Medicare Reimbursement for CPT 23462

CPT 23462 is a surgical procedure code reported to Medicare and other payers. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$977.31	$977.31
ALASKA* (AK)	$1207.60	$1207.60
ALABAMA (AL)	$885.50	$885.50
ARKANSAS (AR)	$874.25	$874.25
ARIZONA (AZ)	$950.58	$950.58
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1109.46	$1109.46
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1125.50	$1125.50
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1015.46	$1015.46
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1026.94	$1026.94
NAPA (CA)	$1069.33	$1069.33
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1113.16	$1113.16
VALLEJO (CA)	$1063.99	$1063.99
BAKERSFIELD (CA)	$978.68	$978.68
CHICO (CA)	$969.70	$969.70
FRESNO (CA)	$969.70	$969.70
HANFORD-CORCORAN (CA)	$969.70	$969.70
MADERA (CA)	$969.70	$969.70
MERCED (CA)	$969.70	$969.70
MODESTO (CA)	$969.70	$969.70
REDDING (CA)	$969.70	$969.70
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1004.73	$1004.73
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1003.31	$1003.31
SALINAS (CA)	$999.33	$999.33
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1140.63	$1140.63
SANTA CRUZ-WATSONVILLE (CA)	$1014.16	$1014.16
SANTA ROSA-PETALUMA (CA)	$1023.40	$1023.40
STOCKTON (CA)	$969.70	$969.70
VISALIA (CA)	$969.70	$969.70
YUBA CITY (CA)	$969.70	$969.70
EL CENTRO (CA)	$970.25	$970.25
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1012.65	$1012.65
SAN LUIS OBISPO-PASO ROBLES (CA)	$985.03	$985.03
SANTA MARIA-SANTA BARBARA (CA)	$1000.28	$1000.28
REST OF CALIFORNIA (CA)	$969.70	$969.70
COLORADO (CO)	$982.42	$982.42
CONNECTICUT (CT)	$1037.86	$1037.86
DC + MD/VA SUBURBS (DC)	$1080.70	$1080.70
DELAWARE (DE)	$964.60	$964.60
FORT LAUDERDALE (FL)	$1069.92	$1069.92
MIAMI (FL)	$1158.41	$1158.41
REST OF FLORIDA (FL)	$1016.40	$1016.40
ATLANTA (GA)	$1006.43	$1006.43
REST OF GEORGIA (GA)	$959.73	$959.73
HAWAII, GUAM (HI)	$980.29	$980.29
IOWA (IA)	$881.36	$881.36
IDAHO (ID)	$891.42	$891.42
EAST ST. LOUIS (IL)	$1059.21	$1059.21
SUBURBAN CHICAGO (IL)	$1074.58	$1074.58
CHICAGO (IL)	$1123.69	$1123.69
REST OF ILLINOIS (IL)	$1007.61	$1007.61
INDIANA (IN)	$895.33	$895.33
KANSAS (KS)	$889.09	$889.09
KENTUCKY (KY)	$928.50	$928.50
NEW ORLEANS (LA)	$971.09	$971.09
REST OF LOUISIANA (LA)	$931.75	$931.75
METROPOLITAN BOSTON (MA)	$1055.47	$1055.47
REST OF MASSACHUSETTS (MA)	$982.29	$982.29
BALTIMORE/SURR. CNTYS (MD)	$1037.33	$1037.33
REST OF MARYLAND (MD)	$977.78	$977.78
SOUTHERN MAINE (ME)	$933.92	$933.92
REST OF MAINE (ME)	$907.64	$907.64
DETROIT (MI)	$1039.53	$1039.53
REST OF MICHIGAN (MI)	$960.35	$960.35
MINNESOTA (MN)	$910.99	$910.99
METROPOLITAN ST. LOUIS (MO)	$960.42	$960.42
METROPOLITAN KANSAS CITY (MO)	$953.07	$953.07
REST OF MISSOURI (MO)	$925.30	$925.30
MISSISSIPPI (MS)	$899.35	$899.35
MONTANA** (MT)	$977.09	$977.09
NORTH CAROLINA (NC)	$914.12	$914.12
NORTH DAKOTA** (ND)	$912.63	$912.63
NEBRASKA (NE)	$882.14	$882.14
NEW HAMPSHIRE (NH)	$978.31	$978.31
NORTHERN NJ (NJ)	$1073.99	$1073.99
REST OF NEW JERSEY (NJ)	$1041.14	$1041.14
NEW MEXICO (NM)	$969.62	$969.62
NEVADA** (NV)	$959.48	$959.48
MANHATTAN (NY)	$1131.62	$1131.62
NYC SUBURBS/LONG ISLAND (NY)	$1170.75	$1170.75
POUGHKPSIE/N NYC SUBURBS (NY)	$1057.08	$1057.08
QUEENS (NY)	$1123.07	$1123.07
REST OF NEW YORK (NY)	$927.15	$927.15
OHIO (OH)	$947.18	$947.18
OKLAHOMA (OK)	$914.90	$914.90
PORTLAND (OR)	$997.19	$997.19
REST OF OREGON (OR)	$943.55	$943.55
METROPOLITAN PHILADELPHIA (PA)	$1022.15	$1022.15
REST OF PENNSYLVANIA (PA)	$942.10	$942.10
PUERTO RICO (PR)	$979.60	$979.60
RHODE ISLAND (RI)	$987.04	$987.04
SOUTH CAROLINA (SC)	$933.89	$933.89
SOUTH DAKOTA** (SD)	$905.01	$905.01
TENNESSEE (TN)	$894.46	$894.46
BRAZORIA (TX)	$954.24	$954.24
DALLAS (TX)	$965.03	$965.03
GALVESTON (TX)	$960.18	$960.18
HOUSTON (TX)	$1019.85	$1019.85
BEAUMONT (TX)	$937.50	$937.50
FORT WORTH (TX)	$962.88	$962.88
AUSTIN (TX)	$986.59	$986.59
REST OF TEXAS (TX)	$948.57	$948.57
UTAH (UT)	$944.82	$944.82
VIRGINIA (VA)	$939.24	$939.24
VIRGIN ISLANDS (VI)	$979.60	$979.60
VERMONT (VT)	$919.96	$919.96
SEATTLE (KING CNTY) (WA)	$1063.89	$1063.89
REST OF WASHINGTON (WA)	$976.83	$976.83
WISCONSIN (WI)	$886.99	$886.99
WEST VIRGINIA (WV)	$977.55	$977.55
WYOMING** (WY)	$949.00	$949.00

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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 — assigned to the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar allowed amount. Non-facility and facility settings can differ because the practice-expense RVU often varies depending on whether the service is furnished in a physician office versus a hospital or ambulatory surgical center, though for some codes these values are the same.

RVUs — work 15.33, practice expense 10.67 (non-facility) / 10.67 (facility), malpractice 3.26 — × 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 patient's deductible is met; the remainder is patient or secondary-payer responsibility.
Modifiers, multiple-procedure reductions, bilateral rules, and other claim-specific adjustments can change the final paid amount.
Sequestration and annual budget-neutrality adjustments to RVUs or the conversion factor can shift payment year to year.
Always verify the exact allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the amount differ between non-facility and facility settings?

The practice-expense RVU component can differ because overhead costs (staff, supplies, equipment) are treated differently when a service is performed in a physician's office versus a hospital or ASC, where the facility absorbs some of those costs.

Why does the allowed amount change by locality?

Geographic Practice Cost Indices (GPCIs) adjust the work, practice-expense, and malpractice RVUs to reflect regional differences in wages, rents, and other costs, so the same code can have a different allowed amount in different parts of the country.

Does this amount reflect what Medicare actually pays?

It reflects the Medicare-allowed amount before beneficiary cost-sharing. Medicare generally pays 80% of this amount after the deductible, with the patient or supplemental insurance covering the remaining 20%.

Can modifiers change this estimate?

Yes. Modifiers such as those indicating bilateral procedures, multiple procedures, or reduced services can increase or decrease the final payment relative to the base PFS amount shown here.

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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.