Medicare Reimbursement for CPT 23650

CPT 23650 is a procedure code defined by the American Medical Association; its descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and by locality, separately for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$433.88	$367.74
ALASKA* (AK)	$497.98	$427.55
ALABAMA (AL)	$385.54	$327.68
ARKANSAS (AR)	$379.48	$322.67
ARIZONA (AZ)	$420.89	$356.81
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$548.60	$455.35
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$558.88	$463.52
OXNARD-THOUSAND OAKS-VENTURA (CA)	$479.84	$401.67
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$482.75	$404.51
NAPA (CA)	$520.37	$433.20
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$549.53	$456.28
VALLEJO (CA)	$519.02	$431.86
BAKERSFIELD (CA)	$453.34	$380.86
CHICO (CA)	$451.12	$378.63
FRESNO (CA)	$451.12	$378.63
HANFORD-CORCORAN (CA)	$451.12	$378.63
MADERA (CA)	$451.12	$378.63
MERCED (CA)	$451.12	$378.63
MODESTO (CA)	$451.12	$378.63
REDDING (CA)	$451.12	$378.63
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$459.91	$387.43
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$472.83	$395.92
SALINAS (CA)	$471.09	$394.44
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$562.69	$467.33
SANTA CRUZ-WATSONVILLE (CA)	$486.27	$405.92
SANTA ROSA-PETALUMA (CA)	$491.10	$409.89
STOCKTON (CA)	$451.12	$378.63
VISALIA (CA)	$451.12	$378.63
YUBA CITY (CA)	$451.12	$378.63
EL CENTRO (CA)	$451.25	$378.77
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$481.93	$402.84
SAN LUIS OBISPO-PASO ROBLES (CA)	$463.65	$388.33
SANTA MARIA-SANTA BARBARA (CA)	$472.79	$395.68
REST OF CALIFORNIA (CA)	$451.12	$378.63
COLORADO (CO)	$447.92	$377.55
CONNECTICUT (CT)	$464.38	$393.15
DC + MD/VA SUBURBS (DC)	$495.08	$417.17
DELAWARE (DE)	$428.19	$362.85
FORT LAUDERDALE (FL)	$459.80	$392.80
MIAMI (FL)	$487.71	$418.86
REST OF FLORIDA (FL)	$434.82	$371.60
ATLANTA (GA)	$444.39	$377.20
REST OF GEORGIA (GA)	$407.64	$348.65
HAWAII, GUAM (HI)	$462.29	$387.10
IOWA (IA)	$392.58	$332.06
IDAHO (ID)	$396.12	$335.27
EAST ST. LOUIS (IL)	$438.32	$377.48
SUBURBAN CHICAGO (IL)	$463.70	$395.78
CHICAGO (IL)	$471.61	$405.14
REST OF ILLINOIS (IL)	$423.93	$363.55
INDIANA (IN)	$398.51	$337.21
KANSAS (KS)	$392.30	$332.52
KENTUCKY (KY)	$399.18	$340.39
NEW ORLEANS (LA)	$420.40	$358.17
REST OF LOUISIANA (LA)	$399.19	$340.67
METROPOLITAN BOSTON (MA)	$492.14	$413.18
REST OF MASSACHUSETTS (MA)	$445.61	$375.97
BALTIMORE/SURR. CNTYS (MD)	$463.49	$392.53
REST OF MARYLAND (MD)	$436.28	$369.35
SOUTHERN MAINE (ME)	$421.15	$355.61
REST OF MAINE (ME)	$400.20	$339.35
DETROIT (MI)	$442.46	$378.64
REST OF MICHIGAN (MI)	$412.04	$351.66
MINNESOTA (MN)	$423.05	$355.00
METROPOLITAN ST. LOUIS (MO)	$419.94	$356.98
METROPOLITAN KANSAS CITY (MO)	$415.46	$353.36
REST OF MISSOURI (MO)	$392.93	$335.92
MISSISSIPPI (MS)	$386.20	$329.26
MONTANA** (MT)	$433.82	$367.69
NORTH CAROLINA (NC)	$404.45	$342.75
NORTH DAKOTA** (ND)	$417.61	$351.47
NEBRASKA (NE)	$394.39	$333.35
NEW HAMPSHIRE (NH)	$442.41	$373.56
NORTHERN NJ (NJ)	$489.63	$412.92
REST OF NEW JERSEY (NJ)	$467.96	$395.74
NEW MEXICO (NM)	$415.18	$354.54
NEVADA** (NV)	$429.60	$363.40
MANHATTAN (NY)	$504.52	$427.67
NYC SUBURBS/LONG ISLAND (NY)	$519.81	$441.18
POUGHKPSIE/N NYC SUBURBS (NY)	$472.50	$400.08
QUEENS (NY)	$506.41	$428.24
REST OF NEW YORK (NY)	$411.16	$348.34
OHIO (OH)	$408.73	$348.35
OKLAHOMA (OK)	$396.57	$337.51
PORTLAND (OR)	$461.07	$387.60
REST OF OREGON (OR)	$424.58	$358.71
METROPOLITAN PHILADELPHIA (PA)	$453.19	$384.34
REST OF PENNSYLVANIA (PA)	$408.46	$347.75
PUERTO RICO (PR)	$436.67	$369.81
RHODE ISLAND (RI)	$442.73	$374.41
SOUTH CAROLINA (SC)	$407.61	$346.50
SOUTH DAKOTA** (SD)	$415.69	$349.56
TENNESSEE (TN)	$394.66	$334.55
BRAZORIA (TX)	$426.15	$360.61
DALLAS (TX)	$429.86	$363.99
GALVESTON (TX)	$428.04	$362.37
HOUSTON (TX)	$443.05	$377.38
BEAUMONT (TX)	$405.69	$345.51
FORT WORTH (TX)	$427.30	$362.09
AUSTIN (TX)	$447.90	$377.93
REST OF TEXAS (TX)	$416.35	$353.59
UTAH (UT)	$413.59	$351.42
VIRGINIA (VA)	$420.87	$355.86
VIRGIN ISLANDS (VI)	$436.67	$369.81
VERMONT (VT)	$417.43	$351.96
SEATTLE (KING CNTY) (WA)	$500.80	$419.66
REST OF WASHINGTON (WA)	$444.28	$374.64
WISCONSIN (WI)	$402.68	$339.32
WEST VIRGINIA (WV)	$407.48	$350.01
WYOMING** (WY)	$426.76	$360.62

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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 — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is furnished. The geographically adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital, ASC) settings, which is why the two amounts differ. These figures are recalculated each year as RVUs, GPCIs, and the conversion factor are updated.

RVUs — work 3.44, practice expense 8.73 (non-facility) / 6.75 (facility), malpractice 0.82 — × 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, sequestration, multiple-procedure reductions, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs mean actual allowed amounts vary by where the service is performed.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why is the facility amount lower than the non-facility amount?

In facility settings, Medicare assumes the facility (not the physician's office) bears certain overhead costs, so the practice-expense RVU component is lower, reducing the total allowed amount.

Does this amount reflect what Medicare will actually pay?

No. It's an estimated allowed amount before the 80/20 split, deductible status, modifiers, and any local or claim-specific adjustments are applied.

Why do allowed amounts differ by locality?

The Geographic Practice Cost Indices adjust the work, practice-expense, and malpractice RVUs to reflect regional cost differences, so the same code can price differently across localities.

Can I use this figure for billing or appeals?

Treat it as a reference estimate only. For billing, denials, or appeals, confirm the applicable rate and policy details with your MAC or the current year's PFS final rule.

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.