Medicare Reimbursement for CPT Code 23406

This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code, both at the national level and adjusted for local geographic costs. Amounts are shown for non-facility (e.g., office) and facility (e.g., hospital) settings, since practice expense can differ between the two. CPT code descriptors are proprietary to the AMA, so this page refers to the code generically rather than reproducing its official description.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$674.03	$674.03
ALASKA* (AK)	$848.33	$848.33
ALABAMA (AL)	$619.30	$619.30
ARKANSAS (AR)	$612.52	$612.52
ARIZONA (AZ)	$658.66	$658.66
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$788.80	$788.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$801.31	$801.31
OXNARD-THOUSAND OAKS-VENTURA (CA)	$713.88	$713.88
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$720.83	$720.83
NAPA (CA)	$756.94	$756.94
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$790.48	$790.48
VALLEJO (CA)	$754.52	$754.52
BAKERSFIELD (CA)	$687.07	$687.07
CHICO (CA)	$682.74	$682.74
FRESNO (CA)	$682.74	$682.74
HANFORD-CORCORAN (CA)	$682.74	$682.74
MADERA (CA)	$682.74	$682.74
MERCED (CA)	$682.74	$682.74
MODESTO (CA)	$682.74	$682.74
REDDING (CA)	$682.74	$682.74
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$698.77	$698.77
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$707.39	$707.39
SALINAS (CA)	$704.53	$704.53
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$808.18	$808.18
SANTA CRUZ-WATSONVILLE (CA)	$715.85	$715.85
SANTA ROSA-PETALUMA (CA)	$722.54	$722.54
STOCKTON (CA)	$682.74	$682.74
VISALIA (CA)	$682.74	$682.74
YUBA CITY (CA)	$682.74	$682.74
EL CENTRO (CA)	$682.99	$682.99
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$714.32	$714.32
SAN LUIS OBISPO-PASO ROBLES (CA)	$694.19	$694.19
SANTA MARIA-SANTA BARBARA (CA)	$705.32	$705.32
REST OF CALIFORNIA (CA)	$682.74	$682.74
COLORADO (CO)	$684.54	$684.54
CONNECTICUT (CT)	$712.08	$712.08
DC + MD/VA SUBURBS (DC)	$746.35	$746.35
DELAWARE (DE)	$667.63	$667.63
FORT LAUDERDALE (FL)	$717.43	$717.43
MIAMI (FL)	$760.53	$760.53
REST OF FLORIDA (FL)	$687.18	$687.18
ATLANTA (GA)	$689.30	$689.30
REST OF GEORGIA (GA)	$654.77	$654.77
HAWAII, GUAM (HI)	$689.69	$689.69
IOWA (IA)	$621.59	$621.59
IDAHO (ID)	$626.68	$626.68
EAST ST. LOUIS (IL)	$702.86	$702.86
SUBURBAN CHICAGO (IL)	$721.89	$721.89
CHICAGO (IL)	$741.89	$741.89
REST OF ILLINOIS (IL)	$678.70	$678.70
INDIANA (IN)	$629.19	$629.19
KANSAS (KS)	$623.96	$623.96
KENTUCKY (KY)	$640.28	$640.28
NEW ORLEANS (LA)	$665.05	$665.05
REST OF LOUISIANA (LA)	$641.34	$641.34
METROPOLITAN BOSTON (MA)	$734.93	$734.93
REST OF MASSACHUSETTS (MA)	$683.84	$683.84
BALTIMORE/SURR. CNTYS (MD)	$710.91	$710.91
REST OF MARYLAND (MD)	$676.76	$676.76
SOUTHERN MAINE (ME)	$653.39	$653.39
REST OF MAINE (ME)	$634.05	$634.05
DETROIT (MI)	$698.62	$698.62
REST OF MICHIGAN (MI)	$657.25	$657.25
MINNESOTA (MN)	$646.95	$646.95
METROPOLITAN ST. LOUIS (MO)	$661.35	$661.35
METROPOLITAN KANSAS CITY (MO)	$656.65	$656.65
REST OF MISSOURI (MO)	$636.01	$636.01
MISSISSIPPI (MS)	$624.13	$624.13
MONTANA** (MT)	$673.93	$673.93
NORTH CAROLINA (NC)	$638.35	$638.35
NORTH DAKOTA** (ND)	$644.67	$644.67
NEBRASKA (NE)	$622.78	$622.78
NEW HAMPSHIRE (NH)	$678.77	$678.77
NORTHERN NJ (NJ)	$742.56	$742.56
REST OF NEW JERSEY (NJ)	$717.65	$717.65
NEW MEXICO (NM)	$661.87	$661.87
NEVADA** (NV)	$666.04	$666.04
MANHATTAN (NY)	$769.06	$769.06
NYC SUBURBS/LONG ISLAND (NY)	$789.64	$789.64
POUGHKPSIE/N NYC SUBURBS (NY)	$725.83	$725.83
QUEENS (NY)	$767.27	$767.27
REST OF NEW YORK (NY)	$646.04	$646.04
OHIO (OH)	$651.27	$651.27
OKLAHOMA (OK)	$634.52	$634.52
PORTLAND (OR)	$696.66	$696.66
REST OF OREGON (OR)	$658.28	$658.28
METROPOLITAN PHILADELPHIA (PA)	$700.94	$700.94
REST OF PENNSYLVANIA (PA)	$649.48	$649.48
PUERTO RICO (PR)	$676.22	$676.22
RHODE ISLAND (RI)	$684.29	$684.29
SOUTH CAROLINA (SC)	$646.38	$646.38
SOUTH DAKOTA** (SD)	$641.21	$641.21
TENNESSEE (TN)	$626.92	$626.92
BRAZORIA (TX)	$663.63	$663.63
DALLAS (TX)	$669.17	$669.17
GALVESTON (TX)	$666.53	$666.53
HOUSTON (TX)	$693.62	$693.62
BEAUMONT (TX)	$646.56	$646.56
FORT WORTH (TX)	$667.15	$667.15
AUSTIN (TX)	$684.55	$684.55
REST OF TEXAS (TX)	$655.66	$655.66
UTAH (UT)	$653.02	$653.02
VIRGINIA (VA)	$654.97	$654.97
VIRGIN ISLANDS (VI)	$676.22	$676.22
VERMONT (VT)	$646.95	$646.95
SEATTLE (KING CNTY) (WA)	$743.33	$743.33
REST OF WASHINGTON (WA)	$680.98	$680.98
WISCONSIN (WI)	$628.64	$628.64
WEST VIRGINIA (WV)	$660.46	$660.46
WYOMING** (WY)	$661.18	$661.18

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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 pricing starts with three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific Medicare locality, reflecting regional differences in cost of living and practice costs. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility rates can differ because practice expense RVUs are typically lower in facility settings, where the facility itself bears more of the overhead cost.

RVUs — work 10.73, practice expense 7.97 (non-facility) / 7.97 (facility), malpractice 1.48 — × 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 annual deductible is met; the patient or secondary payer is responsible for the remainder.
Modifiers, place-of-service codes, sequestration, and multiple-procedure reductions can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates mean amounts can change year to year.
Always verify the final allowed amount with your specific Medicare Administrative Contractor (MAC) and locality.

Frequently asked

Why do non-facility and facility amounts sometimes differ?

Practice expense RVUs differ by setting because overhead costs (rent, staff, supplies) are treated differently when the procedure is performed in a facility versus a non-facility setting. For some codes, like this one, the two amounts may be the same if CMS has not differentiated the practice expense RVU.

Does this amount reflect what Medicare actually pays?

No. This is the allowed amount before the standard 80/20 split and before any adjustments for deductible, modifiers, or sequestration. The actual payment may be lower.

Why does the amount vary by locality?

The Geographic Practice Cost Index (GPCI) adjusts the RVUs for each Medicare locality to reflect differences in local labor, rent, and malpractice costs, so the same code can have different allowed amounts in different parts of the country.

Will this amount be correct for next year?

Not necessarily. CMS updates the conversion factor and may adjust RVUs annually, so amounts should be re-checked each fee schedule year.

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.