Medicare Reimbursement for CPT 23470

This page covers CPT code 23470, a physician procedure code defined by the American Medical Association. It shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both nationally and adjusted by locality, with separate figures for non-facility and facility settings where applicable.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1087.87	$1087.87
ALASKA* (AK)	$1350.85	$1350.85
ALABAMA (AL)	$987.96	$987.96
ARKANSAS (AR)	$975.71	$975.71
ARIZONA (AZ)	$1058.76	$1058.76
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1233.28	$1233.28
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1251.05	$1251.05
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1129.68	$1129.68
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1142.52	$1142.52
NAPA (CA)	$1188.95	$1188.95
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1237.32	$1237.32
VALLEJO (CA)	$1183.13	$1183.13
BAKERSFIELD (CA)	$1089.54	$1089.54
CHICO (CA)	$1079.70	$1079.70
FRESNO (CA)	$1079.70	$1079.70
HANFORD-CORCORAN (CA)	$1079.70	$1079.70
MADERA (CA)	$1079.70	$1079.70
MERCED (CA)	$1079.70	$1079.70
MODESTO (CA)	$1079.70	$1079.70
REDDING (CA)	$1079.70	$1079.70
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1117.97	$1117.97
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1116.66	$1116.66
SALINAS (CA)	$1112.20	$1112.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1267.58	$1267.58
SANTA CRUZ-WATSONVILLE (CA)	$1128.01	$1128.01
SANTA ROSA-PETALUMA (CA)	$1138.28	$1138.28
STOCKTON (CA)	$1079.70	$1079.70
VISALIA (CA)	$1079.70	$1079.70
YUBA CITY (CA)	$1079.70	$1079.70
EL CENTRO (CA)	$1080.29	$1080.29
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1126.63	$1126.63
SAN LUIS OBISPO-PASO ROBLES (CA)	$1096.31	$1096.31
SANTA MARIA-SANTA BARBARA (CA)	$1113.16	$1113.16
REST OF CALIFORNIA (CA)	$1079.70	$1079.70
COLORADO (CO)	$1093.55	$1093.55
CONNECTICUT (CT)	$1154.24	$1154.24
DC + MD/VA SUBURBS (DC)	$1201.55	$1201.55
DELAWARE (DE)	$1074.13	$1074.13
FORT LAUDERDALE (FL)	$1188.97	$1188.97
MIAMI (FL)	$1285.52	$1285.52
REST OF FLORIDA (FL)	$1130.67	$1130.67
ATLANTA (GA)	$1119.70	$1119.70
REST OF GEORGIA (GA)	$1068.96	$1068.96
HAWAII, GUAM (HI)	$1090.75	$1090.75
IOWA (IA)	$983.32	$983.32
IDAHO (ID)	$994.29	$994.29
EAST ST. LOUIS (IL)	$1177.52	$1177.52
SUBURBAN CHICAGO (IL)	$1194.18	$1194.18
CHICAGO (IL)	$1247.86	$1247.86
REST OF ILLINOIS (IL)	$1121.19	$1121.19
INDIANA (IN)	$998.54	$998.54
KANSAS (KS)	$991.79	$991.79
KENTUCKY (KY)	$1034.86	$1034.86
NEW ORLEANS (LA)	$1081.24	$1081.24
REST OF LOUISIANA (LA)	$1038.43	$1038.43
METROPOLITAN BOSTON (MA)	$1173.64	$1173.64
REST OF MASSACHUSETTS (MA)	$1093.53	$1093.53
BALTIMORE/SURR. CNTYS (MD)	$1153.58	$1153.58
REST OF MARYLAND (MD)	$1088.58	$1088.58
SOUTHERN MAINE (ME)	$1040.51	$1040.51
REST OF MAINE (ME)	$1012.00	$1012.00
DETROIT (MI)	$1155.91	$1155.91
REST OF MICHIGAN (MI)	$1069.59	$1069.59
MINNESOTA (MN)	$1015.36	$1015.36
METROPOLITAN ST. LOUIS (MO)	$1069.56	$1069.56
METROPOLITAN KANSAS CITY (MO)	$1061.56	$1061.56
REST OF MISSOURI (MO)	$1031.45	$1031.45
MISSISSIPPI (MS)	$1003.12	$1003.12
MONTANA** (MT)	$1087.63	$1087.63
NORTH CAROLINA (NC)	$1019.05	$1019.05
NORTH DAKOTA** (ND)	$1017.24	$1017.24
NEBRASKA (NE)	$984.15	$984.15
NEW HAMPSHIRE (NH)	$1088.85	$1088.85
NORTHERN NJ (NJ)	$1194.48	$1194.48
REST OF NEW JERSEY (NJ)	$1158.26	$1158.26
NEW MEXICO (NM)	$1079.69	$1079.69
NEVADA** (NV)	$1068.40	$1068.40
MANHATTAN (NY)	$1257.43	$1257.43
NYC SUBURBS/LONG ISLAND (NY)	$1300.09	$1300.09
POUGHKPSIE/N NYC SUBURBS (NY)	$1175.76	$1175.76
QUEENS (NY)	$1248.04	$1248.04
REST OF NEW YORK (NY)	$1033.23	$1033.23
OHIO (OH)	$1055.20	$1055.20
OKLAHOMA (OK)	$1020.00	$1020.00
PORTLAND (OR)	$1109.64	$1109.64
REST OF OREGON (OR)	$1051.01	$1051.01
METROPOLITAN PHILADELPHIA (PA)	$1137.15	$1137.15
REST OF PENNSYLVANIA (PA)	$1049.64	$1049.64
PUERTO RICO (PR)	$1090.33	$1090.33
RHODE ISLAND (RI)	$1098.85	$1098.85
SOUTH CAROLINA (SC)	$1040.66	$1040.66
SOUTH DAKOTA** (SD)	$1008.91	$1008.91
TENNESSEE (TN)	$997.65	$997.65
BRAZORIA (TX)	$1062.89	$1062.89
DALLAS (TX)	$1074.68	$1074.68
GALVESTON (TX)	$1069.37	$1069.37
HOUSTON (TX)	$1134.53	$1134.53
BEAUMONT (TX)	$1044.64	$1044.64
FORT WORTH (TX)	$1072.36	$1072.36
AUSTIN (TX)	$1097.89	$1097.89
REST OF TEXAS (TX)	$1056.62	$1056.62
UTAH (UT)	$1052.55	$1052.55
VIRGINIA (VA)	$1046.34	$1046.34
VIRGIN ISLANDS (VI)	$1090.33	$1090.33
VERMONT (VT)	$1025.26	$1025.26
SEATTLE (KING CNTY) (WA)	$1182.96	$1182.96
REST OF WASHINGTON (WA)	$1087.50	$1087.50
WISCONSIN (WI)	$989.35	$989.35
WEST VIRGINIA (WV)	$1088.49	$1088.49
WYOMING** (WY)	$1056.95	$1056.95

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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 the Geographic Practice Cost Indices (GPCIs) for the specific 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 typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings, reflecting the overhead a physician practice incurs; for this code, the practice expense RVU is the same in both settings, so the non-facility and facility national amounts shown are identical. Rates change each year as CMS updates RVUs, GPCIs, and the conversion factor, often under a budget-neutrality requirement.

RVUs — work 17.44, practice expense 11.57 (non-facility) / 11.57 (facility), malpractice 3.56 — × 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 beneficiary or secondary payer is responsible for the remainder.
Actual payment can vary based on locality, applicable modifiers, sequestration, and annual budget-neutrality adjustments.
Always verify the exact allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why do the non-facility and facility amounts look the same for this code?

Because the practice expense RVU used in the formula is identical for both non-facility and facility settings for this code, the resulting national PFS amounts come out the same.

Will the amount shown match what I actually get paid?

Not necessarily. The figure is a national or locality-adjusted estimate; your MAC applies additional factors like modifiers, sequestration, and any local adjustments before issuing final payment.

Why does the fee schedule amount change each year?

CMS updates the work, practice expense, and malpractice RVUs, the GPCIs, and the conversion factor annually, which can raise or lower the calculated amount even if the code itself hasn't changed.

Does this page tell me the patient's out-of-pocket cost?

No. This page shows the Medicare allowed amount only. Patient responsibility depends on deductible status, coinsurance, and any secondary insurance coverage.

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.