Medicare Reimbursement for CPT 23490

CPT 23490 is a procedure code reported to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$800.62	$800.62
ALASKA* (AK)	$981.54	$981.54
ALABAMA (AL)	$723.95	$723.95
ARKANSAS (AR)	$714.52	$714.52
ARIZONA (AZ)	$778.53	$778.53
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$920.85	$920.85
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$934.67	$934.67
OXNARD-THOUSAND OAKS-VENTURA (CA)	$838.09	$838.09
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$847.02	$847.02
NAPA (CA)	$885.75	$885.75
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$923.73	$923.73
VALLEJO (CA)	$881.61	$881.61
BAKERSFIELD (CA)	$805.82	$805.82
CHICO (CA)	$798.86	$798.86
FRESNO (CA)	$798.86	$798.86
HANFORD-CORCORAN (CA)	$798.86	$798.86
MADERA (CA)	$798.86	$798.86
MERCED (CA)	$798.86	$798.86
MODESTO (CA)	$798.86	$798.86
REDDING (CA)	$798.86	$798.86
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$826.05	$826.05
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$827.83	$827.83
SALINAS (CA)	$824.57	$824.57
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$946.42	$946.42
SANTA CRUZ-WATSONVILLE (CA)	$838.52	$838.52
SANTA ROSA-PETALUMA (CA)	$846.25	$846.25
STOCKTON (CA)	$798.86	$798.86
VISALIA (CA)	$798.86	$798.86
YUBA CITY (CA)	$798.86	$798.86
EL CENTRO (CA)	$799.28	$799.28
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$836.52	$836.52
SAN LUIS OBISPO-PASO ROBLES (CA)	$812.62	$812.62
SANTA MARIA-SANTA BARBARA (CA)	$825.62	$825.62
REST OF CALIFORNIA (CA)	$798.86	$798.86
COLORADO (CO)	$807.35	$807.35
CONNECTICUT (CT)	$850.93	$850.93
DC + MD/VA SUBURBS (DC)	$888.52	$888.52
DELAWARE (DE)	$790.23	$790.23
FORT LAUDERDALE (FL)	$873.06	$873.06
MIAMI (FL)	$942.95	$942.95
REST OF FLORIDA (FL)	$829.05	$829.05
ATLANTA (GA)	$823.91	$823.91
REST OF GEORGIA (GA)	$782.29	$782.29
HAWAII, GUAM (HI)	$808.88	$808.88
IOWA (IA)	$722.47	$722.47
IDAHO (ID)	$730.49	$730.49
EAST ST. LOUIS (IL)	$860.71	$860.71
SUBURBAN CHICAGO (IL)	$877.27	$877.27
CHICAGO (IL)	$914.43	$914.43
REST OF ILLINOIS (IL)	$820.36	$820.36
INDIANA (IN)	$733.83	$733.83
KANSAS (KS)	$727.99	$727.99
KENTUCKY (KY)	$757.92	$757.92
NEW ORLEANS (LA)	$793.23	$793.23
REST OF LOUISIANA (LA)	$760.27	$760.27
METROPOLITAN BOSTON (MA)	$869.64	$869.64
REST OF MASSACHUSETTS (MA)	$806.76	$806.76
BALTIMORE/SURR. CNTYS (MD)	$850.34	$850.34
REST OF MARYLAND (MD)	$801.49	$801.49
SOUTHERN MAINE (ME)	$766.56	$766.56
REST OF MAINE (ME)	$743.08	$743.08
DETROIT (MI)	$847.39	$847.39
REST OF MICHIGAN (MI)	$783.68	$783.68
MINNESOTA (MN)	$750.41	$750.41
METROPOLITAN ST. LOUIS (MO)	$785.43	$785.43
METROPOLITAN KANSAS CITY (MO)	$779.16	$779.16
REST OF MISSOURI (MO)	$754.27	$754.27
MISSISSIPPI (MS)	$734.09	$734.09
MONTANA** (MT)	$800.45	$800.45
NORTH CAROLINA (NC)	$748.67	$748.67
NORTH DAKOTA** (ND)	$750.42	$750.42
NEBRASKA (NE)	$723.42	$723.42
NEW HAMPSHIRE (NH)	$803.18	$803.18
NORTHERN NJ (NJ)	$882.52	$882.52
REST OF NEW JERSEY (NJ)	$854.10	$854.10
NEW MEXICO (NM)	$791.05	$791.05
NEVADA** (NV)	$786.83	$786.83
MANHATTAN (NY)	$927.33	$927.33
NYC SUBURBS/LONG ISLAND (NY)	$958.87	$958.87
POUGHKPSIE/N NYC SUBURBS (NY)	$866.59	$866.59
QUEENS (NY)	$921.56	$921.56
REST OF NEW YORK (NY)	$759.52	$759.52
OHIO (OH)	$773.46	$773.46
OKLAHOMA (OK)	$747.54	$747.54
PORTLAND (OR)	$820.84	$820.84
REST OF OREGON (OR)	$774.24	$774.24
METROPOLITAN PHILADELPHIA (PA)	$837.18	$837.18
REST OF PENNSYLVANIA (PA)	$769.73	$769.73
PUERTO RICO (PR)	$802.87	$802.87
RHODE ISLAND (RI)	$809.58	$809.58
SOUTH CAROLINA (SC)	$763.63	$763.63
SOUTH DAKOTA** (SD)	$744.51	$744.51
TENNESSEE (TN)	$732.38	$732.38
BRAZORIA (TX)	$782.32	$782.32
DALLAS (TX)	$790.91	$790.91
GALVESTON (TX)	$787.01	$787.01
HOUSTON (TX)	$833.32	$833.32
BEAUMONT (TX)	$765.82	$765.82
FORT WORTH (TX)	$788.80	$788.80
AUSTIN (TX)	$810.34	$810.34
REST OF TEXAS (TX)	$776.10	$776.10
UTAH (UT)	$772.80	$772.80
VIRGINIA (VA)	$770.34	$770.34
VIRGIN ISLANDS (VI)	$802.87	$802.87
VERMONT (VT)	$755.67	$755.67
SEATTLE (KING CNTY) (WA)	$877.60	$877.60
REST OF WASHINGTON (WA)	$802.53	$802.53
WISCONSIN (WI)	$728.70	$728.70
WEST VIRGINIA (WV)	$795.12	$795.12
WYOMING** (WY)	$778.65	$778.65

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 Physician Fee Schedule 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 furnished, to reflect local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, which is why the two amounts may differ, though for some codes they are the same.

RVUs — work 11.86, practice expense 9.58 (non-facility) / 9.58 (facility), malpractice 2.53 — × 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 beneficiary or secondary payer may owe the rest.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual conversion factor updates and budget-neutrality adjustments can shift fees from year to year.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does CPT 23490 show the same amount for non-facility and facility settings?

When the practice-expense RVUs are identical for both settings, the calculated allowed amount comes out the same, even though the underlying formula still applies separately to each setting.

Will my local Medicare payment match the national amount shown here?

Not necessarily. The national figure uses a GPCI value, but each locality has its own GPCI values, so the actual local allowed amount can be higher or lower.

Does this amount include what the patient owes?

No. The figure represents the total Medicare-allowed amount; Medicare generally pays 80% after the deductible, with the remainder being the patient's or secondary insurer's responsibility.

Can modifiers change the payment for this code?

Yes. Modifiers (e.g., bilateral, multiple procedure, or reduced services) can increase or decrease the allowed amount from what is shown here.

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.