Medicare Reimbursement for CPT 23466

CPT 23466 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code at the national level and by locality, comparing non-facility and facility payment settings. Because the CPT descriptor is proprietary to the AMA, this page refers to it generically as 'this procedure code.'

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1034.76	$1034.76
ALASKA* (AK)	$1272.01	$1272.01
ALABAMA (AL)	$937.35	$937.35
ARKANSAS (AR)	$925.35	$925.35
ARIZONA (AZ)	$1006.79	$1006.79
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1193.57	$1193.57
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1211.64	$1211.64
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1085.19	$1085.19
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1096.60	$1096.60
NAPA (CA)	$1147.61	$1147.61
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1197.14	$1197.14
VALLEJO (CA)	$1142.47	$1142.47
BAKERSFIELD (CA)	$1043.39	$1043.39
CHICO (CA)	$1034.70	$1034.70
FRESNO (CA)	$1034.70	$1034.70
HANFORD-CORCORAN (CA)	$1034.70	$1034.70
MADERA (CA)	$1034.70	$1034.70
MERCED (CA)	$1034.70	$1034.70
MODESTO (CA)	$1034.70	$1034.70
REDDING (CA)	$1034.70	$1034.70
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1068.46	$1068.46
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1072.30	$1072.30
SALINAS (CA)	$1068.06	$1068.06
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1226.22	$1226.22
SANTA CRUZ-WATSONVILLE (CA)	$1086.17	$1086.17
SANTA ROSA-PETALUMA (CA)	$1096.20	$1096.20
STOCKTON (CA)	$1034.70	$1034.70
VISALIA (CA)	$1034.70	$1034.70
YUBA CITY (CA)	$1034.70	$1034.70
EL CENTRO (CA)	$1035.23	$1035.23
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1083.54	$1083.54
SAN LUIS OBISPO-PASO ROBLES (CA)	$1052.56	$1052.56
SANTA MARIA-SANTA BARBARA (CA)	$1069.43	$1069.43
REST OF CALIFORNIA (CA)	$1034.70	$1034.70
COLORADO (CO)	$1044.54	$1044.54
CONNECTICUT (CT)	$1099.05	$1099.05
DC + MD/VA SUBURBS (DC)	$1148.31	$1148.31
DELAWARE (DE)	$1021.76	$1021.76
FORT LAUDERDALE (FL)	$1124.90	$1124.90
MIAMI (FL)	$1212.14	$1212.14
REST OF FLORIDA (FL)	$1069.25	$1069.25
ATLANTA (GA)	$1064.03	$1064.03
REST OF GEORGIA (GA)	$1010.06	$1010.06
HAWAII, GUAM (HI)	$1047.48	$1047.48
IOWA (IA)	$936.23	$936.23
IDAHO (ID)	$946.27	$946.27
EAST ST. LOUIS (IL)	$1107.89	$1107.89
SUBURBAN CHICAGO (IL)	$1130.54	$1130.54
CHICAGO (IL)	$1176.26	$1176.26
REST OF ILLINOIS (IL)	$1057.69	$1057.69
INDIANA (IN)	$950.54	$950.54
KANSAS (KS)	$942.88	$942.88
KENTUCKY (KY)	$979.76	$979.76
NEW ORLEANS (LA)	$1024.53	$1024.53
REST OF LOUISIANA (LA)	$982.61	$982.61
METROPOLITAN BOSTON (MA)	$1124.87	$1124.87
REST OF MASSACHUSETTS (MA)	$1043.71	$1043.71
BALTIMORE/SURR. CNTYS (MD)	$1098.16	$1098.16
REST OF MARYLAND (MD)	$1036.29	$1036.29
SOUTHERN MAINE (ME)	$992.32	$992.32
REST OF MAINE (ME)	$961.90	$961.90
DETROIT (MI)	$1092.18	$1092.18
REST OF MICHIGAN (MI)	$1012.17	$1012.17
MINNESOTA (MN)	$972.97	$972.97
METROPOLITAN ST. LOUIS (MO)	$1015.04	$1015.04
METROPOLITAN KANSAS CITY (MO)	$1007.02	$1007.02
REST OF MISSOURI (MO)	$974.74	$974.74
MISSISSIPPI (MS)	$949.68	$949.68
MONTANA** (MT)	$1034.55	$1034.55
NORTH CAROLINA (NC)	$969.08	$969.08
NORTH DAKOTA** (ND)	$972.46	$972.46
NEBRASKA (NE)	$937.56	$937.56
NEW HAMPSHIRE (NH)	$1038.67	$1038.67
NORTHERN NJ (NJ)	$1140.75	$1140.75
REST OF NEW JERSEY (NJ)	$1103.72	$1103.72
NEW MEXICO (NM)	$1021.38	$1021.38
NEVADA** (NV)	$1017.66	$1017.66
MANHATTAN (NY)	$1196.42	$1196.42
NYC SUBURBS/LONG ISLAND (NY)	$1236.05	$1236.05
POUGHKPSIE/N NYC SUBURBS (NY)	$1119.39	$1119.39
QUEENS (NY)	$1189.62	$1189.62
REST OF NEW YORK (NY)	$982.85	$982.85
OHIO (OH)	$999.48	$999.48
OKLAHOMA (OK)	$966.95	$966.95
PORTLAND (OR)	$1062.23	$1062.23
REST OF OREGON (OR)	$1001.95	$1001.95
METROPOLITAN PHILADELPHIA (PA)	$1081.29	$1081.29
REST OF PENNSYLVANIA (PA)	$994.95	$994.95
PUERTO RICO (PR)	$1037.75	$1037.75
RHODE ISLAND (RI)	$1046.91	$1046.91
SOUTH CAROLINA (SC)	$987.47	$987.47
SOUTH DAKOTA** (SD)	$965.12	$965.12
TENNESSEE (TN)	$948.42	$948.42
BRAZORIA (TX)	$1012.07	$1012.07
DALLAS (TX)	$1022.84	$1022.84
GALVESTON (TX)	$1017.93	$1017.93
HOUSTON (TX)	$1075.41	$1075.41
BEAUMONT (TX)	$989.95	$989.95
FORT WORTH (TX)	$1020.05	$1020.05
AUSTIN (TX)	$1047.91	$1047.91
REST OF TEXAS (TX)	$1003.41	$1003.41
UTAH (UT)	$999.15	$999.15
VIRGINIA (VA)	$996.87	$996.87
VIRGIN ISLANDS (VI)	$1037.75	$1037.75
VERMONT (VT)	$978.80	$978.80
SEATTLE (KING CNTY) (WA)	$1135.55	$1135.55
REST OF WASHINGTON (WA)	$1038.39	$1038.39
WISCONSIN (WI)	$944.75	$944.75
WEST VIRGINIA (WV)	$1025.57	$1025.57
WYOMING** (WY)	$1007.49	$1007.49

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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 pricing for this procedure code is based on three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — which reflect the relative resources needed to furnish the service. Each RVU component is adjusted by locality-specific Geographic Practice Cost Indices (GPCIs) to account for regional cost differences, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility and facility rates differ because the practice-expense RVU is typically higher in non-facility settings (e.g., physician office) where the practice bears more overhead, compared to facility settings (e.g., hospital) where the facility absorbs some costs. For this code, the non-facility and facility PE RVUs shown are identical, so the resulting national amounts are the same in both settings. Final payment also reflects any applicable modifiers, sequestration, and yearly budget-neutrality adjustments set by CMS.

RVUs — work 15.41, practice expense 12.43 (non-facility) / 12.43 (facility), malpractice 3.14 — × 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.
Actual payment can vary by locality, facility type, modifiers, claim-specific circumstances, and federal sequestration adjustments.
Conversion factors and RVUs are updated annually and may change mid-year due to legislation.
Always verify final allowed amounts with your Medicare Administrative Contractor (MAC).

Frequently asked

Why do non-facility and facility amounts differ for some codes but not this one?

Facility and non-facility amounts differ when the practice-expense RVU differs between settings, usually because overhead costs are split differently when a facility absorbs certain costs. For this code, the practice-expense RVU is the same in both settings, so the calculated amounts match.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare Physician Fee Schedule allowed amount before patient responsibility, secondary insurance, modifiers, and local adjustments are applied.

Why does the amount change by locality?

Medicare adjusts each RVU component using Geographic Practice Cost Indices (GPCIs) specific to each payment locality to reflect differences in local costs of labor, rent, and malpractice insurance.

Can modifiers change this amount?

Yes. Modifiers such as those indicating bilateral procedures, multiple procedures, or reduced services can increase or decrease the final allowed amount relative to the base fee schedule rate 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.