Medicare Reimbursement for CPT 23330
This page covers CPT code 23330, a physician procedure billed under the Medicare Physician Fee Schedule (PFS). It shows the national average Medicare-allowed amount for 2026, along with how that amount differs by locality and by site of service (non-facility vs. facility). All figures are estimates derived from the standard PFS formula.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $328.33 | $166.34 |
| ALASKA* (AK) | $369.68 | $197.16 |
| ALABAMA (AL) | $290.89 | $149.14 |
| ARKANSAS (AR) | $286.15 | $147.00 |
| ARIZONA (AZ) | $318.56 | $161.59 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $430.32 | $201.91 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $438.98 | $205.38 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $371.10 | $179.63 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $372.71 | $181.07 |
| NAPA (CA) | $406.16 | $192.65 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $430.78 | $202.36 |
| VALLEJO (CA) | $405.51 | $192.00 |
| BAKERSFIELD (CA) | $348.59 | $171.04 |
| CHICO (CA) | $347.49 | $169.94 |
| FRESNO (CA) | $347.49 | $169.94 |
| HANFORD-CORCORAN (CA) | $347.49 | $169.94 |
| MADERA (CA) | $347.49 | $169.94 |
| MERCED (CA) | $347.49 | $169.94 |
| MODESTO (CA) | $347.49 | $169.94 |
| REDDING (CA) | $347.49 | $169.94 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $351.78 | $174.24 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $365.62 | $177.22 |
| SALINAS (CA) | $364.30 | $176.55 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $440.83 | $207.24 |
| SANTA CRUZ-WATSONVILLE (CA) | $377.86 | $181.04 |
| SANTA ROSA-PETALUMA (CA) | $381.71 | $182.78 |
| STOCKTON (CA) | $347.49 | $169.94 |
| VISALIA (CA) | $347.49 | $169.94 |
| YUBA CITY (CA) | $347.49 | $169.94 |
| EL CENTRO (CA) | $347.55 | $170.01 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $373.69 | $179.94 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $358.37 | $173.86 |
| SANTA MARIA-SANTA BARBARA (CA) | $365.89 | $177.00 |
| REST OF CALIFORNIA (CA) | $347.49 | $169.94 |
| COLORADO (CO) | $342.35 | $169.99 |
| CONNECTICUT (CT) | $351.87 | $177.40 |
| DC + MD/VA SUBURBS (DC) | $378.24 | $187.41 |
| DELAWARE (DE) | $324.25 | $164.20 |
| FORT LAUDERDALE (FL) | $342.42 | $178.32 |
| MIAMI (FL) | $359.14 | $190.50 |
| REST OF FLORIDA (FL) | $323.91 | $169.04 |
| ATLANTA (GA) | $335.25 | $170.67 |
| REST OF GEORGIA (GA) | $303.55 | $159.05 |
| HAWAII, GUAM (HI) | $357.39 | $173.20 |
| IOWA (IA) | $298.75 | $150.53 |
| IDAHO (ID) | $301.04 | $152.00 |
| EAST ST. LOUIS (IL) | $321.62 | $172.59 |
| SUBURBAN CHICAGO (IL) | $345.91 | $179.55 |
| CHICAGO (IL) | $347.33 | $184.53 |
| REST OF ILLINOIS (IL) | $313.83 | $165.93 |
| INDIANA (IN) | $302.98 | $152.81 |
| KANSAS (KS) | $297.40 | $150.96 |
| KENTUCKY (KY) | $299.09 | $155.08 |
| NEW ORLEANS (LA) | $315.21 | $162.77 |
| REST OF LOUISIANA (LA) | $298.65 | $155.29 |
| METROPOLITAN BOSTON (MA) | $378.51 | $185.09 |
| REST OF MASSACHUSETTS (MA) | $340.03 | $169.45 |
| BALTIMORE/SURR. CNTYS (MD) | $350.97 | $177.15 |
| REST OF MARYLAND (MD) | $330.89 | $166.95 |
| SOUTHERN MAINE (ME) | $321.12 | $160.59 |
| REST OF MAINE (ME) | $303.03 | $153.99 |
| DETROIT (MI) | $328.63 | $172.31 |
| REST OF MICHIGAN (MI) | $308.03 | $160.13 |
| MINNESOTA (MN) | $326.27 | $159.58 |
| METROPOLITAN ST. LOUIS (MO) | $316.20 | $161.99 |
| METROPOLITAN KANSAS CITY (MO) | $312.58 | $160.47 |
| REST OF MISSOURI (MO) | $293.04 | $153.41 |
| MISSISSIPPI (MS) | $289.65 | $150.17 |
| MONTANA** (MT) | $328.30 | $166.31 |
| NORTH CAROLINA (NC) | $306.54 | $155.40 |
| NORTH DAKOTA** (ND) | $320.39 | $158.40 |
| NEBRASKA (NE) | $300.53 | $151.01 |
| NEW HAMPSHIRE (NH) | $337.04 | $168.40 |
| NORTHERN NJ (NJ) | $373.64 | $185.73 |
| REST OF NEW JERSEY (NJ) | $355.39 | $178.49 |
| NEW MEXICO (NM) | $310.00 | $161.45 |
| NEVADA** (NV) | $326.35 | $164.20 |
| MANHATTAN (NY) | $381.13 | $192.89 |
| NYC SUBURBS/LONG ISLAND (NY) | $391.59 | $198.97 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $357.97 | $180.59 |
| QUEENS (NY) | $384.27 | $192.79 |
| REST OF NEW YORK (NY) | $311.70 | $157.81 |
| OHIO (OH) | $306.41 | $158.51 |
| OKLAHOMA (OK) | $298.26 | $153.60 |
| PORTLAND (OR) | $354.00 | $174.03 |
| REST OF OREGON (OR) | $323.35 | $162.00 |
| METROPOLITAN PHILADELPHIA (PA) | $342.40 | $173.77 |
| REST OF PENNSYLVANIA (PA) | $306.84 | $158.12 |
| PUERTO RICO (PR) | $330.92 | $167.14 |
| RHODE ISLAND (RI) | $336.42 | $169.08 |
| SOUTH CAROLINA (SC) | $307.09 | $157.40 |
| SOUTH DAKOTA** (SD) | $319.46 | $157.47 |
| TENNESSEE (TN) | $299.11 | $151.85 |
| BRAZORIA (TX) | $323.61 | $163.07 |
| DALLAS (TX) | $325.98 | $164.63 |
| GALVESTON (TX) | $324.75 | $163.89 |
| HOUSTON (TX) | $332.08 | $171.22 |
| BEAUMONT (TX) | $304.60 | $157.18 |
| FORT WORTH (TX) | $323.62 | $163.89 |
| AUSTIN (TX) | $341.62 | $170.23 |
| REST OF TEXAS (TX) | $314.12 | $160.39 |
| UTAH (UT) | $311.78 | $159.50 |
| VIRGINIA (VA) | $320.10 | $160.86 |
| VIRGIN ISLANDS (VI) | $330.92 | $167.14 |
| VERMONT (VT) | $319.20 | $158.82 |
| SEATTLE (KING CNTY) (WA) | $386.45 | $187.68 |
| REST OF WASHINGTON (WA) | $339.36 | $168.78 |
| WISCONSIN (WI) | $308.45 | $153.26 |
| WEST VIRGINIA (WV) | $300.92 | $160.15 |
| WYOMING** (WY) | $324.86 | $162.86 |
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Maximum units per day (MUE)
Medicare’s Medically Unlikely Edit caps this code at 2 units 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 allowed amount for this procedure code is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality, reflecting regional differences in wages and costs. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs, which is why the two allowed amounts differ — non-facility payments are typically higher because they cover the practice's overhead, while facility payments assume the facility bears those costs separately.
RVUs — work 1.85, practice expense 7.58 (non-facility) / 2.73 (facility), malpractice 0.4 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- This is an estimated Medicare allowed amount only, not a guarantee of payment.
- Medicare typically pays 80% of the allowed amount after the patient meets their Part B deductible; the patient or secondary insurer is responsible for the remainder.
- Actual payment can vary based on the specific locality, applicable modifiers, claims-processing adjustments, sequestration, and annual budget-neutrality changes to the fee schedule.
- Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.
Frequently asked
Why is the facility amount lower than the non-facility amount for this code?
Facility amounts use a lower practice-expense RVU because the facility (such as a hospital) absorbs certain overhead costs, whereas the non-facility rate reflects the physician's practice covering those costs directly.
Why might the amount I was paid differ from the national figure shown here?
Medicare applies a Geographic Practice Cost Index (GPCI) specific to the locality where the service was performed, which adjusts the RVUs up or down from the national average before the conversion factor is applied.
Does this amount reflect what the patient owes?
No. The figure shown is the Medicare-allowed amount. Medicare generally pays 80% of that after the deductible, with the remaining 20% typically owed by the patient or a secondary payer.
Can modifiers change this amount?
Yes. Certain modifiers (e.g., bilateral, multiple procedure, or assistant-at-surgery modifiers) can increase or reduce the allowed amount from the base rate shown here.
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.
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