Medicare Reimbursement for CPT 23480

CPT code 23480 is a physician procedure code; its specific clinical descriptor is licensed by the AMA and not reproduced here. 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)	$763.88	$763.88
ALASKA* (AK)	$935.78	$935.78
ALABAMA (AL)	$690.59	$690.59
ARKANSAS (AR)	$681.58	$681.58
ARIZONA (AZ)	$742.79	$742.79
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$879.74	$879.74
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$892.99	$892.99
OXNARD-THOUSAND OAKS-VENTURA (CA)	$800.23	$800.23
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$808.71	$808.71
NAPA (CA)	$846.04	$846.04
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$882.47	$882.47
VALLEJO (CA)	$842.11	$842.11
BAKERSFIELD (CA)	$769.24	$769.24
CHICO (CA)	$762.64	$762.64
FRESNO (CA)	$762.64	$762.64
HANFORD-CORCORAN (CA)	$762.64	$762.64
MADERA (CA)	$762.64	$762.64
MERCED (CA)	$762.64	$762.64
MODESTO (CA)	$762.64	$762.64
REDDING (CA)	$762.64	$762.64
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$788.42	$788.42
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$790.41	$790.41
SALINAS (CA)	$787.30	$787.30
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$904.13	$904.13
SANTA CRUZ-WATSONVILLE (CA)	$800.78	$800.78
SANTA ROSA-PETALUMA (CA)	$808.17	$808.17
STOCKTON (CA)	$762.64	$762.64
VISALIA (CA)	$762.64	$762.64
YUBA CITY (CA)	$762.64	$762.64
EL CENTRO (CA)	$763.04	$763.04
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$798.80	$798.80
SAN LUIS OBISPO-PASO ROBLES (CA)	$775.88	$775.88
SANTA MARIA-SANTA BARBARA (CA)	$788.33	$788.33
REST OF CALIFORNIA (CA)	$762.64	$762.64
COLORADO (CO)	$770.54	$770.54
CONNECTICUT (CT)	$811.94	$811.94
DC + MD/VA SUBURBS (DC)	$848.04	$848.04
DELAWARE (DE)	$753.97	$753.97
FORT LAUDERDALE (FL)	$832.65	$832.65
MIAMI (FL)	$899.07	$899.07
REST OF FLORIDA (FL)	$790.65	$790.65
ATLANTA (GA)	$786.05	$786.05
REST OF GEORGIA (GA)	$746.01	$746.01
HAWAII, GUAM (HI)	$772.32	$772.32
IOWA (IA)	$689.36	$689.36
IDAHO (ID)	$697.00	$697.00
EAST ST. LOUIS (IL)	$820.53	$820.53
SUBURBAN CHICAGO (IL)	$836.71	$836.71
CHICAGO (IL)	$871.86	$871.86
REST OF ILLINOIS (IL)	$782.22	$782.22
INDIANA (IN)	$700.19	$700.19
KANSAS (KS)	$694.55	$694.55
KENTUCKY (KY)	$722.88	$722.88
NEW ORLEANS (LA)	$756.61	$756.61
REST OF LOUISIANA (LA)	$725.10	$725.10
METROPOLITAN BOSTON (MA)	$830.21	$830.21
REST OF MASSACHUSETTS (MA)	$769.94	$769.94
BALTIMORE/SURR. CNTYS (MD)	$811.37	$811.37
REST OF MARYLAND (MD)	$764.76	$764.76
SOUTHERN MAINE (ME)	$731.53	$731.53
REST OF MAINE (ME)	$708.94	$708.94
DETROIT (MI)	$808.09	$808.09
REST OF MICHIGAN (MI)	$747.43	$747.43
MINNESOTA (MN)	$716.38	$716.38
METROPOLITAN ST. LOUIS (MO)	$749.26	$749.26
METROPOLITAN KANSAS CITY (MO)	$743.25	$743.25
REST OF MISSOURI (MO)	$719.30	$719.30
MISSISSIPPI (MS)	$700.15	$700.15
MONTANA** (MT)	$763.72	$763.72
NORTH CAROLINA (NC)	$714.31	$714.31
NORTH DAKOTA** (ND)	$716.26	$716.26
NEBRASKA (NE)	$690.31	$690.31
NEW HAMPSHIRE (NH)	$766.48	$766.48
NORTHERN NJ (NJ)	$842.28	$842.28
REST OF NEW JERSEY (NJ)	$815.02	$815.02
NEW MEXICO (NM)	$754.43	$754.43
NEVADA** (NV)	$750.80	$750.80
MANHATTAN (NY)	$884.79	$884.79
NYC SUBURBS/LONG ISLAND (NY)	$914.83	$914.83
POUGHKPSIE/N NYC SUBURBS (NY)	$826.88	$826.88
QUEENS (NY)	$879.41	$879.41
REST OF NEW YORK (NY)	$724.67	$724.67
OHIO (OH)	$737.73	$737.73
OKLAHOMA (OK)	$713.05	$713.05
PORTLAND (OR)	$783.55	$783.55
REST OF OREGON (OR)	$738.84	$738.84
METROPOLITAN PHILADELPHIA (PA)	$798.74	$798.74
REST OF PENNSYLVANIA (PA)	$734.22	$734.22
PUERTO RICO (PR)	$766.06	$766.06
RHODE ISLAND (RI)	$772.52	$772.52
SOUTH CAROLINA (SC)	$728.45	$728.45
SOUTH DAKOTA** (SD)	$710.65	$710.65
TENNESSEE (TN)	$698.74	$698.74
BRAZORIA (TX)	$746.48	$746.48
DALLAS (TX)	$754.65	$754.65
GALVESTON (TX)	$750.94	$750.94
HOUSTON (TX)	$794.87	$794.87
BEAUMONT (TX)	$730.47	$730.47
FORT WORTH (TX)	$752.61	$752.61
AUSTIN (TX)	$773.35	$773.35
REST OF TEXAS (TX)	$740.40	$740.40
UTAH (UT)	$737.22	$737.22
VIRGINIA (VA)	$735.08	$735.08
VIRGIN ISLANDS (VI)	$766.06	$766.06
VERMONT (VT)	$721.20	$721.20
SEATTLE (KING CNTY) (WA)	$837.90	$837.90
REST OF WASHINGTON (WA)	$765.93	$765.93
WISCONSIN (WI)	$695.47	$695.47
WEST VIRGINIA (WV)	$758.09	$758.09
WYOMING** (WY)	$743.04	$743.04

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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 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 performed, reflecting local cost differences. 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, which is why the two amounts can diverge.

RVUs — work 11.25, practice expense 9.22 (non-facility) / 9.22 (facility), malpractice 2.4 — × 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 patient or secondary insurer is responsible for the remainder.
Modifiers, place of service, and multiple-procedure or bilateral adjustments can change the actual amount paid.
Sequestration and annual budget-neutrality adjustments may further reduce or alter the final payment.
Rates vary by Medicare Administrative Contractor (MAC) locality; always verify with your local MAC or official CMS fee schedule tools before billing.

Frequently asked

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

Practice-expense RVUs differ because non-facility settings (like a physician's office) include overhead costs that facility settings (like a hospital) do not, since the facility itself bears those costs.

Is this the amount my practice will actually receive?

No. This is a national or locality-adjusted estimate based on standard PFS inputs. Actual payment depends on your specific locality, applicable modifiers, patient coverage, and any claim adjustments.

Does this amount include the patient's share?

No. The figure shown is the total allowed amount. Medicare generally pays 80% after the deductible, with the patient or secondary payer responsible for the remaining 20%.

Why can the fee schedule amount change year to year?

CMS updates RVUs, GPCIs, and the conversion factor annually, and budget-neutrality adjustments required by law can shift payment amounts even if the code's RVUs stay the same.

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.