Medicare Reimbursement for CPT 23800

CPT 23800 is a surgical procedure code reported to Medicare and other payers; the specific service it describes is defined by the AMA's CPT code set. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both at the national level and adjusted for local geographic cost differences, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$946.58	$946.58
ALASKA* (AK)	$1164.39	$1164.39
ALABAMA (AL)	$856.73	$856.73
ARKANSAS (AR)	$845.70	$845.70
ARIZONA (AZ)	$920.59	$920.59
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1083.25	$1083.25
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1099.27	$1099.27
OXNARD-THOUSAND OAKS-VENTURA (CA)	$988.05	$988.05
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$998.83	$998.83
NAPA (CA)	$1042.77	$1042.77
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1086.71	$1086.71
VALLEJO (CA)	$1037.78	$1037.78
BAKERSFIELD (CA)	$950.91	$950.91
CHICO (CA)	$942.51	$942.51
FRESNO (CA)	$942.51	$942.51
HANFORD-CORCORAN (CA)	$942.51	$942.51
MADERA (CA)	$942.51	$942.51
MERCED (CA)	$942.51	$942.51
MODESTO (CA)	$942.51	$942.51
REDDING (CA)	$942.51	$942.51
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$975.29	$975.29
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$976.09	$976.09
SALINAS (CA)	$972.23	$972.23
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1113.43	$1113.43
SANTA CRUZ-WATSONVILLE (CA)	$987.88	$987.88
SANTA ROSA-PETALUMA (CA)	$996.94	$996.94
STOCKTON (CA)	$942.51	$942.51
VISALIA (CA)	$942.51	$942.51
YUBA CITY (CA)	$942.51	$942.51
EL CENTRO (CA)	$943.02	$943.02
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$985.87	$985.87
SAN LUIS OBISPO-PASO ROBLES (CA)	$958.21	$958.21
SANTA MARIA-SANTA BARBARA (CA)	$973.34	$973.34
REST OF CALIFORNIA (CA)	$942.51	$942.51
COLORADO (CO)	$953.39	$953.39
CONNECTICUT (CT)	$1005.68	$1005.68
DC + MD/VA SUBURBS (DC)	$1048.98	$1048.98
DELAWARE (DE)	$934.31	$934.31
FORT LAUDERDALE (FL)	$1033.64	$1033.64
MIAMI (FL)	$1117.31	$1117.31
REST OF FLORIDA (FL)	$981.76	$981.76
ATLANTA (GA)	$974.34	$974.34
REST OF GEORGIA (GA)	$926.71	$926.71
HAWAII, GUAM (HI)	$953.71	$953.71
IOWA (IA)	$854.12	$854.12
IDAHO (ID)	$863.69	$863.69
EAST ST. LOUIS (IL)	$1020.67	$1020.67
SUBURBAN CHICAGO (IL)	$1038.44	$1038.44
CHICAGO (IL)	$1083.69	$1083.69
REST OF ILLINOIS (IL)	$972.17	$972.17
INDIANA (IN)	$867.57	$867.57
KANSAS (KS)	$861.01	$861.01
KENTUCKY (KY)	$897.40	$897.40
NEW ORLEANS (LA)	$938.90	$938.90
REST OF LOUISIANA (LA)	$900.32	$900.32
METROPOLITAN BOSTON (MA)	$1025.86	$1025.86
REST OF MASSACHUSETTS (MA)	$952.92	$952.92
BALTIMORE/SURR. CNTYS (MD)	$1005.05	$1005.05
REST OF MARYLAND (MD)	$947.41	$947.41
SOUTHERN MAINE (ME)	$905.70	$905.70
REST OF MAINE (ME)	$878.87	$878.87
DETROIT (MI)	$1003.69	$1003.69
REST OF MICHIGAN (MI)	$927.96	$927.96
MINNESOTA (MN)	$885.45	$885.45
METROPOLITAN ST. LOUIS (MO)	$929.26	$929.26
METROPOLITAN KANSAS CITY (MO)	$921.97	$921.97
REST OF MISSOURI (MO)	$893.55	$893.55
MISSISSIPPI (MS)	$869.25	$869.25
MONTANA** (MT)	$946.38	$946.38
NORTH CAROLINA (NC)	$885.35	$885.35
NORTH DAKOTA** (ND)	$886.07	$886.07
NEBRASKA (NE)	$855.11	$855.11
NEW HAMPSHIRE (NH)	$948.82	$948.82
NORTHERN NJ (NJ)	$1042.14	$1042.14
REST OF NEW JERSEY (NJ)	$1009.24	$1009.24
NEW MEXICO (NM)	$936.76	$936.76
NEVADA** (NV)	$929.93	$929.93
MANHATTAN (NY)	$1096.12	$1096.12
NYC SUBURBS/LONG ISLAND (NY)	$1133.58	$1133.58
POUGHKPSIE/N NYC SUBURBS (NY)	$1024.24	$1024.24
QUEENS (NY)	$1088.75	$1088.75
REST OF NEW YORK (NY)	$898.07	$898.07
OHIO (OH)	$915.64	$915.64
OKLAHOMA (OK)	$884.80	$884.80
PORTLAND (OR)	$968.70	$968.70
REST OF OREGON (OR)	$914.87	$914.87
METROPOLITAN PHILADELPHIA (PA)	$989.84	$989.84
REST OF PENNSYLVANIA (PA)	$911.04	$911.04
PUERTO RICO (PR)	$949.07	$949.07
RHODE ISLAND (RI)	$956.74	$956.74
SOUTH CAROLINA (SC)	$903.56	$903.56
SOUTH DAKOTA** (SD)	$878.94	$878.94
TENNESSEE (TN)	$866.19	$866.19
BRAZORIA (TX)	$924.72	$924.72
DALLAS (TX)	$934.97	$934.97
GALVESTON (TX)	$930.34	$930.34
HOUSTON (TX)	$986.17	$986.17
BEAUMONT (TX)	$906.49	$906.49
FORT WORTH (TX)	$932.65	$932.65
AUSTIN (TX)	$957.10	$957.10
REST OF TEXAS (TX)	$918.08	$918.08
UTAH (UT)	$914.29	$914.29
VIRGINIA (VA)	$910.42	$910.42
VIRGIN ISLANDS (VI)	$949.07	$949.07
VERMONT (VT)	$892.61	$892.61
SEATTLE (KING CNTY) (WA)	$1034.79	$1034.79
REST OF WASHINGTON (WA)	$947.82	$947.82
WISCONSIN (WI)	$860.75	$860.75
WEST VIRGINIA (WV)	$942.66	$942.66
WYOMING** (WY)	$920.09	$920.09

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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 — assigned to the code each year. Each RVU component is adjusted by a Geographic Practice Cost Index (GPCI) specific to the billing locality, reflecting local differences in wages, rents, and liability costs. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the dollar allowed amount. Non-facility and facility settings can have different practice-expense RVUs, since facility settings (like hospitals) shift certain overhead costs away from the billing physician; for this code those practice-expense RVUs are the same in both settings, so the non-facility and facility national amounts match here.

RVUs — work 14.36, practice expense 10.93 (non-facility) / 10.93 (facility), malpractice 3.05 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment; actual claims processing may differ.
Medicare typically pays 80% of the approved amount after the patient's annual deductible is met; the patient or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs mean the actual reimbursement in your area may differ from the national figure shown.
Always confirm current rates and claim-specific details with your Medicare Administrative Contractor (MAC).

Frequently asked

Why do non-facility and facility amounts differ for some codes but not others?

The difference depends on the practice-expense RVU assigned to each setting. If a code's practice-expense RVU is identical for non-facility and facility, the calculated allowed amounts will match, as shown here.

Does this figure reflect what Medicare will actually pay?

No. This is the PFS allowed amount estimate before the standard 80/20 split, deductible status, modifiers, or local adjustments are applied.

Why might my locality's amount differ from the national figure?

Medicare applies Geographic Practice Cost Indices (GPCIs) to adjust for regional differences in labor, overhead, and malpractice costs before applying the conversion factor.

Where can I find the official CPT descriptor for this code?

CPT code descriptors are copyrighted by the American Medical Association; consult your CPT codebook, EHR system, or AMA resources for the official language.

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.