Medicare Reimbursement for CPT Code 23545

This page covers the Medicare Physician Fee Schedule (PFS) allowed amount for CPT code 23545, a procedure code maintained by the AMA. Because the full code descriptor is proprietary, it is referred to generically here. The figures shown reflect the national PFS estimate and locality-adjusted amounts for both non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$502.02	$426.20
ALASKA* (AK)	$568.93	$488.18
ALABAMA (AL)	$444.64	$378.30
ARKANSAS (AR)	$437.42	$372.30
ARIZONA (AZ)	$486.78	$413.31
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$645.39	$538.49
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$657.90	$548.57
OXNARD-THOUSAND OAKS-VENTURA (CA)	$560.71	$471.09
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$563.65	$473.96
NAPA (CA)	$610.75	$510.82
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$646.34	$539.43
VALLEJO (CA)	$609.40	$509.46
BAKERSFIELD (CA)	$528.12	$445.02
CHICO (CA)	$525.87	$442.77
FRESNO (CA)	$525.87	$442.77
HANFORD-CORCORAN (CA)	$525.87	$442.77
MADERA (CA)	$525.87	$442.77
MERCED (CA)	$525.87	$442.77
MODESTO (CA)	$525.87	$442.77
REDDING (CA)	$525.87	$442.77
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$534.77	$451.67
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$552.29	$464.12
SALINAS (CA)	$550.29	$462.41
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$661.75	$552.42
SANTA CRUZ-WATSONVILLE (CA)	$569.48	$477.36
SANTA ROSA-PETALUMA (CA)	$575.20	$482.10
STOCKTON (CA)	$525.87	$442.77
VISALIA (CA)	$525.87	$442.77
YUBA CITY (CA)	$525.87	$442.77
EL CENTRO (CA)	$526.01	$442.91
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$563.76	$473.08
SAN LUIS OBISPO-PASO ROBLES (CA)	$541.47	$455.11
SANTA MARIA-SANTA BARBARA (CA)	$552.49	$464.08
REST OF CALIFORNIA (CA)	$525.87	$442.77
COLORADO (CO)	$520.50	$439.83
CONNECTICUT (CT)	$538.00	$456.34
DC + MD/VA SUBURBS (DC)	$575.74	$486.42
DELAWARE (DE)	$495.42	$420.51
FORT LAUDERDALE (FL)	$529.13	$452.33
MIAMI (FL)	$559.28	$480.35
REST OF FLORIDA (FL)	$500.00	$427.52
ATLANTA (GA)	$513.73	$436.69
REST OF GEORGIA (GA)	$468.16	$400.53
HAWAII, GUAM (HI)	$540.04	$453.83
IOWA (IA)	$454.47	$385.09
IDAHO (ID)	$458.39	$388.63
EAST ST. LOUIS (IL)	$501.11	$431.35
SUBURBAN CHICAGO (IL)	$533.99	$456.13
CHICAGO (IL)	$540.51	$464.31
REST OF ILLINOIS (IL)	$486.07	$416.84
INDIANA (IN)	$461.29	$391.00
KANSAS (KS)	$453.44	$384.90
KENTUCKY (KY)	$459.40	$391.99
NEW ORLEANS (LA)	$484.38	$413.04
REST OF LOUISIANA (LA)	$459.14	$392.04
METROPOLITAN BOSTON (MA)	$573.91	$483.38
REST OF MASSACHUSETTS (MA)	$517.40	$437.56
BALTIMORE/SURR. CNTYS (MD)	$536.85	$455.50
REST OF MARYLAND (MD)	$505.21	$428.48
SOUTHERN MAINE (ME)	$488.52	$413.38
REST OF MAINE (ME)	$462.52	$392.76
DETROIT (MI)	$508.34	$435.17
REST OF MICHIGAN (MI)	$474.03	$404.81
MINNESOTA (MN)	$493.02	$415.00
METROPOLITAN ST. LOUIS (MO)	$484.66	$412.48
METROPOLITAN KANSAS CITY (MO)	$479.25	$408.06
REST OF MISSOURI (MO)	$451.24	$385.88
MISSISSIPPI (MS)	$444.36	$379.08
MONTANA** (MT)	$501.96	$426.14
NORTH CAROLINA (NC)	$467.70	$396.96
NORTH DAKOTA** (ND)	$485.55	$409.73
NEBRASKA (NE)	$456.84	$386.86
NEW HAMPSHIRE (NH)	$513.42	$434.49
NORTHERN NJ (NJ)	$568.97	$481.02
REST OF NEW JERSEY (NJ)	$542.54	$459.74
NEW MEXICO (NM)	$477.48	$407.95
NEVADA** (NV)	$497.75	$421.85
MANHATTAN (NY)	$584.16	$496.06
NYC SUBURBS/LONG ISLAND (NY)	$601.47	$511.32
POUGHKPSIE/N NYC SUBURBS (NY)	$547.32	$464.29
QUEENS (NY)	$587.43	$497.81
REST OF NEW YORK (NY)	$475.65	$403.62
OHIO (OH)	$470.68	$401.46
OKLAHOMA (OK)	$457.02	$389.31
PORTLAND (OR)	$536.97	$452.73
REST OF OREGON (OR)	$492.33	$416.81
METROPOLITAN PHILADELPHIA (PA)	$524.25	$445.32
REST OF PENNSYLVANIA (PA)	$470.75	$401.14
PUERTO RICO (PR)	$505.59	$428.94
RHODE ISLAND (RI)	$513.11	$434.79
SOUTH CAROLINA (SC)	$470.29	$400.23
SOUTH DAKOTA** (SD)	$483.61	$407.79
TENNESSEE (TN)	$456.17	$387.25
BRAZORIA (TX)	$493.54	$418.41
DALLAS (TX)	$497.63	$422.12
GALVESTON (TX)	$495.60	$420.31
HOUSTON (TX)	$510.79	$435.50
BEAUMONT (TX)	$467.40	$398.40
FORT WORTH (TX)	$494.37	$419.61
AUSTIN (TX)	$520.12	$439.90
REST OF TEXAS (TX)	$480.83	$408.87
UTAH (UT)	$477.42	$406.15
VIRGINIA (VA)	$487.70	$413.17
VIRGIN ISLANDS (VI)	$505.59	$428.94
VERMONT (VT)	$484.69	$409.63
SEATTLE (KING CNTY) (WA)	$584.86	$491.83
REST OF WASHINGTON (WA)	$516.06	$436.23
WISCONSIN (WI)	$467.60	$394.96
WEST VIRGINIA (WV)	$466.45	$400.56
WYOMING** (WY)	$494.81	$418.99

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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 — assigned to each code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is performed, reflecting local cost differences. The locality-adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility settings use different practice-expense RVUs, since facility settings assume some costs are borne by the facility rather than the billing physician.

RVUs — work 3.34, practice expense 10.86 (non-facility) / 8.59 (facility), malpractice 0.83 — × 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 payer is responsible for the remainder.
Modifiers, sequestration, multiple-procedure reductions, and annual budget-neutrality adjustments can change the actual paid amount.
Locality-specific GPCIs mean actual payment varies by where the service is furnished.
Always verify the current fee schedule amount and any applicable edits with your Medicare Administrative Contractor (MAC).

Frequently asked

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

The practice-expense RVU is lower in the facility setting because overhead costs like equipment and staff are assumed to be covered by the facility (e.g., hospital) rather than the billing provider's own practice.

Why does the payment amount change by locality?

Medicare applies Geographic Practice Cost Indices (GPCIs) to each RVU component to account for regional differences in wages, rent, and malpractice costs before applying the conversion factor.

Does this figure represent what Medicare will actually pay?

No. It is the PFS allowed amount estimate. Medicare generally reimburses 80% of this amount after the deductible is met, and the final payment can be affected by modifiers, sequestration, and other adjustments.

Where can I find the official rate for my area?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules, which should be used to confirm the exact allowed amount for billing purposes.

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.