Medicare Reimbursement for CPT 23420

This page covers CPT code 23420, a physician procedure billed under the Medicare Physician Fee Schedule (PFS). It shows the estimated Medicare-allowed amount nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$906.50	$906.50
ALASKA* (AK)	$1109.66	$1109.66
ALABAMA (AL)	$819.71	$819.71
ARKANSAS (AR)	$809.02	$809.02
ARIZONA (AZ)	$881.61	$881.61
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1048.15	$1048.15
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1064.11	$1064.11
OXNARD-THOUSAND OAKS-VENTURA (CA)	$951.87	$951.87
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$961.77	$961.77
NAPA (CA)	$1007.40	$1007.40
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1051.30	$1051.30
VALLEJO (CA)	$1002.87	$1002.87
BAKERSFIELD (CA)	$914.52	$914.52
CHICO (CA)	$906.88	$906.88
FRESNO (CA)	$906.88	$906.88
HANFORD-CORCORAN (CA)	$906.88	$906.88
MADERA (CA)	$906.88	$906.88
MERCED (CA)	$906.88	$906.88
MODESTO (CA)	$906.88	$906.88
REDDING (CA)	$906.88	$906.88
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$936.65	$936.65
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$940.26	$940.26
SALINAS (CA)	$936.56	$936.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1076.97	$1076.97
SANTA CRUZ-WATSONVILLE (CA)	$953.04	$953.04
SANTA ROSA-PETALUMA (CA)	$961.86	$961.86
STOCKTON (CA)	$906.88	$906.88
VISALIA (CA)	$906.88	$906.88
YUBA CITY (CA)	$906.88	$906.88
EL CENTRO (CA)	$907.35	$907.35
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$950.48	$950.48
SAN LUIS OBISPO-PASO ROBLES (CA)	$922.93	$922.93
SANTA MARIA-SANTA BARBARA (CA)	$937.85	$937.85
REST OF CALIFORNIA (CA)	$906.88	$906.88
COLORADO (CO)	$915.41	$915.41
CONNECTICUT (CT)	$963.48	$963.48
DC + MD/VA SUBURBS (DC)	$1007.17	$1007.17
DELAWARE (DE)	$894.88	$894.88
FORT LAUDERDALE (FL)	$986.11	$986.11
MIAMI (FL)	$1063.26	$1063.26
REST OF FLORIDA (FL)	$936.62	$936.62
ATLANTA (GA)	$932.39	$932.39
REST OF GEORGIA (GA)	$883.97	$883.97
HAWAII, GUAM (HI)	$918.66	$918.66
IOWA (IA)	$819.00	$819.00
IDAHO (ID)	$827.90	$827.90
EAST ST. LOUIS (IL)	$970.47	$970.47
SUBURBAN CHICAGO (IL)	$991.09	$991.09
CHICAGO (IL)	$1031.27	$1031.27
REST OF ILLINOIS (IL)	$926.13	$926.13
INDIANA (IN)	$831.71	$831.71
KANSAS (KS)	$824.79	$824.79
KENTUCKY (KY)	$857.22	$857.22
NEW ORLEANS (LA)	$897.07	$897.07
REST OF LOUISIANA (LA)	$859.71	$859.71
METROPOLITAN BOSTON (MA)	$986.78	$986.78
REST OF MASSACHUSETTS (MA)	$914.55	$914.55
BALTIMORE/SURR. CNTYS (MD)	$962.72	$962.72
REST OF MARYLAND (MD)	$907.80	$907.80
SOUTHERN MAINE (ME)	$869.00	$869.00
REST OF MAINE (ME)	$841.68	$841.68
DETROIT (MI)	$956.91	$956.91
REST OF MICHIGAN (MI)	$885.98	$885.98
MINNESOTA (MN)	$852.19	$852.19
METROPOLITAN ST. LOUIS (MO)	$888.78	$888.78
METROPOLITAN KANSAS CITY (MO)	$881.61	$881.61
REST OF MISSOURI (MO)	$852.61	$852.61
MISSISSIPPI (MS)	$830.49	$830.49
MONTANA** (MT)	$906.32	$906.32
NORTH CAROLINA (NC)	$848.10	$848.10
NORTH DAKOTA** (ND)	$851.54	$851.54
NEBRASKA (NE)	$820.22	$820.22
NEW HAMPSHIRE (NH)	$910.23	$910.23
NORTHERN NJ (NJ)	$1000.26	$1000.26
REST OF NEW JERSEY (NJ)	$967.43	$967.43
NEW MEXICO (NM)	$894.13	$894.13
NEVADA** (NV)	$891.42	$891.42
MANHATTAN (NY)	$1049.37	$1049.37
NYC SUBURBS/LONG ISLAND (NY)	$1084.52	$1084.52
POUGHKPSIE/N NYC SUBURBS (NY)	$981.21	$981.21
QUEENS (NY)	$1043.51	$1043.51
REST OF NEW YORK (NY)	$860.37	$860.37
OHIO (OH)	$874.78	$874.78
OKLAHOMA (OK)	$845.95	$845.95
PORTLAND (OR)	$931.28	$931.28
REST OF OREGON (OR)	$877.53	$877.53
METROPOLITAN PHILADELPHIA (PA)	$947.59	$947.59
REST OF PENNSYLVANIA (PA)	$870.82	$870.82
PUERTO RICO (PR)	$909.22	$909.22
RHODE ISLAND (RI)	$917.20	$917.20
SOUTH CAROLINA (SC)	$864.27	$864.27
SOUTH DAKOTA** (SD)	$845.07	$845.07
TENNESSEE (TN)	$829.71	$829.71
BRAZORIA (TX)	$886.32	$886.32
DALLAS (TX)	$895.84	$895.84
GALVESTON (TX)	$891.50	$891.50
HOUSTON (TX)	$942.20	$942.20
BEAUMONT (TX)	$866.35	$866.35
FORT WORTH (TX)	$893.31	$893.31
AUSTIN (TX)	$918.47	$918.47
REST OF TEXAS (TX)	$878.50	$878.50
UTAH (UT)	$874.68	$874.68
VIRGINIA (VA)	$872.96	$872.96
VIRGIN ISLANDS (VI)	$909.22	$909.22
VERMONT (VT)	$857.06	$857.06
SEATTLE (KING CNTY) (WA)	$996.30	$996.30
REST OF WASHINGTON (WA)	$909.89	$909.89
WISCONSIN (WI)	$826.81	$826.81
WEST VIRGINIA (WV)	$897.50	$897.50
WYOMING** (WY)	$882.45	$882.45

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. 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 — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice-expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the allowed amount may vary by place of service.

RVUs — work 13.2, practice expense 11.17 (non-facility) / 11.17 (facility), malpractice 2.77 — × 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 Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
Actual payment can be affected by modifiers, sequestration, multiple-procedure reductions, and annual budget-neutrality adjustments.
Rates vary by locality based on GPCI values; always confirm with your Medicare Administrative Contractor (MAC) for the exact, current rate.

Frequently asked

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

The practice-expense RVU component can differ depending on whether the service is performed in a non-facility setting (like a physician's office, where the practice bears more overhead) versus a facility setting (like a hospital, where the facility bears more overhead).

Does this amount reflect what Medicare will actually pay?

No. The figure shown is the Medicare PFS allowed amount estimate. Medicare generally reimburses 80% of this amount after the deductible is met, and the final payment can be adjusted by modifiers, sequestration, or other factors.

Why might the amount change year to year?

RVUs, GPCIs, and the conversion factor are updated annually by CMS, and budget-neutrality adjustments can shift overall payment levels even if a code's RVUs stay the same.

Where can I find the exact rate for my locality?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules, which should be used to confirm the exact allowed amount for your area.

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.