Medicare Reimbursement for CPT 23570

CPT 23570 is a procedure code reported to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code at the national level and by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$265.87	$252.84
ALASKA* (AK)	$308.50	$294.63
ALABAMA (AL)	$237.39	$225.99
ARKANSAS (AR)	$233.81	$222.63
ARIZONA (AZ)	$258.24	$245.61
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$335.22	$316.85
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$341.48	$322.69
OXNARD-THOUSAND OAKS-VENTURA (CA)	$293.65	$278.26
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$295.47	$280.06
NAPA (CA)	$318.11	$300.94
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$335.75	$317.38
VALLEJO (CA)	$317.34	$300.17
BAKERSFIELD (CA)	$277.83	$263.56
CHICO (CA)	$276.53	$262.26
FRESNO (CA)	$276.53	$262.26
HANFORD-CORCORAN (CA)	$276.53	$262.26
MADERA (CA)	$276.53	$262.26
MERCED (CA)	$276.53	$262.26
MODESTO (CA)	$276.53	$262.26
REDDING (CA)	$276.53	$262.26
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$281.59	$267.31
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$289.61	$274.46
SALINAS (CA)	$288.53	$273.43
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$343.66	$324.87
SANTA CRUZ-WATSONVILLE (CA)	$297.47	$281.64
SANTA ROSA-PETALUMA (CA)	$300.42	$284.42
STOCKTON (CA)	$276.53	$262.26
VISALIA (CA)	$276.53	$262.26
YUBA CITY (CA)	$276.53	$262.26
EL CENTRO (CA)	$276.61	$262.34
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$294.96	$279.38
SAN LUIS OBISPO-PASO ROBLES (CA)	$283.99	$269.15
SANTA MARIA-SANTA BARBARA (CA)	$289.51	$274.33
REST OF CALIFORNIA (CA)	$276.53	$262.26
COLORADO (CO)	$274.45	$260.59
CONNECTICUT (CT)	$284.05	$270.02
DC + MD/VA SUBURBS (DC)	$302.65	$287.30
DELAWARE (DE)	$262.59	$249.72
FORT LAUDERDALE (FL)	$280.81	$267.61
MIAMI (FL)	$296.98	$283.42
REST OF FLORIDA (FL)	$266.14	$253.69
ATLANTA (GA)	$272.03	$258.80
REST OF GEORGIA (GA)	$250.16	$238.54
HAWAII, GUAM (HI)	$283.01	$268.20
IOWA (IA)	$241.67	$229.75
IDAHO (ID)	$243.73	$231.75
EAST ST. LOUIS (IL)	$267.92	$255.94
SUBURBAN CHICAGO (IL)	$283.21	$269.83
CHICAGO (IL)	$287.61	$274.51
REST OF ILLINOIS (IL)	$259.63	$247.73
INDIANA (IN)	$245.15	$233.07
KANSAS (KS)	$241.44	$229.67
KENTUCKY (KY)	$245.29	$233.71
NEW ORLEANS (LA)	$257.78	$245.52
REST OF LOUISIANA (LA)	$245.28	$233.75
METROPOLITAN BOSTON (MA)	$300.92	$285.37
REST OF MASSACHUSETTS (MA)	$273.10	$259.38
BALTIMORE/SURR. CNTYS (MD)	$283.48	$269.50
REST OF MARYLAND (MD)	$267.43	$254.25
SOUTHERN MAINE (ME)	$258.52	$245.61
REST OF MAINE (ME)	$246.07	$234.08
DETROIT (MI)	$270.57	$258.00
REST OF MICHIGAN (MI)	$252.81	$240.92
MINNESOTA (MN)	$259.85	$246.44
METROPOLITAN ST. LOUIS (MO)	$257.58	$245.18
METROPOLITAN KANSAS CITY (MO)	$254.94	$242.70
REST OF MISSOURI (MO)	$241.54	$230.31
MISSISSIPPI (MS)	$237.68	$226.46
MONTANA** (MT)	$265.84	$252.81
NORTH CAROLINA (NC)	$248.59	$236.44
NORTH DAKOTA** (ND)	$256.55	$243.52
NEBRASKA (NE)	$242.76	$230.74
NEW HAMPSHIRE (NH)	$271.02	$257.46
NORTHERN NJ (NJ)	$299.51	$284.40
REST OF NEW JERSEY (NJ)	$286.42	$272.19
NEW MEXICO (NM)	$254.64	$242.69
NEVADA** (NV)	$263.42	$250.38
MANHATTAN (NY)	$308.07	$292.93
NYC SUBURBS/LONG ISLAND (NY)	$317.00	$301.52
POUGHKPSIE/N NYC SUBURBS (NY)	$289.09	$274.83
QUEENS (NY)	$309.28	$293.88
REST OF NEW YORK (NY)	$252.54	$240.17
OHIO (OH)	$250.92	$239.02
OKLAHOMA (OK)	$243.82	$232.19
PORTLAND (OR)	$282.32	$267.85
REST OF OREGON (OR)	$260.52	$247.54
METROPOLITAN PHILADELPHIA (PA)	$277.39	$263.83
REST OF PENNSYLVANIA (PA)	$250.79	$238.83
PUERTO RICO (PR)	$267.54	$254.37
RHODE ISLAND (RI)	$271.36	$257.90
SOUTH CAROLINA (SC)	$250.34	$238.31
SOUTH DAKOTA** (SD)	$255.45	$242.42
TENNESSEE (TN)	$242.83	$230.99
BRAZORIA (TX)	$261.47	$248.56
DALLAS (TX)	$263.64	$250.67
GALVESTON (TX)	$262.57	$249.64
HOUSTON (TX)	$271.17	$258.24
BEAUMONT (TX)	$249.16	$237.30
FORT WORTH (TX)	$262.11	$249.27
AUSTIN (TX)	$274.29	$260.51
REST OF TEXAS (TX)	$255.51	$243.15
UTAH (UT)	$253.87	$241.62
VIRGINIA (VA)	$258.31	$245.50
VIRGIN ISLANDS (VI)	$267.54	$254.37
VERMONT (VT)	$256.38	$243.49
SEATTLE (KING CNTY) (WA)	$306.19	$290.21
REST OF WASHINGTON (WA)	$272.31	$258.59
WISCONSIN (WI)	$247.73	$235.25
WEST VIRGINIA (WV)	$249.93	$238.61
WYOMING** (WY)	$261.79	$248.76

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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 a dollar amount. Practice-expense RVUs differ between non-facility and facility settings because overhead costs (equipment, supplies, staff) are treated differently depending on where the service is furnished.

RVUs — work 2.3, practice expense 5.19 (non-facility) / 4.8 (facility), malpractice 0.47 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount 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, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual payment.
Locality-specific GPCIs mean the amount can vary meaningfully from the national figure shown here.
Always verify the final allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why is the facility amount different from the non-facility amount for CPT 23570?

The practice-expense RVU is lower in the facility setting because Medicare assumes the facility (e.g., hospital) — not the physician's office — bears costs like equipment, supplies, and staff time.

Does this page tell me what my practice will actually be paid?

No. It shows an estimated PFS allowed amount. Actual payment depends on your specific locality, any modifiers applied, the patient's deductible/coinsurance status, and other claim-specific factors.

Why do these amounts change every year?

CMS updates RVUs, GPCIs, and the conversion factor annually (and sometimes mid-year) to reflect updated cost data, policy changes, and statutory budget-neutrality requirements.

What should I do if a claim for CPT 23570 was paid less than expected?

Check the remittance advice for the specific MAC locality, applied modifiers, and any adjustment codes, and compare against your MAC's published fee schedule before appealing.

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.