Medicare Reimbursement for CPT 23802

CPT 23802 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1182.39	$1182.39
ALASKA* (AK)	$1454.44	$1454.44
ALABAMA (AL)	$1070.05	$1070.05
ARKANSAS (AR)	$1056.25	$1056.25
ARIZONA (AZ)	$1149.88	$1149.88
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1352.20	$1352.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1372.17	$1372.17
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1233.70	$1233.70
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1247.19	$1247.19
NAPA (CA)	$1301.80	$1301.80
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1356.55	$1356.55
VALLEJO (CA)	$1295.54	$1295.54
BAKERSFIELD (CA)	$1187.41	$1187.41
CHICO (CA)	$1176.87	$1176.87
FRESNO (CA)	$1176.87	$1176.87
HANFORD-CORCORAN (CA)	$1176.87	$1176.87
MADERA (CA)	$1176.87	$1176.87
MERCED (CA)	$1176.87	$1176.87
MODESTO (CA)	$1176.87	$1176.87
REDDING (CA)	$1176.87	$1176.87
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1218.02	$1218.02
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1218.73	$1218.73
SALINAS (CA)	$1213.91	$1213.91
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1389.95	$1389.95
SANTA CRUZ-WATSONVILLE (CA)	$1233.37	$1233.37
SANTA ROSA-PETALUMA (CA)	$1244.68	$1244.68
STOCKTON (CA)	$1176.87	$1176.87
VISALIA (CA)	$1176.87	$1176.87
YUBA CITY (CA)	$1176.87	$1176.87
EL CENTRO (CA)	$1177.51	$1177.51
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1230.90	$1230.90
SAN LUIS OBISPO-PASO ROBLES (CA)	$1196.42	$1196.42
SANTA MARIA-SANTA BARBARA (CA)	$1215.29	$1215.29
REST OF CALIFORNIA (CA)	$1176.87	$1176.87
COLORADO (CO)	$1190.67	$1190.67
CONNECTICUT (CT)	$1256.26	$1256.26
DC + MD/VA SUBURBS (DC)	$1310.16	$1310.16
DELAWARE (DE)	$1167.02	$1167.02
FORT LAUDERDALE (FL)	$1291.67	$1291.67
MIAMI (FL)	$1396.63	$1396.63
REST OF FLORIDA (FL)	$1226.74	$1226.74
ATLANTA (GA)	$1217.18	$1217.18
REST OF GEORGIA (GA)	$1157.86	$1157.86
HAWAII, GUAM (HI)	$1190.81	$1190.81
IOWA (IA)	$1066.61	$1066.61
IDAHO (ID)	$1078.61	$1078.61
EAST ST. LOUIS (IL)	$1275.74	$1275.74
SUBURBAN CHICAGO (IL)	$1297.62	$1297.62
CHICAGO (IL)	$1354.53	$1354.53
REST OF ILLINOIS (IL)	$1214.86	$1214.86
INDIANA (IN)	$1083.45	$1083.45
KANSAS (KS)	$1075.30	$1075.30
KENTUCKY (KY)	$1121.06	$1121.06
NEW ORLEANS (LA)	$1172.97	$1172.97
REST OF LOUISIANA (LA)	$1124.74	$1124.74
METROPOLITAN BOSTON (MA)	$1281.10	$1281.10
REST OF MASSACHUSETTS (MA)	$1190.11	$1190.11
BALTIMORE/SURR. CNTYS (MD)	$1255.49	$1255.49
REST OF MARYLAND (MD)	$1183.36	$1183.36
SOUTHERN MAINE (ME)	$1131.10	$1131.10
REST OF MAINE (ME)	$1097.67	$1097.67
DETROIT (MI)	$1254.24	$1254.24
REST OF MICHIGAN (MI)	$1159.35	$1159.35
MINNESOTA (MN)	$1105.52	$1105.52
METROPOLITAN ST. LOUIS (MO)	$1160.83	$1160.83
METROPOLITAN KANSAS CITY (MO)	$1151.72	$1151.72
REST OF MISSOURI (MO)	$1116.33	$1116.33
MISSISSIPPI (MS)	$1085.82	$1085.82
MONTANA** (MT)	$1182.14	$1182.14
NORTH CAROLINA (NC)	$1105.75	$1105.75
NORTH DAKOTA** (ND)	$1106.40	$1106.40
NEBRASKA (NE)	$1067.82	$1067.82
NEW HAMPSHIRE (NH)	$1185.04	$1185.04
NORTHERN NJ (NJ)	$1301.62	$1301.62
REST OF NEW JERSEY (NJ)	$1260.62	$1260.62
NEW MEXICO (NM)	$1170.37	$1170.37
NEVADA** (NV)	$1161.48	$1161.48
MANHATTAN (NY)	$1369.39	$1369.39
NYC SUBURBS/LONG ISLAND (NY)	$1416.33	$1416.33
POUGHKPSIE/N NYC SUBURBS (NY)	$1279.44	$1279.44
QUEENS (NY)	$1360.06	$1360.06
REST OF NEW YORK (NY)	$1121.67	$1121.67
OHIO (OH)	$1143.87	$1143.87
OKLAHOMA (OK)	$1105.22	$1105.22
PORTLAND (OR)	$1209.70	$1209.70
REST OF OREGON (OR)	$1142.58	$1142.58
METROPOLITAN PHILADELPHIA (PA)	$1236.52	$1236.52
REST OF PENNSYLVANIA (PA)	$1138.08	$1138.08
PUERTO RICO (PR)	$1185.47	$1185.47
RHODE ISLAND (RI)	$1194.97	$1194.97
SOUTH CAROLINA (SC)	$1128.65	$1128.65
SOUTH DAKOTA** (SD)	$1097.45	$1097.45
TENNESSEE (TN)	$1081.80	$1081.80
BRAZORIA (TX)	$1154.96	$1154.96
DALLAS (TX)	$1167.81	$1167.81
GALVESTON (TX)	$1162.01	$1162.01
HOUSTON (TX)	$1232.11	$1232.11
BEAUMONT (TX)	$1132.40	$1132.40
FORT WORTH (TX)	$1164.92	$1164.92
AUSTIN (TX)	$1195.37	$1195.37
REST OF TEXAS (TX)	$1146.80	$1146.80
UTAH (UT)	$1142.07	$1142.07
VIRGINIA (VA)	$1137.05	$1137.05
VIRGIN ISLANDS (VI)	$1185.47	$1185.47
VERMONT (VT)	$1114.65	$1114.65
SEATTLE (KING CNTY) (WA)	$1292.17	$1292.17
REST OF WASHINGTON (WA)	$1183.71	$1183.71
WISCONSIN (WI)	$1074.77	$1074.77
WEST VIRGINIA (WV)	$1177.98	$1177.98
WYOMING** (WY)	$1149.13	$1149.13

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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 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 national conversion factor to produce the allowed amount. Non-facility and facility allowed amounts can differ because practice-expense RVUs are typically lower in facility settings, where the facility itself bears overhead costs; malpractice and work RVUs generally stay the same across settings.

RVUs — work 17.96, practice expense 13.61 (non-facility) / 13.61 (facility), malpractice 3.83 — × 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 annual deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates can shift amounts year to year.
Always confirm the exact allowed amount with your Medicare Administrative Contractor (MAC) or current fee schedule lookup tool before billing or appealing a denial.

Frequently asked

Why does the allowed amount differ between facility and non-facility settings?

Practice-expense RVUs are usually lower in the facility setting because the facility, rather than the physician's practice, incurs the overhead costs. This can make the facility-based allowed amount lower than the non-facility amount for the same code.

Why might the amount differ by locality even though the RVUs are the same?

Each locality has its own GPCIs for work, practice expense, and malpractice, which adjust the RVUs to reflect local cost-of-living and practice-cost differences before the conversion factor is applied.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare-allowed amount before cost-sharing. Medicare generally pays 80% after the deductible, and factors like modifiers or sequestration can further adjust the final payment.

Can this amount change during the year?

Yes. The conversion factor and RVUs can be updated through mid-year corrections, legislative action, or annual rulemaking, so the figure shown reflects the most recent data available.

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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.