Medicare Reimbursement for CPT 23030

CPT 23030 is a surgical procedure code; the exact clinical description is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and adjusted for your locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$473.96	$243.83
ALASKA* (AK)	$541.86	$296.77
ALABAMA (AL)	$421.60	$220.24
ARKANSAS (AR)	$415.01	$217.32
ARIZONA (AZ)	$460.12	$237.13
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$609.69	$285.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$621.53	$289.68
OXNARD-THOUSAND OAKS-VENTURA (CA)	$529.76	$257.75
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$532.53	$260.28
NAPA (CA)	$576.95	$273.64
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$610.48	$286.00
VALLEJO (CA)	$575.81	$272.49
BAKERSFIELD (CA)	$499.38	$247.15
CHICO (CA)	$497.45	$245.22
FRESNO (CA)	$497.45	$245.22
HANFORD-CORCORAN (CA)	$497.45	$245.22
MADERA (CA)	$497.45	$245.22
MERCED (CA)	$497.45	$245.22
MODESTO (CA)	$497.45	$245.22
REDDING (CA)	$497.45	$245.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$504.97	$252.75
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$522.22	$254.57
SALINAS (CA)	$520.30	$253.58
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$624.78	$292.93
SANTA CRUZ-WATSONVILLE (CA)	$538.08	$258.47
SANTA ROSA-PETALUMA (CA)	$543.49	$260.89
STOCKTON (CA)	$497.45	$245.22
VISALIA (CA)	$497.45	$245.22
YUBA CITY (CA)	$497.45	$245.22
EL CENTRO (CA)	$497.56	$245.34
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$532.82	$257.59
SAN LUIS OBISPO-PASO ROBLES (CA)	$511.97	$249.85
SANTA MARIA-SANTA BARBARA (CA)	$522.33	$253.99
REST OF CALIFORNIA (CA)	$497.45	$245.22
COLORADO (CO)	$491.80	$246.94
CONNECTICUT (CT)	$507.13	$259.28
DC + MD/VA SUBURBS (DC)	$542.80	$271.71
DELAWARE (DE)	$468.11	$240.74
FORT LAUDERDALE (FL)	$497.24	$264.12
MIAMI (FL)	$523.55	$283.99
REST OF FLORIDA (FL)	$470.86	$250.85
ATLANTA (GA)	$484.40	$250.59
REST OF GEORGIA (GA)	$441.98	$236.70
HAWAII, GUAM (HI)	$510.38	$248.72
IOWA (IA)	$431.16	$220.59
IDAHO (ID)	$434.62	$222.90
EAST ST. LOUIS (IL)	$470.65	$258.93
SUBURBAN CHICAGO (IL)	$501.92	$265.57
CHICAGO (IL)	$506.72	$275.43
REST OF ILLINOIS (IL)	$457.74	$247.63
INDIANA (IN)	$437.29	$223.96
KANSAS (KS)	$429.94	$221.90
KENTUCKY (KY)	$434.49	$229.90
NEW ORLEANS (LA)	$457.22	$240.66
REST OF LOUISIANA (LA)	$434.14	$230.48
METROPOLITAN BOSTON (MA)	$541.53	$266.75
REST OF MASSACHUSETTS (MA)	$488.92	$246.59
BALTIMORE/SURR. CNTYS (MD)	$505.96	$259.03
REST OF MARYLAND (MD)	$477.22	$244.33
SOUTHERN MAINE (ME)	$462.29	$234.23
REST OF MAINE (ME)	$438.11	$226.38
DETROIT (MI)	$478.18	$256.10
REST OF MICHIGAN (MI)	$447.60	$237.49
MINNESOTA (MN)	$467.29	$230.49
METROPOLITAN ST. LOUIS (MO)	$457.80	$238.71
METROPOLITAN KANSAS CITY (MO)	$452.82	$236.73
REST OF MISSOURI (MO)	$426.75	$228.38
MISSISSIPPI (MS)	$420.92	$222.77
MONTANA** (MT)	$473.91	$243.78
NORTH CAROLINA (NC)	$442.89	$228.18
NORTH DAKOTA** (ND)	$460.07	$229.94
NEBRASKA (NE)	$433.41	$221.00
NEW HAMPSHIRE (NH)	$484.88	$245.31
NORTHERN NJ (NJ)	$536.69	$269.74
REST OF NEW JERSEY (NJ)	$511.81	$260.50
NEW MEXICO (NM)	$450.63	$239.60
NEVADA** (NV)	$470.39	$240.03
MANHATTAN (NY)	$549.59	$282.18
NYC SUBURBS/LONG ISLAND (NY)	$565.04	$291.42
POUGHKPSIE/N NYC SUBURBS (NY)	$516.03	$264.03
QUEENS (NY)	$552.98	$280.96
REST OF NEW YORK (NY)	$450.13	$231.50
OHIO (OH)	$444.77	$234.66
OKLAHOMA (OK)	$432.61	$227.10
PORTLAND (OR)	$507.26	$251.59
REST OF OREGON (OR)	$465.66	$236.45
METROPOLITAN PHILADELPHIA (PA)	$494.35	$254.78
REST OF PENNSYLVANIA (PA)	$444.98	$233.72
PUERTO RICO (PR)	$477.32	$244.66
RHODE ISLAND (RI)	$484.72	$247.00
SOUTH CAROLINA (SC)	$444.79	$232.15
SOUTH DAKOTA** (SD)	$458.43	$228.30
TENNESSEE (TN)	$432.40	$223.21
BRAZORIA (TX)	$466.68	$238.62
DALLAS (TX)	$470.30	$241.09
GALVESTON (TX)	$468.48	$239.96
HOUSTON (TX)	$481.29	$252.77
BEAUMONT (TX)	$441.91	$232.49
FORT WORTH (TX)	$467.23	$240.32
AUSTIN (TX)	$491.10	$247.62
REST OF TEXAS (TX)	$454.47	$236.07
UTAH (UT)	$451.31	$234.99
VIRGINIA (VA)	$461.34	$235.12
VIRGIN ISLANDS (VI)	$477.32	$244.66
VERMONT (VT)	$459.03	$231.20
SEATTLE (KING CNTY) (WA)	$551.98	$269.61
REST OF WASHINGTON (WA)	$487.74	$245.41
WISCONSIN (WI)	$443.60	$223.13
WEST VIRGINIA (WV)	$439.80	$239.81
WYOMING** (WY)	$467.88	$237.75

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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 Indices (GPCIs) for the specific locality where the service is performed. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility rates differ mainly because practice-expense RVUs are lower when the service is performed in a facility, since the facility itself bears more of the overhead cost. These RVU, GPCI, and conversion factor values are published annually by CMS and updated each year.

RVUs — work 3.38, practice expense 10.11 (non-facility) / 3.22 (facility), malpractice 0.7 — × 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 insurer is responsible for the remainder.
Actual payment can vary with modifiers, place of service, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Always confirm final allowed amounts with your Medicare Administrative Contractor (MAC), as applied edits and local policies may affect payment.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The facility rate uses lower practice-expense RVUs because overhead costs (equipment, staff, supplies) are assumed to be borne by the facility rather than the billing provider.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare Physician Fee Schedule allowed amount before the 80/20 payment split, deductible status, and any applicable modifiers or adjustments.

Why do GPCIs matter?

GPCIs adjust the national RVUs for local differences in wages, rents, and malpractice costs, so the same code can have different allowed amounts depending on the locality where it's billed.

Will this amount change next year?

Yes. CMS updates RVUs, GPCIs, and the conversion factor annually, and budget-neutrality adjustments can shift fees even if coding and documentation stay the same.

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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.