Medicare Reimbursement for CPT 23210

CPT 23210 is a physician procedure code reported to Medicare and other payers; the full descriptor is maintained by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and, where available, by locality, with non-facility and facility rates shown separately.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1589.21	$1589.21
ALASKA* (AK)	$1981.15	$1981.15
ALABAMA (AL)	$1443.12	$1443.12
ARKANSAS (AR)	$1425.28	$1425.28
ARIZONA (AZ)	$1546.13	$1546.13
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1776.11	$1776.11
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1800.60	$1800.60
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1636.68	$1636.68
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1656.44	$1656.44
NAPA (CA)	$1716.03	$1716.03
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1782.51	$1782.51
VALLEJO (CA)	$1706.80	$1706.80
BAKERSFIELD (CA)	$1581.81	$1581.81
CHICO (CA)	$1566.28	$1566.28
FRESNO (CA)	$1566.28	$1566.28
HANFORD-CORCORAN (CA)	$1566.28	$1566.28
MADERA (CA)	$1566.28	$1566.28
MERCED (CA)	$1566.28	$1566.28
MODESTO (CA)	$1566.28	$1566.28
REDDING (CA)	$1566.28	$1566.28
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1626.89	$1626.89
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1617.60	$1617.60
SALINAS (CA)	$1611.11	$1611.11
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1826.78	$1826.78
SANTA CRUZ-WATSONVILLE (CA)	$1631.08	$1631.08
SANTA ROSA-PETALUMA (CA)	$1645.74	$1645.74
STOCKTON (CA)	$1566.28	$1566.28
VISALIA (CA)	$1566.28	$1566.28
YUBA CITY (CA)	$1566.28	$1566.28
EL CENTRO (CA)	$1567.22	$1567.22
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1630.40	$1630.40
SAN LUIS OBISPO-PASO ROBLES (CA)	$1588.41	$1588.41
SANTA MARIA-SANTA BARBARA (CA)	$1612.06	$1612.06
REST OF CALIFORNIA (CA)	$1566.28	$1566.28
COLORADO (CO)	$1591.53	$1591.53
CONNECTICUT (CT)	$1686.13	$1686.13
DC + MD/VA SUBURBS (DC)	$1749.97	$1749.97
DELAWARE (DE)	$1568.44	$1568.44
FORT LAUDERDALE (FL)	$1748.12	$1748.12
MIAMI (FL)	$1898.35	$1898.35
REST OF FLORIDA (FL)	$1661.32	$1661.32
ATLANTA (GA)	$1637.97	$1637.97
REST OF GEORGIA (GA)	$1569.80	$1569.80
HAWAII, GUAM (HI)	$1580.42	$1580.42
IOWA (IA)	$1431.87	$1431.87
IDAHO (ID)	$1448.76	$1448.76
EAST ST. LOUIS (IL)	$1739.06	$1739.06
SUBURBAN CHICAGO (IL)	$1754.75	$1754.75
CHICAGO (IL)	$1841.94	$1841.94
REST OF ILLINOIS (IL)	$1650.49	$1650.49
INDIANA (IN)	$1454.81	$1454.81
KANSAS (KS)	$1446.37	$1446.37
KENTUCKY (KY)	$1516.07	$1516.07
NEW ORLEANS (LA)	$1584.47	$1584.47
REST OF LOUISIANA (LA)	$1522.11	$1522.11
METROPOLITAN BOSTON (MA)	$1704.68	$1704.68
REST OF MASSACHUSETTS (MA)	$1592.43	$1592.43
BALTIMORE/SURR. CNTYS (MD)	$1685.61	$1685.61
REST OF MARYLAND (MD)	$1588.81	$1588.81
SOUTHERN MAINE (ME)	$1515.07	$1515.07
REST OF MAINE (ME)	$1476.83	$1476.83
DETROIT (MI)	$1700.43	$1700.43
REST OF MICHIGAN (MI)	$1568.74	$1568.74
MINNESOTA (MN)	$1471.52	$1471.52
METROPOLITAN ST. LOUIS (MO)	$1564.89	$1564.89
METROPOLITAN KANSAS CITY (MO)	$1553.48	$1553.48
REST OF MISSOURI (MO)	$1513.29	$1513.29
MISSISSIPPI (MS)	$1468.50	$1468.50
MONTANA** (MT)	$1588.84	$1588.84
NORTH CAROLINA (NC)	$1486.72	$1486.72
NORTH DAKOTA** (ND)	$1477.32	$1477.32
NEBRASKA (NE)	$1432.41	$1432.41
NEW HAMPSHIRE (NH)	$1586.77	$1586.77
NORTHERN NJ (NJ)	$1740.20	$1740.20
REST OF NEW JERSEY (NJ)	$1690.29	$1690.29
NEW MEXICO (NM)	$1584.36	$1584.36
NEVADA** (NV)	$1558.27	$1558.27
MANHATTAN (NY)	$1839.70	$1839.70
NYC SUBURBS/LONG ISLAND (NY)	$1904.65	$1904.65
POUGHKPSIE/N NYC SUBURBS (NY)	$1717.55	$1717.55
QUEENS (NY)	$1822.87	$1822.87
REST OF NEW YORK (NY)	$1507.53	$1507.53
OHIO (OH)	$1545.94	$1545.94
OKLAHOMA (OK)	$1492.13	$1492.13
PORTLAND (OR)	$1612.30	$1612.30
REST OF OREGON (OR)	$1531.21	$1531.21
METROPOLITAN PHILADELPHIA (PA)	$1662.63	$1662.63
REST OF PENNSYLVANIA (PA)	$1536.65	$1536.65
PUERTO RICO (PR)	$1592.05	$1592.05
RHODE ISLAND (RI)	$1602.69	$1602.69
SOUTH CAROLINA (SC)	$1521.84	$1521.84
SOUTH DAKOTA** (SD)	$1464.13	$1464.13
TENNESSEE (TN)	$1455.16	$1455.16
BRAZORIA (TX)	$1550.23	$1550.23
DALLAS (TX)	$1568.38	$1568.38
GALVESTON (TX)	$1560.30	$1560.30
HOUSTON (TX)	$1663.53	$1663.53
BEAUMONT (TX)	$1529.52	$1529.52
FORT WORTH (TX)	$1565.68	$1565.68
AUSTIN (TX)	$1599.36	$1599.36
REST OF TEXAS (TX)	$1544.69	$1544.69
UTAH (UT)	$1539.12	$1539.12
VIRGINIA (VA)	$1525.08	$1525.08
VIRGIN ISLANDS (VI)	$1592.05	$1592.05
VERMONT (VT)	$1491.01	$1491.01
SEATTLE (KING CNTY) (WA)	$1715.89	$1715.89
REST OF WASHINGTON (WA)	$1582.99	$1582.99
WISCONSIN (WI)	$1437.24	$1437.24
WEST VIRGINIA (WV)	$1602.98	$1602.98
WYOMING** (WY)	$1540.24	$1540.24

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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 PFS amounts are 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 performed, 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., office) and facility (e.g., hospital) settings because overhead costs differ, which is why this code may show different non-facility and facility amounts. The conversion factor and RVUs are updated annually and can change due to budget-neutrality adjustments or legislation.

RVUs — work 26.53, practice expense 15.41 (non-facility) / 15.41 (facility), malpractice 5.64 — × 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 patient meets the annual Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the final paid amount.
Annual budget-neutrality adjustments and legislative changes to the conversion factor may alter this figure from year to year.
Always verify current rates and local adjustments with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does the facility amount differ from the non-facility amount?

The two settings use different practice-expense RVUs because the resources and overhead a physician must supply differ between an office setting and a facility like a hospital, where the facility itself bears many of those costs.

Does this figure represent what Medicare will actually pay?

No. It represents the Medicare-allowed amount under the national fee schedule formula. Actual payment is typically 80% of this amount after the deductible, and can be further affected by modifiers, sequestration, and locality-specific adjustments.

Why might the amount shown here differ from what I see in my MAC's fee schedule lookup?

Locality-specific GPCIs, annual conversion factor updates, and any claim-level modifiers or policy adjustments can cause variation between a generic PFS calculation and your MAC's published or claims-processed amount.

Can I use this number for patient estimates or appeals?

It can serve as a general reference, but for binding estimates, pre-authorization, or denial appeals you should confirm the exact allowed amount and policy details with your MAC or the payer's 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.