Medicare Reimbursement for CPT 23120

CPT 23120 is a surgical procedure code; the full code description is not shown here due to AMA licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and, where available, by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$564.81	$564.81
ALASKA* (AK)	$680.87	$680.87
ALABAMA (AL)	$509.04	$509.04
ARKANSAS (AR)	$502.12	$502.12
ARIZONA (AZ)	$549.18	$549.18
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$671.83	$671.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$682.84	$682.84
OXNARD-THOUSAND OAKS-VENTURA (CA)	$602.88	$602.88
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$608.32	$608.32
NAPA (CA)	$642.97	$642.97
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$673.51	$673.51
VALLEJO (CA)	$640.55	$640.55
BAKERSFIELD (CA)	$576.41	$576.41
CHICO (CA)	$572.32	$572.32
FRESNO (CA)	$572.32	$572.32
HANFORD-CORCORAN (CA)	$572.32	$572.32
MADERA (CA)	$572.32	$572.32
MERCED (CA)	$572.32	$572.32
MODESTO (CA)	$572.32	$572.32
REDDING (CA)	$572.32	$572.32
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$588.23	$588.23
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$595.29	$595.29
SALINAS (CA)	$592.99	$592.99
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$689.72	$689.72
SANTA CRUZ-WATSONVILLE (CA)	$605.96	$605.96
SANTA ROSA-PETALUMA (CA)	$611.70	$611.70
STOCKTON (CA)	$572.32	$572.32
VISALIA (CA)	$572.32	$572.32
YUBA CITY (CA)	$572.32	$572.32
EL CENTRO (CA)	$572.57	$572.57
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$603.21	$603.21
SAN LUIS OBISPO-PASO ROBLES (CA)	$584.13	$584.13
SANTA MARIA-SANTA BARBARA (CA)	$594.19	$594.19
REST OF CALIFORNIA (CA)	$572.32	$572.32
COLORADO (CO)	$574.44	$574.44
CONNECTICUT (CT)	$601.15	$601.15
DC + MD/VA SUBURBS (DC)	$632.27	$632.27
DELAWARE (DE)	$557.73	$557.73
FORT LAUDERDALE (FL)	$608.32	$608.32
MIAMI (FL)	$651.65	$651.65
REST OF FLORIDA (FL)	$577.59	$577.59
ATLANTA (GA)	$579.86	$579.86
REST OF GEORGIA (GA)	$544.65	$544.65
HAWAII, GUAM (HI)	$581.61	$581.61
IOWA (IA)	$511.66	$511.66
IDAHO (ID)	$516.79	$516.79
EAST ST. LOUIS (IL)	$592.97	$592.97
SUBURBAN CHICAGO (IL)	$612.07	$612.07
CHICAGO (IL)	$631.88	$631.88
REST OF ILLINOIS (IL)	$568.75	$568.75
INDIANA (IN)	$519.36	$519.36
KANSAS (KS)	$513.93	$513.93
KENTUCKY (KY)	$530.13	$530.13
NEW ORLEANS (LA)	$555.33	$555.33
REST OF LOUISIANA (LA)	$531.16	$531.16
METROPOLITAN BOSTON (MA)	$622.51	$622.51
REST OF MASSACHUSETTS (MA)	$573.18	$573.18
BALTIMORE/SURR. CNTYS (MD)	$600.42	$600.42
REST OF MARYLAND (MD)	$566.46	$566.46
SOUTHERN MAINE (ME)	$544.10	$544.10
REST OF MAINE (ME)	$524.16	$524.16
DETROIT (MI)	$589.11	$589.11
REST OF MICHIGAN (MI)	$547.30	$547.30
MINNESOTA (MN)	$537.97	$537.97
METROPOLITAN ST. LOUIS (MO)	$551.73	$551.73
METROPOLITAN KANSAS CITY (MO)	$546.92	$546.92
REST OF MISSOURI (MO)	$525.64	$525.64
MISSISSIPPI (MS)	$513.74	$513.74
MONTANA** (MT)	$564.71	$564.71
NORTH CAROLINA (NC)	$528.57	$528.57
NORTH DAKOTA** (ND)	$535.45	$535.45
NEBRASKA (NE)	$512.92	$512.92
NEW HAMPSHIRE (NH)	$569.89	$569.89
NORTHERN NJ (NJ)	$627.27	$627.27
REST OF NEW JERSEY (NJ)	$604.50	$604.50
NEW MEXICO (NM)	$551.96	$551.96
NEVADA** (NV)	$556.83	$556.83
MANHATTAN (NY)	$653.67	$653.67
NYC SUBURBS/LONG ISLAND (NY)	$674.48	$674.48
POUGHKPSIE/N NYC SUBURBS (NY)	$612.11	$612.11
QUEENS (NY)	$652.04	$652.04
REST OF NEW YORK (NY)	$536.40	$536.40
OHIO (OH)	$541.32	$541.32
OKLAHOMA (OK)	$524.41	$524.41
PORTLAND (OR)	$586.48	$586.48
REST OF OREGON (OR)	$549.03	$549.03
METROPOLITAN PHILADELPHIA (PA)	$589.94	$589.94
REST OF PENNSYLVANIA (PA)	$539.58	$539.58
PUERTO RICO (PR)	$567.09	$567.09
RHODE ISLAND (RI)	$573.11	$573.11
SOUTH CAROLINA (SC)	$536.53	$536.53
SOUTH DAKOTA** (SD)	$531.99	$531.99
TENNESSEE (TN)	$516.94	$516.94
BRAZORIA (TX)	$553.39	$553.39
DALLAS (TX)	$558.86	$558.86
GALVESTON (TX)	$556.31	$556.31
HOUSTON (TX)	$583.40	$583.40
BEAUMONT (TX)	$536.59	$536.59
FORT WORTH (TX)	$556.76	$556.76
AUSTIN (TX)	$575.58	$575.58
REST OF TEXAS (TX)	$546.01	$546.01
UTAH (UT)	$543.29	$543.29
VIRGINIA (VA)	$545.61	$545.61
VIRGIN ISLANDS (VI)	$567.09	$567.09
VERMONT (VT)	$537.64	$537.64
SEATTLE (KING CNTY) (WA)	$630.13	$630.13
REST OF WASHINGTON (WA)	$570.68	$570.68
WISCONSIN (WI)	$519.07	$519.07
WEST VIRGINIA (WV)	$550.15	$550.15
WYOMING** (WY)	$551.96	$551.96

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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: 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) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Index (GPCI) for the service location. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, though for some codes the two amounts may be identical. The conversion factor and GPCIs are updated annually and can change the allowed amount even if RVUs stay the same.

RVUs — work 7.21, practice expense 8.22 (non-facility) / 8.22 (facility), malpractice 1.48 — × 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.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual amount paid.
Locality-specific GPCIs mean the amount can vary significantly by geographic area.
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?

They reflect different practice-expense RVUs because non-facility settings (like a private office) bear direct overhead costs that facilities (like hospitals) do not. For some codes these amounts may end up being the same.

Why can the amount for this code vary by locality?

Each Medicare locality has its own GPCI values for work, practice expense, and malpractice, which adjust the RVUs to reflect local cost differences before the conversion factor is applied.

Is this the amount my practice will actually be paid?

No. This is a PFS-based estimate. Actual payment depends on the patient's specific plan, deductible status, applicable modifiers, and any sequestration or budget-neutrality adjustments in effect.

Where can I find the official CPT code description?

CPT code descriptors are copyrighted by the American Medical Association (AMA). Consult your CPT codebook or AMA-licensed coding software for the full official description.

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.