Medicare Reimbursement for CPT 23145

CPT 23145 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$657.00	$657.00
ALASKA* (AK)	$799.46	$799.46
ALABAMA (AL)	$593.03	$593.03
ARKANSAS (AR)	$585.14	$585.14
ARIZONA (AZ)	$638.76	$638.76
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$765.73	$765.73
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$777.64	$777.64
OXNARD-THOUSAND OAKS-VENTURA (CA)	$692.99	$692.99
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$699.93	$699.93
NAPA (CA)	$735.06	$735.06
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$767.94	$767.94
VALLEJO (CA)	$731.87	$731.87
BAKERSFIELD (CA)	$664.76	$664.76
CHICO (CA)	$659.40	$659.40
FRESNO (CA)	$659.40	$659.40
HANFORD-CORCORAN (CA)	$659.40	$659.40
MADERA (CA)	$659.40	$659.40
MERCED (CA)	$659.40	$659.40
MODESTO (CA)	$659.40	$659.40
REDDING (CA)	$659.40	$659.40
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$680.35	$680.35
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$684.35	$684.35
SALINAS (CA)	$681.68	$681.68
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$786.69	$786.69
SANTA CRUZ-WATSONVILLE (CA)	$694.61	$694.61
SANTA ROSA-PETALUMA (CA)	$701.07	$701.07
STOCKTON (CA)	$659.40	$659.40
VISALIA (CA)	$659.40	$659.40
YUBA CITY (CA)	$659.40	$659.40
EL CENTRO (CA)	$659.72	$659.72
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$692.33	$692.33
SAN LUIS OBISPO-PASO ROBLES (CA)	$671.68	$671.68
SANTA MARIA-SANTA BARBARA (CA)	$682.76	$682.76
REST OF CALIFORNIA (CA)	$659.40	$659.40
COLORADO (CO)	$664.68	$664.68
CONNECTICUT (CT)	$698.79	$698.79
DC + MD/VA SUBURBS (DC)	$731.73	$731.73
DELAWARE (DE)	$648.52	$648.52
FORT LAUDERDALE (FL)	$713.33	$713.33
MIAMI (FL)	$768.29	$768.29
REST OF FLORIDA (FL)	$677.19	$677.19
ATLANTA (GA)	$675.58	$675.58
REST OF GEORGIA (GA)	$638.66	$638.66
HAWAII, GUAM (HI)	$668.70	$668.70
IOWA (IA)	$593.45	$593.45
IDAHO (ID)	$599.83	$599.83
EAST ST. LOUIS (IL)	$700.19	$700.19
SUBURBAN CHICAGO (IL)	$717.13	$717.13
CHICAGO (IL)	$744.91	$744.91
REST OF ILLINOIS (IL)	$668.82	$668.82
INDIANA (IN)	$602.67	$602.67
KANSAS (KS)	$597.27	$597.27
KENTUCKY (KY)	$619.76	$619.76
NEW ORLEANS (LA)	$649.00	$649.00
REST OF LOUISIANA (LA)	$621.42	$621.42
METROPOLITAN BOSTON (MA)	$717.79	$717.79
REST OF MASSACHUSETTS (MA)	$663.81	$663.81
BALTIMORE/SURR. CNTYS (MD)	$698.18	$698.18
REST OF MARYLAND (MD)	$658.14	$658.14
SOUTHERN MAINE (ME)	$630.39	$630.39
REST OF MAINE (ME)	$609.53	$609.53
DETROIT (MI)	$691.68	$691.68
REST OF MICHIGAN (MI)	$640.55	$640.55
MINNESOTA (MN)	$619.42	$619.42
METROPOLITAN ST. LOUIS (MO)	$643.42	$643.42
METROPOLITAN KANSAS CITY (MO)	$638.08	$638.08
REST OF MISSOURI (MO)	$615.89	$615.89
MISSISSIPPI (MS)	$600.30	$600.30
MONTANA** (MT)	$656.87	$656.87
NORTH CAROLINA (NC)	$614.35	$614.35
NORTH DAKOTA** (ND)	$618.31	$618.31
NEBRASKA (NE)	$594.49	$594.49
NEW HAMPSHIRE (NH)	$660.56	$660.56
NORTHERN NJ (NJ)	$726.41	$726.41
REST OF NEW JERSEY (NJ)	$701.84	$701.84
NEW MEXICO (NM)	$646.38	$646.38
NEVADA** (NV)	$646.40	$646.40
MANHATTAN (NY)	$761.03	$761.03
NYC SUBURBS/LONG ISLAND (NY)	$786.39	$786.39
POUGHKPSIE/N NYC SUBURBS (NY)	$711.59	$711.59
QUEENS (NY)	$757.36	$757.36
REST OF NEW YORK (NY)	$623.37	$623.37
OHIO (OH)	$632.67	$632.67
OKLAHOMA (OK)	$611.91	$611.91
PORTLAND (OR)	$676.92	$676.92
REST OF OREGON (OR)	$636.51	$636.51
METROPOLITAN PHILADELPHIA (PA)	$686.79	$686.79
REST OF PENNSYLVANIA (PA)	$630.00	$630.00
PUERTO RICO (PR)	$659.16	$659.16
RHODE ISLAND (RI)	$665.20	$665.20
SOUTH CAROLINA (SC)	$625.52	$625.52
SOUTH DAKOTA** (SD)	$613.75	$613.75
TENNESSEE (TN)	$600.85	$600.85
BRAZORIA (TX)	$642.55	$642.55
DALLAS (TX)	$649.36	$649.36
GALVESTON (TX)	$646.24	$646.24
HOUSTON (TX)	$681.94	$681.94
BEAUMONT (TX)	$626.67	$626.67
FORT WORTH (TX)	$647.35	$647.35
AUSTIN (TX)	$666.75	$666.75
REST OF TEXAS (TX)	$636.11	$636.11
UTAH (UT)	$633.22	$633.22
VIRGINIA (VA)	$632.99	$632.99
VIRGIN ISLANDS (VI)	$659.16	$659.16
VERMONT (VT)	$621.96	$621.96
SEATTLE (KING CNTY) (WA)	$725.22	$725.22
REST OF WASHINGTON (WA)	$660.55	$660.55
WISCONSIN (WI)	$599.93	$599.93
WEST VIRGINIA (WV)	$647.66	$647.66
WYOMING** (WY)	$640.06	$640.06

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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) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality to reflect local cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs often differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings because overhead costs differ, which is why the same code can have two different allowed amounts depending on place of service.

RVUs — work 9.17, practice expense 8.55 (non-facility) / 8.55 (facility), malpractice 1.95 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount 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 final paid amount.
Locality-specific GPCI values and the conversion factor can change year to year, so amounts shown are tied to the stated year.
Always verify the current rate and any claim-specific adjustments with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does CPT 23145 have different amounts for non-facility and facility settings?

The practice-expense RVU component differs by setting because overhead costs (staff, supplies, equipment) are treated differently when the procedure is performed in a physician office versus a hospital or facility setting.

Does this page show what Medicare will actually pay me?

No. It shows the estimated PFS allowed amount. Actual payment depends on the patient's deductible status, applicable modifiers, secondary insurance, and any claim-specific adjustments.

Why might the amount differ from what my MAC pays?

Local GPCI values, sequestration, annual conversion factor updates, and budget-neutrality adjustments can all cause the MAC-paid amount to differ slightly from a generic PFS estimate.

Can I use this figure to bill the patient directly?

No. This figure is for reference and estimating purposes only; actual patient billing should follow your Medicare contract terms and any applicable coinsurance or deductible rules.

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.