Medicare Reimbursement for CPT 23440

This page covers CPT code 23440, a physician procedure code, and is intended to help billers and practice managers understand how Medicare's Physician Fee Schedule (PFS) estimates its allowed amount. Figures are shown nationally and can vary by locality, as well as by site of service (non-facility vs. facility).

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$701.42	$701.42
ALASKA* (AK)	$860.43	$860.43
ALABAMA (AL)	$634.64	$634.64
ARKANSAS (AR)	$626.42	$626.42
ARIZONA (AZ)	$682.22	$682.22
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$808.50	$808.50
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$820.71	$820.71
OXNARD-THOUSAND OAKS-VENTURA (CA)	$735.22	$735.22
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$742.98	$742.98
NAPA (CA)	$777.44	$777.44
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$810.97	$810.97
VALLEJO (CA)	$773.89	$773.89
BAKERSFIELD (CA)	$706.79	$706.79
CHICO (CA)	$700.80	$700.80
FRESNO (CA)	$700.80	$700.80
HANFORD-CORCORAN (CA)	$700.80	$700.80
MADERA (CA)	$700.80	$700.80
MERCED (CA)	$700.80	$700.80
MODESTO (CA)	$700.80	$700.80
REDDING (CA)	$700.80	$700.80
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$724.13	$724.13
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$726.32	$726.32
SALINAS (CA)	$723.45	$723.45
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$830.79	$830.79
SANTA CRUZ-WATSONVILLE (CA)	$735.81	$735.81
SANTA ROSA-PETALUMA (CA)	$742.61	$742.61
STOCKTON (CA)	$700.80	$700.80
VISALIA (CA)	$700.80	$700.80
YUBA CITY (CA)	$700.80	$700.80
EL CENTRO (CA)	$701.17	$701.17
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$734.00	$734.00
SAN LUIS OBISPO-PASO ROBLES (CA)	$712.95	$712.95
SANTA MARIA-SANTA BARBARA (CA)	$724.39	$724.39
REST OF CALIFORNIA (CA)	$700.80	$700.80
COLORADO (CO)	$707.79	$707.79
CONNECTICUT (CT)	$745.33	$745.33
DC + MD/VA SUBURBS (DC)	$778.61	$778.61
DELAWARE (DE)	$692.44	$692.44
FORT LAUDERDALE (FL)	$763.66	$763.66
MIAMI (FL)	$823.83	$823.83
REST OF FLORIDA (FL)	$725.44	$725.44
ATLANTA (GA)	$721.55	$721.55
REST OF GEORGIA (GA)	$684.82	$684.82
HAWAII, GUAM (HI)	$709.62	$709.62
IOWA (IA)	$633.69	$633.69
IDAHO (ID)	$640.62	$640.62
EAST ST. LOUIS (IL)	$752.31	$752.31
SUBURBAN CHICAGO (IL)	$767.43	$767.43
CHICAGO (IL)	$799.12	$799.12
REST OF ILLINOIS (IL)	$717.64	$717.64
INDIANA (IN)	$643.54	$643.54
KANSAS (KS)	$638.34	$638.34
KENTUCKY (KY)	$663.89	$663.89
NEW ORLEANS (LA)	$694.60	$694.60
REST OF LOUISIANA (LA)	$665.88	$665.88
METROPOLITAN BOSTON (MA)	$762.47	$762.47
REST OF MASSACHUSETTS (MA)	$707.22	$707.22
BALTIMORE/SURR. CNTYS (MD)	$744.77	$744.77
REST OF MARYLAND (MD)	$702.33	$702.33
SOUTHERN MAINE (ME)	$672.13	$672.13
REST OF MAINE (ME)	$651.42	$651.42
DETROIT (MI)	$741.25	$741.25
REST OF MICHIGAN (MI)	$686.19	$686.19
MINNESOTA (MN)	$658.59	$658.59
METROPOLITAN ST. LOUIS (MO)	$688.00	$688.00
METROPOLITAN KANSAS CITY (MO)	$682.51	$682.51
REST OF MISSOURI (MO)	$660.54	$660.54
MISSISSIPPI (MS)	$643.22	$643.22
MONTANA** (MT)	$701.27	$701.27
NORTH CAROLINA (NC)	$656.32	$656.32
NORTH DAKOTA** (ND)	$658.37	$658.37
NEBRASKA (NE)	$634.58	$634.58
NEW HAMPSHIRE (NH)	$703.94	$703.94
NORTHERN NJ (NJ)	$773.38	$773.38
REST OF NEW JERSEY (NJ)	$748.30	$748.30
NEW MEXICO (NM)	$692.53	$692.53
NEVADA** (NV)	$689.60	$689.60
MANHATTAN (NY)	$811.84	$811.84
NYC SUBURBS/LONG ISLAND (NY)	$839.11	$839.11
POUGHKPSIE/N NYC SUBURBS (NY)	$759.07	$759.07
QUEENS (NY)	$807.05	$807.05
REST OF NEW YORK (NY)	$665.76	$665.76
OHIO (OH)	$677.42	$677.42
OKLAHOMA (OK)	$655.02	$655.02
PORTLAND (OR)	$719.77	$719.77
REST OF OREGON (OR)	$678.76	$678.76
METROPOLITAN PHILADELPHIA (PA)	$733.23	$733.23
REST OF PENNSYLVANIA (PA)	$674.26	$674.26
PUERTO RICO (PR)	$703.44	$703.44
RHODE ISLAND (RI)	$709.50	$709.50
SOUTH CAROLINA (SC)	$669.07	$669.07
SOUTH DAKOTA** (SD)	$653.29	$653.29
TENNESSEE (TN)	$642.15	$642.15
BRAZORIA (TX)	$685.70	$685.70
DALLAS (TX)	$693.11	$693.11
GALVESTON (TX)	$689.75	$689.75
HOUSTON (TX)	$729.46	$729.46
BEAUMONT (TX)	$670.84	$670.84
FORT WORTH (TX)	$691.23	$691.23
AUSTIN (TX)	$710.24	$710.24
REST OF TEXAS (TX)	$679.98	$679.98
UTAH (UT)	$677.07	$677.07
VIRGINIA (VA)	$675.31	$675.31
VIRGIN ISLANDS (VI)	$703.44	$703.44
VERMONT (VT)	$662.79	$662.79
SEATTLE (KING CNTY) (WA)	$769.62	$769.62
REST OF WASHINGTON (WA)	$703.58	$703.58
WISCONSIN (WI)	$639.39	$639.39
WEST VIRGINIA (WV)	$695.64	$695.64
WYOMING** (WY)	$682.57	$682.57

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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: 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 — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the Medicare locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Practice-expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the same code can have two different allowed amounts depending on where it's billed. Because GPCIs and the conversion factor are updated periodically, the resulting dollar amount can change from year to year even if RVUs stay the same.

RVUs — work 10.37, practice expense 8.46 (non-facility) / 8.46 (facility), malpractice 2.17 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on the national or locality-adjusted PFS formula — not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient's annual deductible is met; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the final paid amount.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does CPT 23440 show different amounts for non-facility and facility settings?

The practice-expense RVU component differs by site of service because overhead costs (staff, supplies, equipment) are treated differently when the procedure is performed in a physician office versus a hospital or facility setting.

Does the national amount apply to my claim?

No. The national figure uses standardized GPCIs and is a reference point. Actual payment depends on the GPCIs for the specific locality where the service was rendered.

Why might my actual payment differ from the amount shown here?

Factors like modifiers, multiple-procedure payment reductions, sequestration, secondary payer coordination, and mid-year or annual rate updates can all cause the paid amount to differ from this estimate.

Can this page be used to predict an appeal outcome for a denied claim?

No. This page only illustrates how the PFS allowed amount is calculated. Claim denials and appeals depend on coverage policy, documentation, and payer-specific rules, which are outside the scope of this fee estimate.

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.