Medicare Reimbursement for CPT 23174

CPT code 23174 is a physician procedure code reimbursed under the Medicare Physician Fee Schedule (PFS). This page shows the estimated national PFS allowed amount for this procedure code, along with how that amount can vary by locality and by site of service (non-facility vs. facility).

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$724.80	$724.80
ALASKA* (AK)	$878.42	$878.42
ALABAMA (AL)	$653.55	$653.55
ARKANSAS (AR)	$644.74	$644.74
ARIZONA (AZ)	$704.59	$704.59
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$850.10	$850.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$863.54	$863.54
OXNARD-THOUSAND OAKS-VENTURA (CA)	$767.28	$767.28
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$774.73	$774.73
NAPA (CA)	$815.27	$815.27
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$852.47	$852.47
VALLEJO (CA)	$811.85	$811.85
BAKERSFIELD (CA)	$735.18	$735.18
CHICO (CA)	$729.43	$729.43
FRESNO (CA)	$729.43	$729.43
HANFORD-CORCORAN (CA)	$729.43	$729.43
MADERA (CA)	$729.43	$729.43
MERCED (CA)	$729.43	$729.43
MODESTO (CA)	$729.43	$729.43
REDDING (CA)	$729.43	$729.43
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$751.89	$751.89
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$757.60	$757.60
SALINAS (CA)	$754.65	$754.65
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$873.24	$873.24
SANTA CRUZ-WATSONVILLE (CA)	$769.73	$769.73
SANTA ROSA-PETALUMA (CA)	$776.94	$776.94
STOCKTON (CA)	$729.43	$729.43
VISALIA (CA)	$729.43	$729.43
YUBA CITY (CA)	$729.43	$729.43
EL CENTRO (CA)	$729.78	$729.78
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$766.87	$766.87
SAN LUIS OBISPO-PASO ROBLES (CA)	$743.52	$743.52
SANTA MARIA-SANTA BARBARA (CA)	$755.97	$755.97
REST OF CALIFORNIA (CA)	$729.43	$729.43
COLORADO (CO)	$734.41	$734.41
CONNECTICUT (CT)	$771.24	$771.24
DC + MD/VA SUBURBS (DC)	$808.69	$808.69
DELAWARE (DE)	$715.45	$715.45
FORT LAUDERDALE (FL)	$785.46	$785.46
MIAMI (FL)	$844.97	$844.97
REST OF FLORIDA (FL)	$745.50	$745.50
ATLANTA (GA)	$745.06	$745.06
REST OF GEORGIA (GA)	$702.82	$702.82
HAWAII, GUAM (HI)	$740.30	$740.30
IOWA (IA)	$654.85	$654.85
IDAHO (ID)	$661.80	$661.80
EAST ST. LOUIS (IL)	$769.37	$769.37
SUBURBAN CHICAGO (IL)	$789.83	$789.83
CHICAGO (IL)	$819.13	$819.13
REST OF ILLINOIS (IL)	$735.59	$735.59
INDIANA (IN)	$665.00	$665.00
KANSAS (KS)	$658.72	$658.72
KENTUCKY (KY)	$682.50	$682.50
NEW ORLEANS (LA)	$714.96	$714.96
REST OF LOUISIANA (LA)	$684.19	$684.19
METROPOLITAN BOSTON (MA)	$794.11	$794.11
REST OF MASSACHUSETTS (MA)	$733.23	$733.23
BALTIMORE/SURR. CNTYS (MD)	$770.50	$770.50
REST OF MARYLAND (MD)	$726.28	$726.28
SOUTHERN MAINE (ME)	$696.09	$696.09
REST OF MAINE (ME)	$672.20	$672.20
DETROIT (MI)	$761.22	$761.22
REST OF MICHIGAN (MI)	$705.30	$705.30
MINNESOTA (MN)	$685.16	$685.16
METROPOLITAN ST. LOUIS (MO)	$709.21	$709.21
METROPOLITAN KANSAS CITY (MO)	$703.21	$703.21
REST OF MISSOURI (MO)	$677.77	$677.77
MISSISSIPPI (MS)	$661.03	$661.03
MONTANA** (MT)	$724.66	$724.66
NORTH CAROLINA (NC)	$677.65	$677.65
NORTH DAKOTA** (ND)	$683.33	$683.33
NEBRASKA (NE)	$656.15	$656.15
NEW HAMPSHIRE (NH)	$729.51	$729.51
NORTHERN NJ (NJ)	$802.59	$802.59
REST OF NEW JERSEY (NJ)	$774.81	$774.81
NEW MEXICO (NM)	$711.63	$711.63
NEVADA** (NV)	$713.47	$713.47
MANHATTAN (NY)	$839.74	$839.74
NYC SUBURBS/LONG ISLAND (NY)	$867.50	$867.50
POUGHKPSIE/N NYC SUBURBS (NY)	$785.32	$785.32
QUEENS (NY)	$836.24	$836.24
REST OF NEW YORK (NY)	$687.68	$687.68
OHIO (OH)	$696.85	$696.85
OKLAHOMA (OK)	$674.17	$674.17
PORTLAND (OR)	$748.54	$748.54
REST OF OREGON (OR)	$702.76	$702.76
METROPOLITAN PHILADELPHIA (PA)	$757.60	$757.60
REST OF PENNSYLVANIA (PA)	$694.09	$694.09
PUERTO RICO (PR)	$727.36	$727.36
RHODE ISLAND (RI)	$734.29	$734.29
SOUTH CAROLINA (SC)	$689.43	$689.43
SOUTH DAKOTA** (SD)	$678.45	$678.45
TENNESSEE (TN)	$662.66	$662.66
BRAZORIA (TX)	$709.11	$709.11
DALLAS (TX)	$716.52	$716.52
GALVESTON (TX)	$713.12	$713.12
HOUSTON (TX)	$751.37	$751.37
BEAUMONT (TX)	$690.35	$690.35
FORT WORTH (TX)	$714.15	$714.15
AUSTIN (TX)	$736.50	$736.50
REST OF TEXAS (TX)	$701.32	$701.32
UTAH (UT)	$698.02	$698.02
VIRGINIA (VA)	$698.71	$698.71
VIRGIN ISLANDS (VI)	$727.36	$727.36
VERMONT (VT)	$687.04	$687.04
SEATTLE (KING CNTY) (WA)	$802.77	$802.77
REST OF WASHINGTON (WA)	$729.74	$729.74
WISCONSIN (WI)	$662.73	$662.73
WEST VIRGINIA (WV)	$711.96	$711.96
WYOMING** (WY)	$706.65	$706.65

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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 — assigned to the procedure code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is performed, reflecting regional cost differences. These locality-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs, since the resources required by the physician's practice differ depending on where the service is rendered; this can cause the allowed amount to vary by setting even when work and malpractice RVUs stay the same.

RVUs — work 9.8, practice expense 9.81 (non-facility) / 9.81 (facility), malpractice 2.09 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on national RVUs and the current conversion factor — not a guarantee of payment.
Medicare typically pays 80% of the approved amount after the patient has met their Part B deductible; the patient or secondary payer is generally responsible for the remainder.
Actual payment depends on the specific locality's GPCI values, which can raise or lower the amount shown here.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the final paid amount.
Always verify the exact allowed amount with your Medicare Administrative Contractor (MAC) and current fee schedule files before billing or appealing a claim.

Frequently asked

Why does the amount for this code differ by locality?

Medicare adjusts the work, practice expense, and malpractice RVUs using locality-specific GPCI values to reflect differences in regional costs, so the same code can have different allowed amounts in different areas.

Why are the non-facility and facility amounts different for some codes?

The practice-expense RVU often differs between non-facility and facility settings because the physician's overhead costs differ depending on whether the service is performed in an office versus a hospital or other facility.

Does this amount represent what Medicare actually pays?

No. The figure shown is the estimated Medicare-approved amount; Medicare generally pays 80% of this after the deductible is met, and modifiers, sequestration, or local adjustments can change the final payment.

Where can I confirm the official payment amount for my claim?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules, and the CMS Physician Fee Schedule Look-Up Tool provides the authoritative source for current-year amounts.

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.