Medicare Reimbursement for CPT 23473

CPT 23473 is a procedure code reported to Medicare for physician and outpatient services; the exact clinical description is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and, where applicable, by locality, along with non-facility and facility rates.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1440.25	$1440.25
ALASKA* (AK)	$1804.14	$1804.14
ALABAMA (AL)	$1311.54	$1311.54
ARKANSAS (AR)	$1295.80	$1295.80
ARIZONA (AZ)	$1402.39	$1402.39
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1613.36	$1613.36
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1635.80	$1635.80
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1485.67	$1485.67
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1503.41	$1503.41
NAPA (CA)	$1558.30	$1558.30
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1618.91	$1618.91
VALLEJO (CA)	$1550.29	$1550.29
BAKERSFIELD (CA)	$1436.27	$1436.27
CHICO (CA)	$1422.71	$1422.71
FRESNO (CA)	$1422.71	$1422.71
HANFORD-CORCORAN (CA)	$1422.71	$1422.71
MADERA (CA)	$1422.71	$1422.71
MERCED (CA)	$1422.71	$1422.71
MODESTO (CA)	$1422.71	$1422.71
REDDING (CA)	$1422.71	$1422.71
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1475.30	$1475.30
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1469.18	$1469.18
SALINAS (CA)	$1463.26	$1463.26
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1658.51	$1658.51
SANTA CRUZ-WATSONVILLE (CA)	$1481.02	$1481.02
SANTA ROSA-PETALUMA (CA)	$1494.36	$1494.36
STOCKTON (CA)	$1422.71	$1422.71
VISALIA (CA)	$1422.71	$1422.71
YUBA CITY (CA)	$1422.71	$1422.71
EL CENTRO (CA)	$1423.53	$1423.53
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1480.54	$1480.54
SAN LUIS OBISPO-PASO ROBLES (CA)	$1442.61	$1442.61
SANTA MARIA-SANTA BARBARA (CA)	$1464.05	$1464.05
REST OF CALIFORNIA (CA)	$1422.71	$1422.71
COLORADO (CO)	$1443.86	$1443.86
CONNECTICUT (CT)	$1526.45	$1526.45
DC + MD/VA SUBURBS (DC)	$1585.02	$1585.02
DELAWARE (DE)	$1422.27	$1422.27
FORT LAUDERDALE (FL)	$1578.23	$1578.23
MIAMI (FL)	$1708.95	$1708.95
REST OF FLORIDA (FL)	$1502.05	$1502.05
ATLANTA (GA)	$1482.92	$1482.92
REST OF GEORGIA (GA)	$1421.65	$1421.65
HAWAII, GUAM (HI)	$1434.86	$1434.86
IOWA (IA)	$1302.44	$1302.44
IDAHO (ID)	$1317.16	$1317.16
EAST ST. LOUIS (IL)	$1568.86	$1568.86
SUBURBAN CHICAGO (IL)	$1584.53	$1584.53
CHICAGO (IL)	$1659.77	$1659.77
REST OF ILLINOIS (IL)	$1491.96	$1491.96
INDIANA (IN)	$1322.53	$1322.53
KANSAS (KS)	$1314.83	$1314.83
KENTUCKY (KY)	$1375.01	$1375.01
NEW ORLEANS (LA)	$1435.17	$1435.17
REST OF LOUISIANA (LA)	$1380.19	$1380.19
METROPOLITAN BOSTON (MA)	$1545.41	$1545.41
REST OF MASSACHUSETTS (MA)	$1444.64	$1444.64
BALTIMORE/SURR. CNTYS (MD)	$1525.76	$1525.76
REST OF MARYLAND (MD)	$1440.55	$1440.55
SOUTHERN MAINE (ME)	$1375.81	$1375.81
REST OF MAINE (ME)	$1341.50	$1341.50
DETROIT (MI)	$1536.10	$1536.10
REST OF MICHIGAN (MI)	$1421.07	$1421.07
MINNESOTA (MN)	$1338.68	$1338.68
METROPOLITAN ST. LOUIS (MO)	$1418.37	$1418.37
METROPOLITAN KANSAS CITY (MO)	$1408.27	$1408.27
REST OF MISSOURI (MO)	$1372.16	$1372.16
MISSISSIPPI (MS)	$1333.32	$1333.32
MONTANA** (MT)	$1439.92	$1439.92
NORTH CAROLINA (NC)	$1350.29	$1350.29
NORTH DAKOTA** (ND)	$1343.23	$1343.23
NEBRASKA (NE)	$1303.03	$1303.03
NEW HAMPSHIRE (NH)	$1438.80	$1438.80
NORTHERN NJ (NJ)	$1576.67	$1576.67
REST OF NEW JERSEY (NJ)	$1531.22	$1531.22
NEW MEXICO (NM)	$1434.68	$1434.68
NEVADA** (NV)	$1413.43	$1413.43
MANHATTAN (NY)	$1663.02	$1663.02
NYC SUBURBS/LONG ISLAND (NY)	$1719.77	$1719.77
POUGHKPSIE/N NYC SUBURBS (NY)	$1555.14	$1555.14
QUEENS (NY)	$1648.75	$1648.75
REST OF NEW YORK (NY)	$1368.61	$1368.61
OHIO (OH)	$1401.31	$1401.31
OKLAHOMA (OK)	$1354.33	$1354.33
PORTLAND (OR)	$1462.81	$1462.81
REST OF OREGON (OR)	$1389.89	$1389.89
METROPOLITAN PHILADELPHIA (PA)	$1505.39	$1505.39
REST OF PENNSYLVANIA (PA)	$1393.33	$1393.33
PUERTO RICO (PR)	$1442.89	$1442.89
RHODE ISLAND (RI)	$1453.34	$1453.34
SOUTH CAROLINA (SC)	$1380.59	$1380.59
SOUTH DAKOTA** (SD)	$1331.80	$1331.80
TENNESSEE (TN)	$1322.53	$1322.53
BRAZORIA (TX)	$1406.67	$1406.67
DALLAS (TX)	$1422.53	$1422.53
GALVESTON (TX)	$1415.43	$1415.43
HOUSTON (TX)	$1504.94	$1504.94
BEAUMONT (TX)	$1387.02	$1387.02
FORT WORTH (TX)	$1420.03	$1420.03
AUSTIN (TX)	$1450.09	$1450.09
REST OF TEXAS (TX)	$1400.81	$1400.81
UTAH (UT)	$1395.83	$1395.83
VIRGINIA (VA)	$1384.36	$1384.36
VIRGIN ISLANDS (VI)	$1442.89	$1442.89
VERMONT (VT)	$1354.94	$1354.94
SEATTLE (KING CNTY) (WA)	$1556.08	$1556.08
REST OF WASHINGTON (WA)	$1436.31	$1436.31
WISCONSIN (WI)	$1307.79	$1307.79
WEST VIRGINIA (WV)	$1450.04	$1450.04
WYOMING** (WY)	$1397.78	$1397.78

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 payment 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 furnished, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs typically differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings because overhead costs differ; for this code the practice-expense RVU is the same in both settings, so the national non-facility and facility amounts shown are identical. Locality-specific amounts will vary based on each area's GPCI values even when the national RVUs stay constant.

RVUs — work 24.38, practice expense 13.85 (non-facility) / 13.85 (facility), malpractice 4.89 — × 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 meets the Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Amounts shown reflect the Medicare Physician Fee Schedule and may differ from what other payers allow.
Always verify current rates and locality-specific adjustments with your Medicare Administrative Contractor (MAC).

Frequently asked

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

For CPT 23473, the practice-expense RVU used in the PFS formula is identical for non-facility and facility settings, so the calculated allowed amounts match. This isn't true for every code.

Will my actual payment match the national amount shown?

Not necessarily. The national amount uses a standard GPCI value of 1.0 for all components; your actual Medicare payment depends on the GPCIs for the specific locality where the service was performed.

Does this amount include the patient's share?

No. The figure shown is the total Medicare-allowed amount. Medicare generally pays 80% after the deductible, with the remaining 20% being the patient's or secondary insurer's responsibility.

Can modifiers change this amount?

Yes. Modifiers indicating bilateral procedures, reduced services, multiple procedures, or other circumstances can increase or decrease the final payment relative to the base PFS amount.

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.