Medicare Reimbursement for CPT Code 23600
CPT code 23600 is a procedure code defined by the American Medical Association; because CPT descriptors are licensed content, a text description is not reproduced here. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for locality, with separate figures for non-facility and facility settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $381.10 | $332.00 |
| ALASKA* (AK) | $437.97 | $385.68 |
| ALABAMA (AL) | $339.40 | $296.44 |
| ARKANSAS (AR) | $334.16 | $291.98 |
| ARIZONA (AZ) | $370.02 | $322.44 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $486.46 | $417.23 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $495.77 | $424.97 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $424.00 | $365.97 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $426.38 | $368.29 |
| NAPA (CA) | $460.84 | $396.12 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $487.15 | $417.92 |
| VALLEJO (CA) | $459.84 | $395.13 |
| BAKERSFIELD (CA) | $400.23 | $346.42 |
| CHICO (CA) | $398.55 | $344.74 |
| FRESNO (CA) | $398.55 | $344.74 |
| HANFORD-CORCORAN (CA) | $398.55 | $344.74 |
| MADERA (CA) | $398.55 | $344.74 |
| MERCED (CA) | $398.55 | $344.74 |
| MODESTO (CA) | $398.55 | $344.74 |
| REDDING (CA) | $398.55 | $344.74 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $405.11 | $351.29 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $418.02 | $360.92 |
| SALINAS (CA) | $416.48 | $359.57 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $498.60 | $427.80 |
| SANTA CRUZ-WATSONVILLE (CA) | $430.22 | $370.57 |
| SANTA ROSA-PETALUMA (CA) | $434.52 | $374.23 |
| STOCKTON (CA) | $398.55 | $344.74 |
| VISALIA (CA) | $398.55 | $344.74 |
| YUBA CITY (CA) | $398.55 | $344.74 |
| EL CENTRO (CA) | $398.65 | $344.84 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $426.23 | $367.51 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $409.85 | $353.93 |
| SANTA MARIA-SANTA BARBARA (CA) | $418.03 | $360.78 |
| REST OF CALIFORNIA (CA) | $398.55 | $344.74 |
| COLORADO (CO) | $394.64 | $342.40 |
| CONNECTICUT (CT) | $407.58 | $354.70 |
| DC + MD/VA SUBURBS (DC) | $435.48 | $377.64 |
| DELAWARE (DE) | $376.38 | $327.87 |
| FORT LAUDERDALE (FL) | $400.98 | $351.25 |
| MIAMI (FL) | $423.03 | $371.92 |
| REST OF FLORIDA (FL) | $379.79 | $332.85 |
| ATLANTA (GA) | $389.70 | $339.81 |
| REST OF GEORGIA (GA) | $356.63 | $312.83 |
| HAWAII, GUAM (HI) | $408.54 | $352.71 |
| IOWA (IA) | $346.47 | $301.55 |
| IDAHO (ID) | $349.34 | $304.17 |
| EAST ST. LOUIS (IL) | $380.73 | $335.56 |
| SUBURBAN CHICAGO (IL) | $404.62 | $354.19 |
| CHICAGO (IL) | $409.49 | $360.14 |
| REST OF ILLINOIS (IL) | $369.71 | $324.88 |
| INDIANA (IN) | $351.44 | $305.93 |
| KANSAS (KS) | $345.76 | $301.38 |
| KENTUCKY (KY) | $350.19 | $306.55 |
| NEW ORLEANS (LA) | $368.37 | $322.16 |
| REST OF LOUISIANA (LA) | $350.02 | $306.57 |
| METROPOLITAN BOSTON (MA) | $433.87 | $375.25 |
| REST OF MASSACHUSETTS (MA) | $392.47 | $340.76 |
| BALTIMORE/SURR. CNTYS (MD) | $406.69 | $354.00 |
| REST OF MARYLAND (MD) | $383.57 | $333.88 |
| SOUTHERN MAINE (ME) | $371.22 | $322.56 |
| REST OF MAINE (ME) | $352.37 | $307.20 |
| DETROIT (MI) | $385.88 | $338.50 |
| REST OF MICHIGAN (MI) | $360.86 | $316.04 |
| MINNESOTA (MN) | $374.38 | $323.86 |
| METROPOLITAN ST. LOUIS (MO) | $368.53 | $321.78 |
| METROPOLITAN KANSAS CITY (MO) | $364.60 | $318.50 |
| REST OF MISSOURI (MO) | $344.30 | $301.98 |
| MISSISSIPPI (MS) | $339.25 | $296.97 |
| MONTANA** (MT) | $381.06 | $331.96 |
| NORTH CAROLINA (NC) | $356.14 | $310.33 |
| NORTH DAKOTA** (ND) | $369.00 | $319.90 |
| NEBRASKA (NE) | $348.19 | $302.87 |
| NEW HAMPSHIRE (NH) | $389.33 | $338.22 |
| NORTHERN NJ (NJ) | $430.71 | $373.76 |
| REST OF NEW JERSEY (NJ) | $411.18 | $357.56 |
| NEW MEXICO (NM) | $363.38 | $318.36 |
| NEVADA** (NV) | $377.96 | $328.82 |
| MANHATTAN (NY) | $441.89 | $384.84 |
| NYC SUBURBS/LONG ISLAND (NY) | $454.51 | $396.13 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $414.76 | $361.00 |
| QUEENS (NY) | $444.21 | $386.18 |
| REST OF NEW YORK (NY) | $361.91 | $315.27 |
| OHIO (OH) | $358.40 | $313.57 |
| OKLAHOMA (OK) | $348.43 | $304.59 |
| PORTLAND (OR) | $406.63 | $352.08 |
| REST OF OREGON (OR) | $374.00 | $325.10 |
| METROPOLITAN PHILADELPHIA (PA) | $397.58 | $346.46 |
| REST OF PENNSYLVANIA (PA) | $358.43 | $313.36 |
| PUERTO RICO (PR) | $383.69 | $334.05 |
| RHODE ISLAND (RI) | $389.44 | $338.72 |
| SOUTH CAROLINA (SC) | $358.07 | $312.70 |
| SOUTH DAKOTA** (SD) | $367.58 | $318.48 |
| TENNESSEE (TN) | $347.75 | $303.12 |
| BRAZORIA (TX) | $375.04 | $326.38 |
| DALLAS (TX) | $378.04 | $329.14 |
| GALVESTON (TX) | $376.54 | $327.79 |
| HOUSTON (TX) | $387.71 | $338.95 |
| BEAUMONT (TX) | $356.00 | $311.32 |
| FORT WORTH (TX) | $375.68 | $327.26 |
| AUSTIN (TX) | $394.22 | $342.28 |
| REST OF TEXAS (TX) | $365.72 | $319.13 |
| UTAH (UT) | $363.25 | $317.10 |
| VIRGINIA (VA) | $370.65 | $322.38 |
| VIRGIN ISLANDS (VI) | $383.69 | $334.05 |
| VERMONT (VT) | $368.41 | $319.80 |
| SEATTLE (KING CNTY) (WA) | $441.94 | $381.69 |
| REST OF WASHINGTON (WA) | $391.44 | $339.74 |
| WISCONSIN (WI) | $355.96 | $308.93 |
| WEST VIRGINIA (WV) | $355.45 | $312.78 |
| WYOMING** (WY) | $375.81 | $326.71 |
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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 fee schedule 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 a Geographic Practice Cost Index (GPCI) specific to the locality where the service is furnished, to reflect regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the dollar amount. Practice expense RVUs differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings, which is why two separate allowed amounts are typically shown for the same code.
RVUs — work 2.93, practice expense 7.87 (non-facility) / 6.4 (facility), malpractice 0.61 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- This is an estimate only, not a guarantee of payment or coverage.
- Medicare typically pays 80% of the allowed amount after the patient's deductible is met; the patient or secondary payer is generally responsible for the remainder.
- Actual payment can vary by locality, applicable modifiers, place of service, sequestration reductions, and annual budget-neutrality adjustments.
- Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.
Frequently asked
Why are there different amounts for non-facility and facility settings?
The practice expense RVU component differs depending on whether the service is performed in a non-facility setting (like a physician's office, where the practice bears more overhead cost) or a facility setting (like a hospital, where the facility bears more of the overhead). This results in two different allowed amounts for the same code.
Why might my locality's amount differ from the national figure?
Each locality has its own Geographic Practice Cost Indices (GPCIs) for work, practice expense, and malpractice, which adjust the RVUs to reflect local cost-of-living and practice cost differences before the conversion factor is applied.
Does this amount reflect what Medicare will actually pay?
No. This figure is the Medicare-allowed amount estimate before patient responsibility, deductible status, modifiers, sequestration, and other adjustments are applied. The actual payment can differ.
Can modifiers change this amount?
Yes. Certain modifiers (e.g., bilateral procedure, reduced services, assistant surgeon) can increase or decrease the allowed amount relative to the base fee schedule rate 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.
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