Medicare Reimbursement for CPT 23180

CPT 23180 is a surgical 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, comparing non-facility and facility payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$654.99	$654.99
ALASKA* (AK)	$793.06	$793.06
ALABAMA (AL)	$590.54	$590.54
ARKANSAS (AR)	$582.57	$582.57
ARIZONA (AZ)	$636.75	$636.75
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$770.07	$770.07
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$782.33	$782.33
OXNARD-THOUSAND OAKS-VENTURA (CA)	$694.36	$694.36
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$701.02	$701.02
NAPA (CA)	$738.26	$738.26
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$772.19	$772.19
VALLEJO (CA)	$735.22	$735.22
BAKERSFIELD (CA)	$665.06	$665.06
CHICO (CA)	$659.94	$659.94
FRESNO (CA)	$659.94	$659.94
HANFORD-CORCORAN (CA)	$659.94	$659.94
MADERA (CA)	$659.94	$659.94
MERCED (CA)	$659.94	$659.94
MODESTO (CA)	$659.94	$659.94
REDDING (CA)	$659.94	$659.94
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$679.93	$679.93
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$685.60	$685.60
SALINAS (CA)	$682.94	$682.94
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$790.96	$790.96
SANTA CRUZ-WATSONVILLE (CA)	$696.80	$696.80
SANTA ROSA-PETALUMA (CA)	$703.34	$703.34
STOCKTON (CA)	$659.94	$659.94
VISALIA (CA)	$659.94	$659.94
YUBA CITY (CA)	$659.94	$659.94
EL CENTRO (CA)	$660.25	$660.25
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$694.11	$694.11
SAN LUIS OBISPO-PASO ROBLES (CA)	$672.84	$672.84
SANTA MARIA-SANTA BARBARA (CA)	$684.16	$684.16
REST OF CALIFORNIA (CA)	$659.94	$659.94
COLORADO (CO)	$664.10	$664.10
CONNECTICUT (CT)	$696.99	$696.99
DC + MD/VA SUBURBS (DC)	$731.22	$731.22
DELAWARE (DE)	$646.58	$646.58
FORT LAUDERDALE (FL)	$709.09	$709.09
MIAMI (FL)	$762.28	$762.28
REST OF FLORIDA (FL)	$673.04	$673.04
ATLANTA (GA)	$673.16	$673.16
REST OF GEORGIA (GA)	$634.53	$634.53
HAWAII, GUAM (HI)	$669.93	$669.93
IOWA (IA)	$592.03	$592.03
IDAHO (ID)	$598.26	$598.26
EAST ST. LOUIS (IL)	$693.99	$693.99
SUBURBAN CHICAGO (IL)	$713.10	$713.10
CHICAGO (IL)	$738.99	$738.99
REST OF ILLINOIS (IL)	$663.87	$663.87
INDIANA (IN)	$601.16	$601.16
KANSAS (KS)	$595.38	$595.38
KENTUCKY (KY)	$616.42	$616.42
NEW ORLEANS (LA)	$645.74	$645.74
REST OF LOUISIANA (LA)	$617.89	$617.89
METROPOLITAN BOSTON (MA)	$718.36	$718.36
REST OF MASSACHUSETTS (MA)	$662.96	$662.96
BALTIMORE/SURR. CNTYS (MD)	$696.30	$696.30
REST OF MARYLAND (MD)	$656.43	$656.43
SOUTHERN MAINE (ME)	$629.37	$629.37
REST OF MAINE (ME)	$607.51	$607.51
DETROIT (MI)	$687.11	$687.11
REST OF MICHIGAN (MI)	$636.91	$636.91
MINNESOTA (MN)	$619.95	$619.95
METROPOLITAN ST. LOUIS (MO)	$640.72	$640.72
METROPOLITAN KANSAS CITY (MO)	$635.27	$635.27
REST OF MISSOURI (MO)	$611.98	$611.98
MISSISSIPPI (MS)	$597.09	$597.09
MONTANA** (MT)	$654.87	$654.87
NORTH CAROLINA (NC)	$612.47	$612.47
NORTH DAKOTA** (ND)	$618.09	$618.09
NEBRASKA (NE)	$593.25	$593.25
NEW HAMPSHIRE (NH)	$659.52	$659.52
NORTHERN NJ (NJ)	$725.66	$725.66
REST OF NEW JERSEY (NJ)	$700.33	$700.33
NEW MEXICO (NM)	$642.58	$642.58
NEVADA** (NV)	$644.92	$644.92
MANHATTAN (NY)	$758.73	$758.73
NYC SUBURBS/LONG ISLAND (NY)	$783.67	$783.67
POUGHKPSIE/N NYC SUBURBS (NY)	$709.71	$709.71
QUEENS (NY)	$755.79	$755.79
REST OF NEW YORK (NY)	$621.54	$621.54
OHIO (OH)	$629.39	$629.39
OKLAHOMA (OK)	$609.04	$609.04
PORTLAND (OR)	$677.07	$677.07
REST OF OREGON (OR)	$635.34	$635.34
METROPOLITAN PHILADELPHIA (PA)	$684.55	$684.55
REST OF PENNSYLVANIA (PA)	$626.98	$626.98
PUERTO RICO (PR)	$657.36	$657.36
RHODE ISLAND (RI)	$663.75	$663.75
SOUTH CAROLINA (SC)	$622.88	$622.88
SOUTH DAKOTA** (SD)	$613.74	$613.74
TENNESSEE (TN)	$598.93	$598.93
BRAZORIA (TX)	$640.97	$640.97
DALLAS (TX)	$647.61	$647.61
GALVESTON (TX)	$644.55	$644.55
HOUSTON (TX)	$678.59	$678.59
BEAUMONT (TX)	$623.59	$623.59
FORT WORTH (TX)	$645.41	$645.41
AUSTIN (TX)	$665.89	$665.89
REST OF TEXAS (TX)	$633.67	$633.67
UTAH (UT)	$630.66	$630.66
VIRGINIA (VA)	$631.63	$631.63
VIRGIN ISLANDS (VI)	$657.36	$657.36
VERMONT (VT)	$621.30	$621.30
SEATTLE (KING CNTY) (WA)	$726.36	$726.36
REST OF WASHINGTON (WA)	$659.85	$659.85
WISCONSIN (WI)	$599.40	$599.40
WEST VIRGINIA (WV)	$642.48	$642.48
WYOMING** (WY)	$638.84	$638.84

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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. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar allowance. Non-facility and facility settings can differ because practice-expense RVUs account for whether overhead costs (like supplies and staff time) are borne by the physician's office or by a facility such as a hospital. For this code, work and malpractice RVUs are the same across settings, so any difference in the final amount stems from the practice-expense RVU change.

RVUs — work 8.77, practice expense 8.98 (non-facility) / 8.98 (facility), malpractice 1.86 — × 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 the annual Part B deductible; the patient or secondary insurer is responsible for the remainder.
Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Local Medicare Administrative Contractors (MACs) may apply additional edits or coverage policies that affect payment.
Always verify current-year rates and locality-specific amounts with your MAC before billing.

Frequently asked

Why does the amount differ between non-facility and facility settings?

The practice-expense RVU component changes depending on whether the service is performed in a physician's office (non-facility) or a facility like a hospital, where some overhead costs are covered separately.

Does this amount reflect what Medicare will actually pay?

No. It's an estimated allowed amount. Actual payment depends on the beneficiary's deductible status, secondary coverage, modifiers used, and sequestration reductions.

Why do amounts vary by locality?

Medicare adjusts RVUs using Geographic Practice Cost Indices (GPCIs) to reflect regional differences in labor, rent, and malpractice insurance costs.

Can I use this estimate for claims appeals or denial disputes?

This figure is a reference estimate only. For claims and denial issues, confirm the exact allowed amount and policy details with your MAC or Medicare remittance advice.

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.