Medicare Reimbursement for CPT 23190

CPT code 23190 is a physician procedure code reported to Medicare for reimbursement purposes; because its official AMA descriptor cannot be reproduced here, it is referred to generically as 'this procedure code.' This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and, where available, by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$548.44	$548.44
ALASKA* (AK)	$663.43	$663.43
ALABAMA (AL)	$494.39	$494.39
ARKANSAS (AR)	$487.70	$487.70
ARIZONA (AZ)	$533.17	$533.17
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$646.04	$646.04
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$656.37	$656.37
OXNARD-THOUSAND OAKS-VENTURA (CA)	$582.06	$582.06
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$587.58	$587.58
NAPA (CA)	$619.18	$619.18
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$647.79	$647.79
VALLEJO (CA)	$616.66	$616.66
BAKERSFIELD (CA)	$557.32	$557.32
CHICO (CA)	$553.08	$553.08
FRESNO (CA)	$553.08	$553.08
HANFORD-CORCORAN (CA)	$553.08	$553.08
MADERA (CA)	$553.08	$553.08
MERCED (CA)	$553.08	$553.08
MODESTO (CA)	$553.08	$553.08
REDDING (CA)	$553.08	$553.08
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$569.63	$569.63
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$574.71	$574.71
SALINAS (CA)	$572.48	$572.48
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$663.52	$663.52
SANTA CRUZ-WATSONVILLE (CA)	$584.26	$584.26
SANTA ROSA-PETALUMA (CA)	$589.75	$589.75
STOCKTON (CA)	$553.08	$553.08
VISALIA (CA)	$553.08	$553.08
YUBA CITY (CA)	$553.08	$553.08
EL CENTRO (CA)	$553.34	$553.34
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$581.93	$581.93
SAN LUIS OBISPO-PASO ROBLES (CA)	$563.99	$563.99
SANTA MARIA-SANTA BARBARA (CA)	$573.52	$573.52
REST OF CALIFORNIA (CA)	$553.08	$553.08
COLORADO (CO)	$556.34	$556.34
CONNECTICUT (CT)	$583.65	$583.65
DC + MD/VA SUBURBS (DC)	$612.57	$612.57
DELAWARE (DE)	$541.42	$541.42
FORT LAUDERDALE (FL)	$593.30	$593.30
MIAMI (FL)	$637.50	$637.50
REST OF FLORIDA (FL)	$563.15	$563.15
ATLANTA (GA)	$563.57	$563.57
REST OF GEORGIA (GA)	$530.90	$530.90
HAWAII, GUAM (HI)	$561.56	$561.56
IOWA (IA)	$495.85	$495.85
IDAHO (ID)	$501.03	$501.03
EAST ST. LOUIS (IL)	$580.29	$580.29
SUBURBAN CHICAGO (IL)	$596.71	$596.71
CHICAGO (IL)	$618.03	$618.03
REST OF ILLINOIS (IL)	$555.32	$555.32
INDIANA (IN)	$503.47	$503.47
KANSAS (KS)	$498.56	$498.56
KENTUCKY (KY)	$515.89	$515.89
NEW ORLEANS (LA)	$540.46	$540.46
REST OF LOUISIANA (LA)	$517.09	$517.09
METROPOLITAN BOSTON (MA)	$602.00	$602.00
REST OF MASSACHUSETTS (MA)	$555.35	$555.35
BALTIMORE/SURR. CNTYS (MD)	$583.05	$583.05
REST OF MARYLAND (MD)	$549.70	$549.70
SOUTHERN MAINE (ME)	$527.18	$527.18
REST OF MAINE (ME)	$508.69	$508.69
DETROIT (MI)	$574.84	$574.84
REST OF MICHIGAN (MI)	$532.99	$532.99
MINNESOTA (MN)	$519.59	$519.59
METROPOLITAN ST. LOUIS (MO)	$536.36	$536.36
METROPOLITAN KANSAS CITY (MO)	$531.78	$531.78
REST OF MISSOURI (MO)	$512.07	$512.07
MISSISSIPPI (MS)	$499.73	$499.73
MONTANA** (MT)	$548.34	$548.34
NORTH CAROLINA (NC)	$512.87	$512.87
NORTH DAKOTA** (ND)	$517.89	$517.89
NEBRASKA (NE)	$496.90	$496.90
NEW HAMPSHIRE (NH)	$552.42	$552.42
NORTHERN NJ (NJ)	$607.88	$607.88
REST OF NEW JERSEY (NJ)	$586.51	$586.51
NEW MEXICO (NM)	$537.71	$537.71
NEVADA** (NV)	$540.11	$540.11
MANHATTAN (NY)	$635.27	$635.27
NYC SUBURBS/LONG ISLAND (NY)	$656.06	$656.06
POUGHKPSIE/N NYC SUBURBS (NY)	$594.30	$594.30
QUEENS (NY)	$632.94	$632.94
REST OF NEW YORK (NY)	$520.47	$520.47
OHIO (OH)	$526.77	$526.77
OKLAHOMA (OK)	$509.81	$509.81
PORTLAND (OR)	$567.34	$567.34
REST OF OREGON (OR)	$532.15	$532.15
METROPOLITAN PHILADELPHIA (PA)	$573.15	$573.15
REST OF PENNSYLVANIA (PA)	$524.80	$524.80
PUERTO RICO (PR)	$550.46	$550.46
RHODE ISLAND (RI)	$555.88	$555.88
SOUTH CAROLINA (SC)	$521.43	$521.43
SOUTH DAKOTA** (SD)	$514.29	$514.29
TENNESSEE (TN)	$501.53	$501.53
BRAZORIA (TX)	$536.79	$536.79
DALLAS (TX)	$542.31	$542.31
GALVESTON (TX)	$539.76	$539.76
HOUSTON (TX)	$567.95	$567.95
BEAUMONT (TX)	$521.94	$521.94
FORT WORTH (TX)	$540.44	$540.44
AUSTIN (TX)	$557.79	$557.79
REST OF TEXAS (TX)	$530.51	$530.51
UTAH (UT)	$527.97	$527.97
VIRGINIA (VA)	$529.00	$529.00
VIRGIN ISLANDS (VI)	$550.46	$550.46
VERMONT (VT)	$520.49	$520.49
SEATTLE (KING CNTY) (WA)	$608.81	$608.81
REST OF WASHINGTON (WA)	$552.76	$552.76
WISCONSIN (WI)	$502.19	$502.19
WEST VIRGINIA (WV)	$537.36	$537.36
WYOMING** (WY)	$535.07	$535.07

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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 Physician Fee Schedule 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 Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, and the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which can make the allowed amount vary by place of service. The conversion factor and RVU values are updated annually and are subject to CMS budget-neutrality adjustments.

RVUs — work 7.28, practice expense 7.6 (non-facility) / 7.6 (facility), malpractice 1.54 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This figure 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 beneficiary or secondary payer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Always confirm the exact allowed amount and any applicable edits with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why do the non-facility and facility amounts sometimes look the same for this code?

When the practice expense RVUs are identical for both settings, the calculated non-facility and facility allowed amounts can come out equal. This depends on how CMS has valued the code's overhead costs for each place of service.

Does this amount reflect what my specific Medicare Administrative Contractor will pay?

Not necessarily. The figure uses the national conversion factor and standard RVUs; your MAC's locality-specific GPCIs and any local coverage or payment policies can change the final allowed amount.

Will modifiers affect the reimbursement for this code?

Yes. Modifiers such as those indicating bilateral procedures, multiple procedures, or reduced services can increase or decrease the base allowed amount shown here.

Is this the amount the patient will owe?

No. This is the Medicare-allowed amount before cost-sharing. After the deductible is met, Medicare generally pays 80%, leaving the patient or supplemental insurer responsible for the remaining 20%.

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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.