-WATSONVILLE (CA)	$445.33	$445.33
SANTA ROSA-PETALUMA (CA)	$449.39	$449.39
STOCKTON (CA)	$424.42	$424.42
VISALIA (CA)	$424.42	$424.42
YUBA CITY (CA)	$424.42	$424.42
EL CENTRO (CA)	$424.68	$424.68
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$444.31	$444.31
SAN LUIS OBISPO-PASO ROBLES (CA)	$431.67	$431.67
SANTA MARIA-SANTA BARBARA (CA)	$438.52	$438.52
REST OF CALIFORNIA (CA)	$424.42	$424.42
COLORADO (CO)	$430.75	$430.75
CONNECTICUT (CT)	$456.96	$456.96
DC + MD/VA SUBURBS (DC)	$476.02	$476.02
DELAWARE (DE)	$422.62	$422.62
FORT LAUDERDALE (FL)	$473.16	$473.16
MIAMI (FL)	$515.45	$515.45
REST OF FLORIDA (FL)	$447.65	$447.65
ATLANTA (GA)	$442.66	$442.66
REST OF GEORGIA (GA)	$420.65	$420.65
HAWAII, GUAM (HI)	$430.04	$430.04
IOWA (IA)	$383.11	$383.11
IDAHO (ID)	$387.91	$387.91
EAST ST. LOUIS (IL)	$468.21	$468.21
SUBURBAN CHICAGO (IL)	$475.10	$475.10
CHICAGO (IL)	$498.64	$498.64
REST OF ILLINOIS (IL)	$443.53	$443.53
INDIANA (IN)	$389.77	$389.77
KANSAS (KS)	$386.83	$386.83
KENTUCKY (KY)	$405.72	$405.72
NEW ORLEANS (LA)	$426.00	$426.00
REST OF LOUISIANA (LA)	$407.28	$407.28
METROPOLITAN BOSTON (MA)	$464.39	$464.39
REST OF MASSACHUSETTS (MA)	$430.56	$430.56
BALTIMORE/SURR. CNTYS (MD)	$456.86	$456.86
REST OF MARYLAND (MD)	$428.70	$428.70
SOUTHERN MAINE (ME)	$408.12	$408.12
REST OF MAINE (ME)	$395.68	$395.68
DETROIT (MI)	$458.71	$458.71
REST OF MICHIGAN (MI)	$420.91	$420.91
MINNESOTA (MN)	$397.08	$397.08
METROPOLITAN ST. LOUIS (MO)	$420.88	$420.88
METROPOLITAN KANSAS CITY (MO)	$417.38	$417.38
REST OF MISSOURI (MO)	$404.24	$404.24
MISSISSIPPI (MS)	$391.82	$391.82
MONTANA** (MT)	$428.76	$428.76
NORTH CAROLINA (NC)	$398.76	$398.76
NORTH DAKOTA** (ND)	$397.92	$397.92
NEBRASKA (NE)	$383.47	$383.47
NEW HAMPSHIRE (NH)	$429.27	$429.27
NORTHERN NJ (NJ)	$472.51	$472.51
REST OF NEW JERSEY (NJ)	$457.76	$457.76
NEW MEXICO (NM)	$425.34	$425.34
NEVADA** (NV)	$420.33	$420.33
MANHATTAN (NY)	$500.04	$500.04
NYC SUBURBS/LONG ISLAND (NY)	$518.72	$518.72
POUGHKPSIE/N NYC SUBURBS (NY)	$465.20	$465.20
QUEENS (NY)	$495.91	$495.91
REST OF NEW YORK (NY)	$404.96	$404.96
OHIO (OH)	$414.61	$414.61
OKLAHOMA (OK)	$399.20	$399.20
PORTLAND (OR)	$437.58	$437.58
REST OF OREGON (OR)	$412.72	$412.72
METROPOLITAN PHILADELPHIA (PA)	$449.59	$449.59
REST OF PENNSYLVANIA (PA)	$412.17	$412.17
PUERTO RICO (PR)	$429.94	$429.94
RHODE ISLAND (RI)	$432.76	$432.76
SOUTH CAROLINA (SC)	$408.23	$408.23
SOUTH DAKOTA** (SD)	$394.27	$394.27
TENNESSEE (TN)	$389.39	$389.39
BRAZORIA (TX)	$417.55	$417.55
DALLAS (TX)	$422.67	$422.67
GALVESTON (TX)	$420.39	$420.39
HOUSTON (TX)	$448.94	$448.94
BEAUMONT (TX)	$409.99	$409.99
FORT WORTH (TX)	$421.66	$421.66
AUSTIN (TX)	$433.13	$433.13
REST OF TEXAS (TX)	$415.21	$415.21
UTAH (UT)	$413.43	$413.43
VIRGINIA (VA)	$410.68	$410.68
VIRGIN ISLANDS (VI)	$429.94	$429.94
VERMONT (VT)	$401.44	$401.44
SEATTLE (KING CNTY) (WA)	$468.03	$468.03
REST OF WASHINGTON (WA)	$428.06	$428.06
WISCONSIN (WI)	$385.73	$385.73
WEST VIRGINIA (WV)	$429.23	$429.23
WYOMING** (WY)	$415.32	$415.32

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 3 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 allowed 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 Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why both are shown separately, though for this code the two currently calculate to the same amount.

RVUs — work 6.23, practice expense 5.05 (non-facility) / 5.05 (facility), malpractice 1.56 — × 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 deductible; the patient or secondary payer is responsible for the rest.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual amount paid.
Allowed amounts vary by locality based on GPCIs; confirm the exact locality used for a specific claim.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why do the non-facility and facility amounts differ for some codes but not others?

The difference comes from practice-expense RVUs, which account for overhead costs. When a procedure's overhead is assumed to be similar regardless of setting, the two amounts can be identical, as shown here.

Does this amount reflect what Medicare will actually pay?

No. It's an estimated allowed amount based on standard RVUs and the conversion factor. Actual payment depends on the specific claim, modifiers, deductible status, and any applicable adjustments.

Why do amounts change year to year?

RVUs, GPCIs, and the conversion factor are updated annually by CMS, and budget-neutrality adjustments can shift payment levels even if the code's RVUs stay the same.

Where can I find the official RVUs and conversion factor used here?

CMS publishes the Physician Fee Schedule Relative Value Files and the annual conversion factor, which your MAC uses to calculate locality-specific payments.

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.