Medicare Reimbursement for CPT 23035

This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this procedure code, both at the national level and adjusted for your locality. Amounts are shown separately for non-facility (e.g., office) and facility (e.g., hospital) settings, since practice expense differs between the two.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$634.62	$634.62
ALASKA* (AK)	$774.03	$774.03
ALABAMA (AL)	$573.58	$573.58
ARKANSAS (AR)	$566.05	$566.05
ARIZONA (AZ)	$617.25	$617.25
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$740.32	$740.32
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$751.87	$751.87
OXNARD-THOUSAND OAKS-VENTURA (CA)	$669.83	$669.83
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$676.50	$676.50
NAPA (CA)	$710.59	$710.59
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$742.41	$742.41
VALLEJO (CA)	$707.57	$707.57
BAKERSFIELD (CA)	$642.64	$642.64
CHICO (CA)	$637.56	$637.56
FRESNO (CA)	$637.56	$637.56
HANFORD-CORCORAN (CA)	$637.56	$637.56
MADERA (CA)	$637.56	$637.56
MERCED (CA)	$637.56	$637.56
MODESTO (CA)	$637.56	$637.56
REDDING (CA)	$637.56	$637.56
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$657.34	$657.34
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$661.65	$661.65
SALINAS (CA)	$659.05	$659.05
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$760.41	$760.41
SANTA CRUZ-WATSONVILLE (CA)	$671.47	$671.47
SANTA ROSA-PETALUMA (CA)	$677.72	$677.72
STOCKTON (CA)	$637.56	$637.56
VISALIA (CA)	$637.56	$637.56
YUBA CITY (CA)	$637.56	$637.56
EL CENTRO (CA)	$637.87	$637.87
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$669.30	$669.30
SAN LUIS OBISPO-PASO ROBLES (CA)	$649.38	$649.38
SANTA MARIA-SANTA BARBARA (CA)	$660.08	$660.08
REST OF CALIFORNIA (CA)	$637.56	$637.56
COLORADO (CO)	$642.33	$642.33
CONNECTICUT (CT)	$674.66	$674.66
DC + MD/VA SUBURBS (DC)	$706.60	$706.60
DELAWARE (DE)	$626.60	$626.60
FORT LAUDERDALE (FL)	$687.85	$687.85
MIAMI (FL)	$739.86	$739.86
REST OF FLORIDA (FL)	$653.44	$653.44
ATLANTA (GA)	$652.26	$652.26
REST OF GEORGIA (GA)	$616.73	$616.73
HAWAII, GUAM (HI)	$646.40	$646.40
IOWA (IA)	$574.19	$574.19
IDAHO (ID)	$580.24	$580.24
EAST ST. LOUIS (IL)	$674.94	$674.94
SUBURBAN CHICAGO (IL)	$691.57	$691.57
CHICAGO (IL)	$717.67	$717.67
REST OF ILLINOIS (IL)	$645.30	$645.30
INDIANA (IN)	$582.96	$582.96
KANSAS (KS)	$577.74	$577.74
KENTUCKY (KY)	$598.88	$598.88
NEW ORLEANS (LA)	$626.76	$626.76
REST OF LOUISIANA (LA)	$600.42	$600.42
METROPOLITAN BOSTON (MA)	$693.41	$693.41
REST OF MASSACHUSETTS (MA)	$641.48	$641.48
BALTIMORE/SURR. CNTYS (MD)	$674.02	$674.02
REST OF MARYLAND (MD)	$635.86	$635.86
SOUTHERN MAINE (ME)	$609.47	$609.47
REST OF MAINE (ME)	$589.39	$589.39
DETROIT (MI)	$667.16	$667.16
REST OF MICHIGAN (MI)	$618.63	$618.63
MINNESOTA (MN)	$599.32	$599.32
METROPOLITAN ST. LOUIS (MO)	$621.55	$621.55
METROPOLITAN KANSAS CITY (MO)	$616.44	$616.44
REST OF MISSOURI (MO)	$595.08	$595.08
MISSISSIPPI (MS)	$580.37	$580.37
MONTANA** (MT)	$634.49	$634.49
NORTH CAROLINA (NC)	$594.01	$594.01
NORTH DAKOTA** (ND)	$598.11	$598.11
NEBRASKA (NE)	$575.22	$575.22
NEW HAMPSHIRE (NH)	$638.21	$638.21
NORTHERN NJ (NJ)	$701.57	$701.57
REST OF NEW JERSEY (NJ)	$677.80	$677.80
NEW MEXICO (NM)	$624.15	$624.15
NEVADA** (NV)	$624.63	$624.63
MANHATTAN (NY)	$734.25	$734.25
NYC SUBURBS/LONG ISLAND (NY)	$758.33	$758.33
POUGHKPSIE/N NYC SUBURBS (NY)	$687.06	$687.06
QUEENS (NY)	$730.90	$730.90
REST OF NEW YORK (NY)	$602.62	$602.62
OHIO (OH)	$611.19	$611.19
OKLAHOMA (OK)	$591.50	$591.50
PORTLAND (OR)	$654.17	$654.17
REST OF OREGON (OR)	$615.26	$615.26
METROPOLITAN PHILADELPHIA (PA)	$663.12	$663.12
REST OF PENNSYLVANIA (PA)	$608.70	$608.70
PUERTO RICO (PR)	$636.72	$636.72
RHODE ISLAND (RI)	$642.72	$642.72
SOUTH CAROLINA (SC)	$604.51	$604.51
SOUTH DAKOTA** (SD)	$593.81	$593.81
TENNESSEE (TN)	$581.15	$581.15
BRAZORIA (TX)	$621.01	$621.01
DALLAS (TX)	$627.47	$627.47
GALVESTON (TX)	$624.51	$624.51
HOUSTON (TX)	$658.19	$658.19
BEAUMONT (TX)	$605.51	$605.51
FORT WORTH (TX)	$625.53	$625.53
AUSTIN (TX)	$644.15	$644.15
REST OF TEXAS (TX)	$614.64	$614.64
UTAH (UT)	$611.86	$611.86
VIRGINIA (VA)	$611.88	$611.88
VIRGIN ISLANDS (VI)	$636.72	$636.72
VERMONT (VT)	$601.51	$601.51
SEATTLE (KING CNTY) (WA)	$700.68	$700.68
REST OF WASHINGTON (WA)	$638.38	$638.38
WISCONSIN (WI)	$580.54	$580.54
WEST VIRGINIA (WV)	$625.09	$625.09
WYOMING** (WY)	$618.64	$618.64

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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: 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 Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility and facility settings typically differ because the practice-expense RVU accounts for whether the physician's office bears the overhead costs or whether a facility does. The conversion factor and RVU values are updated annually and can shift due to budget-neutrality adjustments required by law.

RVUs — work 8.93, practice expense 8.23 (non-facility) / 8.23 (facility), malpractice 1.84 — × 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 their deductible; the patient or secondary insurer is generally responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, and sequestration can change the actual amount paid.
Rates vary by locality due to GPCI adjustments and are updated annually, sometimes with mid-year or budget-neutrality corrections.
Always verify the final allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why is the facility amount different from the non-facility amount?

The practice-expense RVU component differs depending on whether the service is performed in a facility (where the facility bears overhead costs) or a non-facility setting like a physician's office (where the billing provider bears those costs).

Why might my locality's payment differ from the national amount shown here?

Medicare applies Geographic Practice Cost Indices (GPCIs) to adjust work, practice expense, and malpractice RVUs for regional cost differences, so the same code can pay differently depending on where the service is billed.

Does this amount reflect what the patient will owe?

No. This figure is the Medicare-allowed amount before cost-sharing. Patients are generally responsible for any unmet deductible plus 20% coinsurance, unless a secondary payer covers it.

How often does this amount change?

The Medicare conversion factor and RVUs are typically updated annually, though mid-year corrections or budget-neutrality adjustments can also affect the final paid amount.

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.