Medicare Reimbursement for CPT 23620

CPT 23620 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated national Medicare allowed amount for this code, along with non-facility and facility rates, which can be adjusted for a specific locality.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$309.63	$271.55
ALASKA* (AK)	$357.35	$316.79
ALABAMA (AL)	$276.16	$242.84
ARKANSAS (AR)	$271.95	$239.24
ARIZONA (AZ)	$300.72	$263.82
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$393.93	$340.24
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$401.42	$346.51
OXNARD-THOUSAND OAKS-VENTURA (CA)	$343.83	$298.83
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$345.81	$300.77
NAPA (CA)	$373.35	$323.17
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$394.49	$340.80
VALLEJO (CA)	$372.53	$322.35
BAKERSFIELD (CA)	$324.81	$283.08
CHICO (CA)	$323.43	$281.70
FRESNO (CA)	$323.43	$281.70
HANFORD-CORCORAN (CA)	$323.43	$281.70
MADERA (CA)	$323.43	$281.70
MERCED (CA)	$323.43	$281.70
MODESTO (CA)	$323.43	$281.70
REDDING (CA)	$323.43	$281.70
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$328.81	$287.07
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$339.06	$294.78
SALINAS (CA)	$337.81	$293.68
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$403.74	$348.83
SANTA CRUZ-WATSONVILLE (CA)	$348.72	$302.46
SANTA ROSA-PETALUMA (CA)	$352.20	$305.44
STOCKTON (CA)	$323.43	$281.70
VISALIA (CA)	$323.43	$281.70
YUBA CITY (CA)	$323.43	$281.70
EL CENTRO (CA)	$323.51	$281.78
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$345.59	$300.04
SAN LUIS OBISPO-PASO ROBLES (CA)	$332.45	$289.08
SANTA MARIA-SANTA BARBARA (CA)	$339.03	$294.63
REST OF CALIFORNIA (CA)	$323.43	$281.70
COLORADO (CO)	$320.39	$279.88
CONNECTICUT (CT)	$330.95	$289.94
DC + MD/VA SUBURBS (DC)	$353.34	$308.49
DELAWARE (DE)	$305.84	$268.22
FORT LAUDERDALE (FL)	$325.85	$287.28
MIAMI (FL)	$343.76	$304.12
REST OF FLORIDA (FL)	$308.80	$272.40
ATLANTA (GA)	$316.59	$277.90
REST OF GEORGIA (GA)	$290.18	$256.21
HAWAII, GUAM (HI)	$331.33	$288.04
IOWA (IA)	$281.73	$246.89
IDAHO (ID)	$284.04	$249.01
EAST ST. LOUIS (IL)	$309.78	$274.75
SUBURBAN CHICAGO (IL)	$328.76	$289.66
CHICAGO (IL)	$332.88	$294.62
REST OF ILLINOIS (IL)	$300.78	$266.02
INDIANA (IN)	$285.73	$250.43
KANSAS (KS)	$281.21	$246.78
KENTUCKY (KY)	$284.92	$251.07
NEW ORLEANS (LA)	$299.52	$263.69
REST OF LOUISIANA (LA)	$284.80	$251.10
METROPOLITAN BOSTON (MA)	$351.89	$306.43
REST OF MASSACHUSETTS (MA)	$318.68	$278.59
BALTIMORE/SURR. CNTYS (MD)	$330.23	$289.37
REST OF MARYLAND (MD)	$311.61	$273.07
SOUTHERN MAINE (ME)	$301.58	$263.84
REST OF MAINE (ME)	$286.53	$251.50
DETROIT (MI)	$313.74	$277.00
REST OF MICHIGAN (MI)	$293.53	$258.77
MINNESOTA (MN)	$303.95	$264.77
METROPOLITAN ST. LOUIS (MO)	$299.59	$263.34
METROPOLITAN KANSAS CITY (MO)	$296.45	$260.69
REST OF MISSOURI (MO)	$280.25	$247.42
MISSISSIPPI (MS)	$276.11	$243.33
MONTANA** (MT)	$309.59	$271.52
NORTH CAROLINA (NC)	$289.54	$254.02
NORTH DAKOTA** (ND)	$299.71	$261.63
NEBRASKA (NE)	$283.09	$247.94
NEW HAMPSHIRE (NH)	$316.14	$276.50
NORTHERN NJ (NJ)	$349.56	$305.39
REST OF NEW JERSEY (NJ)	$333.87	$292.29
NEW MEXICO (NM)	$295.57	$260.66
NEVADA** (NV)	$307.05	$268.93
MANHATTAN (NY)	$358.72	$314.47
NYC SUBURBS/LONG ISLAND (NY)	$368.91	$323.63
POUGHKPSIE/N NYC SUBURBS (NY)	$336.80	$295.11
QUEENS (NY)	$360.51	$315.50
REST OF NEW YORK (NY)	$294.18	$258.01
OHIO (OH)	$291.51	$256.75
OKLAHOMA (OK)	$283.46	$249.46
PORTLAND (OR)	$329.96	$287.66
REST OF OREGON (OR)	$303.83	$265.90
METROPOLITAN PHILADELPHIA (PA)	$322.95	$283.31
REST OF PENNSYLVANIA (PA)	$291.51	$256.55
PUERTO RICO (PR)	$311.68	$273.19
RHODE ISLAND (RI)	$316.32	$276.99
SOUTH CAROLINA (SC)	$291.18	$256.00
SOUTH DAKOTA** (SD)	$298.54	$260.46
TENNESSEE (TN)	$282.81	$248.19
BRAZORIA (TX)	$304.73	$267.00
DALLAS (TX)	$307.16	$269.24
GALVESTON (TX)	$305.95	$268.14
HOUSTON (TX)	$315.10	$277.29
BEAUMONT (TX)	$289.56	$254.91
FORT WORTH (TX)	$305.28	$267.74
AUSTIN (TX)	$320.05	$279.77
REST OF TEXAS (TX)	$297.31	$261.17
UTAH (UT)	$295.34	$259.55
VIRGINIA (VA)	$301.15	$263.72
VIRGIN ISLANDS (VI)	$311.68	$273.19
VERMONT (VT)	$299.28	$261.58
SEATTLE (KING CNTY) (WA)	$358.34	$311.62
REST OF WASHINGTON (WA)	$317.83	$277.74
WISCONSIN (WI)	$289.26	$252.78
WEST VIRGINIA (WV)	$289.35	$256.26
WYOMING** (WY)	$305.28	$267.21

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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 allowed 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 a Geographic Practice Cost Index (GPCI) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs, which is why the allowed amount differs between the two.

RVUs — work 2.49, practice expense 6.28 (non-facility) / 5.14 (facility), malpractice 0.5 — × 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.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual payment.
Annual budget-neutrality adjustments and conversion factor updates mean amounts change from year to year.
Always confirm final pricing with your Medicare Administrative Contractor (MAC) or official CMS fee schedule files.

Frequently asked

Why is the facility rate different from the non-facility rate for CPT 23620?

Facility and non-facility rates use different practice-expense RVUs because the cost of overhead (staff, equipment, supplies) differs depending on whether the service is performed in a facility setting like a hospital or in a non-facility setting like a physician's office.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare-allowed amount before the standard 80/20 cost-sharing split, deductible status, and any applicable modifiers or adjustments are applied.

Why might my locality's payment differ from the national amount shown here?

The national amount uses a GPCI value of 1.0 for each component. Actual locality-specific pricing applies that area's unique GPCIs for work, practice expense, and malpractice, which can raise or lower the final amount.

Will this code's fee change next year?

Yes, potentially. CMS updates RVUs, GPCIs, and the conversion factor annually, and budget-neutrality requirements can shift payment amounts for individual codes.

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.