Medicare Reimbursement for CPT 23625

CPT 23625 is a physician procedure code reported for professional services under Medicare Part B. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for 2026, both at the national level and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$448.24	$377.43
ALASKA* (AK)	$520.39	$444.97
ALABAMA (AL)	$399.83	$337.87
ARKANSAS (AR)	$393.77	$332.94
ARIZONA (AZ)	$435.16	$366.55
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$560.98	$461.14
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$571.29	$469.18
OXNARD-THOUSAND OAKS-VENTURA (CA)	$492.81	$409.12
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$496.04	$412.27
NAPA (CA)	$532.90	$439.58
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$561.98	$462.14
VALLEJO (CA)	$531.46	$438.14
BAKERSFIELD (CA)	$466.67	$389.06
CHICO (CA)	$464.26	$386.65
FRESNO (CA)	$464.26	$386.65
HANFORD-CORCORAN (CA)	$464.26	$386.65
MADERA (CA)	$464.26	$386.65
MERCED (CA)	$464.26	$386.65
MODESTO (CA)	$464.26	$386.65
REDDING (CA)	$464.26	$386.65
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$473.71	$396.10
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$485.91	$403.55
SALINAS (CA)	$484.10	$402.03
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$575.38	$473.27
SANTA CRUZ-WATSONVILLE (CA)	$498.73	$412.70
SANTA ROSA-PETALUMA (CA)	$503.65	$416.69
STOCKTON (CA)	$464.26	$386.65
VISALIA (CA)	$464.26	$386.65
YUBA CITY (CA)	$464.26	$386.65
EL CENTRO (CA)	$464.40	$386.80
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$494.69	$410.01
SAN LUIS OBISPO-PASO ROBLES (CA)	$476.52	$395.87
SANTA MARIA-SANTA BARBARA (CA)	$485.69	$403.13
REST OF CALIFORNIA (CA)	$464.26	$386.65
COLORADO (CO)	$461.66	$386.32
CONNECTICUT (CT)	$479.05	$402.79
DC + MD/VA SUBURBS (DC)	$509.55	$426.14
DELAWARE (DE)	$442.52	$372.56
FORT LAUDERDALE (FL)	$475.70	$403.97
MIAMI (FL)	$504.88	$431.16
REST OF FLORIDA (FL)	$450.47	$382.78
ATLANTA (GA)	$459.11	$387.17
REST OF GEORGIA (GA)	$423.08	$359.91
HAWAII, GUAM (HI)	$474.94	$394.43
IOWA (IA)	$406.27	$341.48
IDAHO (ID)	$409.93	$344.79
EAST ST. LOUIS (IL)	$455.22	$390.08
SUBURBAN CHICAGO (IL)	$479.57	$406.85
CHICAGO (IL)	$488.67	$417.50
REST OF ILLINOIS (IL)	$439.97	$375.32
INDIANA (IN)	$412.31	$346.67
KANSAS (KS)	$406.28	$342.27
KENTUCKY (KY)	$414.08	$351.13
NEW ORLEANS (LA)	$435.41	$368.78
REST OF LOUISIANA (LA)	$414.20	$351.54
METROPOLITAN BOSTON (MA)	$505.82	$421.27
REST OF MASSACHUSETTS (MA)	$459.53	$384.97
BALTIMORE/SURR. CNTYS (MD)	$478.17	$402.19
REST OF MARYLAND (MD)	$450.59	$378.93
SOUTHERN MAINE (ME)	$434.83	$364.65
REST OF MAINE (ME)	$414.31	$349.16
DETROIT (MI)	$458.42	$390.09
REST OF MICHIGAN (MI)	$427.22	$362.57
MINNESOTA (MN)	$435.82	$362.96
METROPOLITAN ST. LOUIS (MO)	$434.61	$367.20
METROPOLITAN KANSAS CITY (MO)	$430.16	$363.67
REST OF MISSOURI (MO)	$408.11	$347.07
MISSISSIPPI (MS)	$400.92	$339.95
MONTANA** (MT)	$448.18	$377.37
NORTH CAROLINA (NC)	$418.52	$352.45
NORTH DAKOTA** (ND)	$430.78	$359.97
NEBRASKA (NE)	$407.99	$342.64
NEW HAMPSHIRE (NH)	$456.26	$382.55
NORTHERN NJ (NJ)	$504.29	$422.16
REST OF NEW JERSEY (NJ)	$482.68	$405.35
NEW MEXICO (NM)	$430.47	$365.54
NEVADA** (NV)	$443.62	$372.74
MANHATTAN (NY)	$520.22	$437.94
NYC SUBURBS/LONG ISLAND (NY)	$535.89	$451.70
POUGHKPSIE/N NYC SUBURBS (NY)	$487.52	$409.99
QUEENS (NY)	$521.70	$438.00
REST OF NEW YORK (NY)	$425.25	$357.98
OHIO (OH)	$423.66	$359.01
OKLAHOMA (OK)	$411.16	$347.93
PORTLAND (OR)	$474.52	$395.85
REST OF OREGON (OR)	$438.37	$367.84
METROPOLITAN PHILADELPHIA (PA)	$468.01	$394.30
REST OF PENNSYLVANIA (PA)	$423.23	$358.23
PUERTO RICO (PR)	$450.94	$379.35
RHODE ISLAND (RI)	$457.02	$383.87
SOUTH CAROLINA (SC)	$422.15	$356.72
SOUTH DAKOTA** (SD)	$428.72	$357.91
TENNESSEE (TN)	$408.67	$344.31
BRAZORIA (TX)	$440.28	$370.10
DALLAS (TX)	$444.13	$373.60
GALVESTON (TX)	$442.26	$371.94
HOUSTON (TX)	$458.36	$388.05
BEAUMONT (TX)	$420.48	$356.04
FORT WORTH (TX)	$441.66	$371.84
AUSTIN (TX)	$461.70	$386.78
REST OF TEXAS (TX)	$430.84	$363.64
UTAH (UT)	$428.13	$361.57
VIRGINIA (VA)	$434.75	$365.14
VIRGIN ISLANDS (VI)	$450.94	$379.35
VERMONT (VT)	$430.87	$360.77
SEATTLE (KING CNTY) (WA)	$514.29	$427.41
REST OF WASHINGTON (WA)	$458.07	$383.51
WISCONSIN (WI)	$415.92	$348.08
WEST VIRGINIA (WV)	$423.54	$362.01
WYOMING** (WY)	$440.60	$369.79

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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 PFS payment amounts are built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. 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 Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because the resource costs differ depending on where the service is furnished.

RVUs — work 4, practice expense 8.54 (non-facility) / 6.42 (facility), malpractice 0.88 — × 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 patient meets their Part B deductible; 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.
Local Medicare Administrative Contractor (MAC) policies and locality-specific GPCIs may result in amounts that differ from this estimate.
CPT code descriptors are proprietary to the AMA and are not reproduced here; consult official CPT reference materials for the full code description.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The practice-expense RVU component is lower in the facility setting because the facility (such as a hospital) absorbs certain overhead costs, while in non-facility settings the physician's practice bears those costs directly.

Does this amount apply in every state or region?

No. The national figure is a baseline; actual payment is adjusted using locality-specific GPCIs, so the final allowed amount will vary by geographic area.

Will the patient's copay be exactly 20% of the listed amount?

Generally, after the Part B deductible is met, Medicare pays 80% of the allowed amount and the patient or supplemental insurance covers the remaining 20%, though modifiers and other adjustments can affect this.

Why might my actual Medicare payment differ from this estimate?

Factors such as applied modifiers, sequestration cuts, multiple-procedure payment reductions, and yearly budget-neutrality adjustments to the conversion factor can all cause the actual payment to differ from the estimate shown here.

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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.