Medicare Reimbursement for CPT 23530

CPT 23530 is a procedure code defined by the American Medical Association; the descriptor itself is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and, where available, by locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$549.11	$549.11
ALASKA* (AK)	$664.28	$664.28
ALABAMA (AL)	$495.01	$495.01
ARKANSAS (AR)	$488.32	$488.32
ARIZONA (AZ)	$533.82	$533.82
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$646.88	$646.88
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$657.23	$657.23
OXNARD-THOUSAND OAKS-VENTURA (CA)	$582.80	$582.80
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$588.33	$588.33
NAPA (CA)	$619.97	$619.97
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$648.63	$648.63
VALLEJO (CA)	$617.45	$617.45
BAKERSFIELD (CA)	$558.03	$558.03
CHICO (CA)	$553.78	$553.78
FRESNO (CA)	$553.78	$553.78
HANFORD-CORCORAN (CA)	$553.78	$553.78
MADERA (CA)	$553.78	$553.78
MERCED (CA)	$553.78	$553.78
MODESTO (CA)	$553.78	$553.78
REDDING (CA)	$553.78	$553.78
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$570.33	$570.33
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$575.44	$575.44
SALINAS (CA)	$573.21	$573.21
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$664.38	$664.38
SANTA CRUZ-WATSONVILLE (CA)	$585.01	$585.01
SANTA ROSA-PETALUMA (CA)	$590.50	$590.50
STOCKTON (CA)	$553.78	$553.78
VISALIA (CA)	$553.78	$553.78
YUBA CITY (CA)	$553.78	$553.78
EL CENTRO (CA)	$554.04	$554.04
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$582.68	$582.68
SAN LUIS OBISPO-PASO ROBLES (CA)	$564.71	$564.71
SANTA MARIA-SANTA BARBARA (CA)	$574.26	$574.26
REST OF CALIFORNIA (CA)	$553.78	$553.78
COLORADO (CO)	$557.04	$557.04
CONNECTICUT (CT)	$584.35	$584.35
DC + MD/VA SUBURBS (DC)	$613.32	$613.32
DELAWARE (DE)	$542.08	$542.08
FORT LAUDERDALE (FL)	$593.98	$593.98
MIAMI (FL)	$638.18	$638.18
REST OF FLORIDA (FL)	$563.80	$563.80
ATLANTA (GA)	$564.25	$564.25
REST OF GEORGIA (GA)	$531.54	$531.54
HAWAII, GUAM (HI)	$562.28	$562.28
IOWA (IA)	$496.49	$496.49
IDAHO (ID)	$501.67	$501.67
EAST ST. LOUIS (IL)	$580.93	$580.93
SUBURBAN CHICAGO (IL)	$597.39	$597.39
CHICAGO (IL)	$618.70	$618.70
REST OF ILLINOIS (IL)	$555.96	$555.96
INDIANA (IN)	$504.12	$504.12
KANSAS (KS)	$499.20	$499.20
KENTUCKY (KY)	$516.52	$516.52
NEW ORLEANS (LA)	$541.11	$541.11
REST OF LOUISIANA (LA)	$517.72	$517.72
METROPOLITAN BOSTON (MA)	$602.75	$602.75
REST OF MASSACHUSETTS (MA)	$556.04	$556.04
BALTIMORE/SURR. CNTYS (MD)	$583.75	$583.75
REST OF MARYLAND (MD)	$550.38	$550.38
SOUTHERN MAINE (ME)	$527.84	$527.84
REST OF MAINE (ME)	$509.33	$509.33
DETROIT (MI)	$575.50	$575.50
REST OF MICHIGAN (MI)	$533.63	$533.63
MINNESOTA (MN)	$520.27	$520.27
METROPOLITAN ST. LOUIS (MO)	$537.01	$537.01
METROPOLITAN KANSAS CITY (MO)	$532.42	$532.42
REST OF MISSOURI (MO)	$512.70	$512.70
MISSISSIPPI (MS)	$500.35	$500.35
MONTANA** (MT)	$549.01	$549.01
NORTH CAROLINA (NC)	$513.51	$513.51
NORTH DAKOTA** (ND)	$518.56	$518.56
NEBRASKA (NE)	$497.54	$497.54
NEW HAMPSHIRE (NH)	$553.10	$553.10
NORTHERN NJ (NJ)	$608.62	$608.62
REST OF NEW JERSEY (NJ)	$587.22	$587.22
NEW MEXICO (NM)	$538.35	$538.35
NEVADA** (NV)	$540.77	$540.77
MANHATTAN (NY)	$636.01	$636.01
NYC SUBURBS/LONG ISLAND (NY)	$656.82	$656.82
POUGHKPSIE/N NYC SUBURBS (NY)	$595.02	$595.02
QUEENS (NY)	$633.69	$633.69
REST OF NEW YORK (NY)	$521.12	$521.12
OHIO (OH)	$527.41	$527.41
OKLAHOMA (OK)	$510.44	$510.44
PORTLAND (OR)	$568.05	$568.05
REST OF OREGON (OR)	$532.82	$532.82
METROPOLITAN PHILADELPHIA (PA)	$573.84	$573.84
REST OF PENNSYLVANIA (PA)	$525.44	$525.44
PUERTO RICO (PR)	$551.14	$551.14
RHODE ISLAND (RI)	$556.57	$556.57
SOUTH CAROLINA (SC)	$522.08	$522.08
SOUTH DAKOTA** (SD)	$514.96	$514.96
TENNESSEE (TN)	$502.16	$502.16
BRAZORIA (TX)	$537.45	$537.45
DALLAS (TX)	$542.98	$542.98
GALVESTON (TX)	$540.43	$540.43
HOUSTON (TX)	$568.62	$568.62
BEAUMONT (TX)	$522.58	$522.58
FORT WORTH (TX)	$541.11	$541.11
AUSTIN (TX)	$558.48	$558.48
REST OF TEXAS (TX)	$531.16	$531.16
UTAH (UT)	$528.61	$528.61
VIRGINIA (VA)	$529.67	$529.67
VIRGIN ISLANDS (VI)	$551.14	$551.14
VERMONT (VT)	$521.16	$521.16
SEATTLE (KING CNTY) (WA)	$609.57	$609.57
REST OF WASHINGTON (WA)	$553.45	$553.45
WISCONSIN (WI)	$502.84	$502.84
WEST VIRGINIA (WV)	$537.98	$537.98
WYOMING** (WY)	$535.74	$535.74

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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) assigned to a code: physician work, practice expense (PE), and malpractice (MP). Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different PE RVUs because overhead costs differ, which is why two amounts are often shown; for this code, the PE RVU is the same in both settings, so the resulting estimates match. These figures are recalculated each year as RVUs, GPCIs, and the conversion factor are updated.

RVUs — work 7.29, practice expense 7.61 (non-facility) / 7.61 (facility), malpractice 1.54 — × 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 patient or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, facility type, modifiers, multiple-procedure or bilateral adjustments, sequestration, and annual budget-neutrality adjustments.
Always confirm the current allowed amount and any applicable adjustments with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

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

The practice expense RVU used in this fee calculation is identical for both settings for this code, so the non-facility and facility PFS amounts come out equal. This isn't the case for every code.

Why might the amount I was actually paid differ from the estimate on this page?

Actual payment depends on the specific locality's GPCIs, any modifiers appended to the claim, multiple-procedure reductions, sequestration, and year-to-year budget-neutrality adjustments that aren't reflected in a single national estimate.

Does this amount represent what Medicare pays, or what the patient owes?

The PFS amount shown is the total allowed amount. Medicare generally pays 80% of this after the deductible is met, with the remaining 20% typically owed by the patient or a secondary payer.

Where can I verify the official rate for my area?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules and can confirm the exact allowed amount, including any modifier-driven adjustments, for a given claim.

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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.