Medicare Reimbursement for CPT 23680

This page covers the Medicare Physician Fee Schedule (PFS) allowed amount for procedure code 23680, a CPT code whose official descriptor is not reproduced here due to AMA licensing. It shows the national estimate as well as how the amount can vary by locality, and distinguishes non-facility and facility payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$865.08	$865.08
ALASKA* (AK)	$1060.71	$1060.71
ALABAMA (AL)	$782.30	$782.30
ARKANSAS (AR)	$772.12	$772.12
ARIZONA (AZ)	$841.24	$841.24
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$995.07	$995.07
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1010.00	$1010.00
OXNARD-THOUSAND OAKS-VENTURA (CA)	$905.61	$905.61
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$915.26	$915.26
NAPA (CA)	$957.13	$957.13
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$998.17	$998.17
VALLEJO (CA)	$952.66	$952.66
BAKERSFIELD (CA)	$870.75	$870.75
CHICO (CA)	$863.24	$863.24
FRESNO (CA)	$863.24	$863.24
HANFORD-CORCORAN (CA)	$863.24	$863.24
MADERA (CA)	$863.24	$863.24
MERCED (CA)	$863.24	$863.24
MODESTO (CA)	$863.24	$863.24
REDDING (CA)	$863.24	$863.24
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$892.57	$892.57
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$894.54	$894.54
SALINAS (CA)	$891.01	$891.01
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1022.67	$1022.67
SANTA CRUZ-WATSONVILLE (CA)	$906.09	$906.09
SANTA ROSA-PETALUMA (CA)	$914.44	$914.44
STOCKTON (CA)	$863.24	$863.24
VISALIA (CA)	$863.24	$863.24
YUBA CITY (CA)	$863.24	$863.24
EL CENTRO (CA)	$863.70	$863.70
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$903.92	$903.92
SAN LUIS OBISPO-PASO ROBLES (CA)	$878.11	$878.11
SANTA MARIA-SANTA BARBARA (CA)	$892.15	$892.15
REST OF CALIFORNIA (CA)	$863.24	$863.24
COLORADO (CO)	$872.38	$872.38
CONNECTICUT (CT)	$919.41	$919.41
DC + MD/VA SUBURBS (DC)	$960.04	$960.04
DELAWARE (DE)	$853.87	$853.87
FORT LAUDERDALE (FL)	$943.25	$943.25
MIAMI (FL)	$1018.68	$1018.68
REST OF FLORIDA (FL)	$895.74	$895.74
ATLANTA (GA)	$890.23	$890.23
REST OF GEORGIA (GA)	$845.26	$845.26
HAWAII, GUAM (HI)	$874.06	$874.06
IOWA (IA)	$780.71	$780.71
IDAHO (ID)	$789.37	$789.37
EAST ST. LOUIS (IL)	$929.89	$929.89
SUBURBAN CHICAGO (IL)	$947.81	$947.81
CHICAGO (IL)	$987.89	$987.89
REST OF ILLINOIS (IL)	$886.34	$886.34
INDIANA (IN)	$792.98	$792.98
KANSAS (KS)	$786.67	$786.67
KENTUCKY (KY)	$818.96	$818.96
NEW ORLEANS (LA)	$857.09	$857.09
REST OF LOUISIANA (LA)	$821.50	$821.50
METROPOLITAN BOSTON (MA)	$939.67	$939.67
REST OF MASSACHUSETTS (MA)	$871.75	$871.75
BALTIMORE/SURR. CNTYS (MD)	$918.78	$918.78
REST OF MARYLAND (MD)	$866.04	$866.04
SOUTHERN MAINE (ME)	$828.32	$828.32
REST OF MAINE (ME)	$802.96	$802.96
DETROIT (MI)	$915.54	$915.54
REST OF MICHIGAN (MI)	$846.77	$846.77
MINNESOTA (MN)	$810.91	$810.91
METROPOLITAN ST. LOUIS (MO)	$848.67	$848.67
METROPOLITAN KANSAS CITY (MO)	$841.90	$841.90
REST OF MISSOURI (MO)	$815.01	$815.01
MISSISSIPPI (MS)	$793.23	$793.23
MONTANA** (MT)	$864.90	$864.90
NORTH CAROLINA (NC)	$809.00	$809.00
NORTH DAKOTA** (ND)	$810.92	$810.92
NEBRASKA (NE)	$781.75	$781.75
NEW HAMPSHIRE (NH)	$867.86	$867.86
NORTHERN NJ (NJ)	$953.57	$953.57
REST OF NEW JERSEY (NJ)	$922.86	$922.86
NEW MEXICO (NM)	$854.72	$854.72
NEVADA** (NV)	$850.20	$850.20
MANHATTAN (NY)	$1001.93	$1001.93
NYC SUBURBS/LONG ISLAND (NY)	$1035.97	$1035.97
POUGHKPSIE/N NYC SUBURBS (NY)	$936.34	$936.34
QUEENS (NY)	$995.71	$995.71
REST OF NEW YORK (NY)	$820.72	$820.72
OHIO (OH)	$835.74	$835.74
OKLAHOMA (OK)	$807.76	$807.76
PORTLAND (OR)	$886.96	$886.96
REST OF OREGON (OR)	$836.62	$836.62
METROPOLITAN PHILADELPHIA (PA)	$904.56	$904.56
REST OF PENNSYLVANIA (PA)	$831.72	$831.72
PUERTO RICO (PR)	$867.52	$867.52
RHODE ISLAND (RI)	$874.78	$874.78
SOUTH CAROLINA (SC)	$825.13	$825.13
SOUTH DAKOTA** (SD)	$804.54	$804.54
TENNESSEE (TN)	$791.41	$791.41
BRAZORIA (TX)	$845.34	$845.34
DALLAS (TX)	$854.61	$854.61
GALVESTON (TX)	$850.41	$850.41
HOUSTON (TX)	$900.37	$900.37
BEAUMONT (TX)	$827.50	$827.50
FORT WORTH (TX)	$852.33	$852.33
AUSTIN (TX)	$875.60	$875.60
REST OF TEXAS (TX)	$838.61	$838.61
UTAH (UT)	$835.04	$835.04
VIRGINIA (VA)	$832.40	$832.40
VIRGIN ISLANDS (VI)	$867.52	$867.52
VERMONT (VT)	$816.58	$816.58
SEATTLE (KING CNTY) (WA)	$948.28	$948.28
REST OF WASHINGTON (WA)	$867.18	$867.18
WISCONSIN (WI)	$787.46	$787.46
WEST VIRGINIA (WV)	$859.10	$859.10
WYOMING** (WY)	$841.38	$841.38

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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 payments are 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, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice-expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which can make the allowed amount differ between the two; for this code, however, the practice-expense RVU is the same in both settings, so the national estimates shown are equal. Because GPCIs vary by locality, the final estimated amount will differ from one area of the country to another even though the RVUs stay the same.

RVUs — work 12.82, practice expense 10.35 (non-facility) / 10.35 (facility), malpractice 2.73 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on national RVUs and the annual conversion factor — it is not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient's Part B deductible is met; the patient or secondary insurance is responsible for the remainder.
Modifiers, multiple-procedure reductions, bilateral billing, sequestration, and annual budget-neutrality adjustments can all change the actual paid amount.
Locality-specific GPCIs mean the real allowed amount in a given area may be higher or lower than the national figure shown here.
Always confirm the current, locality-adjusted amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does this code show the same amount for non-facility and facility settings?

The practice-expense RVU for this code happens to be identical in both settings, so the calculated national amounts come out the same. For other codes, non-facility and facility amounts often differ because overhead assumptions differ.

Why might my MAC's actual payment differ from the amount shown here?

The figure shown uses national RVUs and the conversion factor without locality GPCI adjustments, modifiers, or any sequestration or budget-neutrality adjustments that may apply in your specific claim and location.

Does this amount reflect what the patient will owe?

No. This is the Medicare-allowed amount before cost-sharing. The patient (or secondary payer) is generally responsible for the remaining 20% coinsurance after any applicable deductible, subject to plan-specific rules.

Can I use this figure to predict a denial or appeal outcome?

No. This page provides a pricing estimate only; it does not address medical necessity, coverage policy, or claim-specific denial reasons, which should be reviewed with your MAC or payer.

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.