Medicare Reimbursement for CPT 23900

CPT 23900 is a procedure code defined by the AMA; the specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code nationally and, where available, by locality, including both non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1256.88	$1256.88
ALASKA* (AK)	$1558.24	$1558.24
ALABAMA (AL)	$1139.72	$1139.72
ARKANSAS (AR)	$1125.38	$1125.38
ARIZONA (AZ)	$1222.60	$1222.60
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1418.20	$1418.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1438.33	$1438.33
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1301.44	$1301.44
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1316.54	$1316.54
NAPA (CA)	$1368.18	$1368.18
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1423.08	$1423.08
VALLEJO (CA)	$1361.14	$1361.14
BAKERSFIELD (CA)	$1255.64	$1255.64
CHICO (CA)	$1243.81	$1243.81
FRESNO (CA)	$1243.81	$1243.81
HANFORD-CORCORAN (CA)	$1243.81	$1243.81
MADERA (CA)	$1243.81	$1243.81
MERCED (CA)	$1243.81	$1243.81
MODESTO (CA)	$1243.81	$1243.81
REDDING (CA)	$1243.81	$1243.81
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1290.01	$1290.01
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1286.01	$1286.01
SALINAS (CA)	$1280.88	$1280.88
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1458.29	$1458.29
SANTA CRUZ-WATSONVILLE (CA)	$1298.69	$1298.69
SANTA ROSA-PETALUMA (CA)	$1310.47	$1310.47
STOCKTON (CA)	$1243.81	$1243.81
VISALIA (CA)	$1243.81	$1243.81
YUBA CITY (CA)	$1243.81	$1243.81
EL CENTRO (CA)	$1244.52	$1244.52
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1297.29	$1297.29
SAN LUIS OBISPO-PASO ROBLES (CA)	$1262.66	$1262.66
SANTA MARIA-SANTA BARBARA (CA)	$1281.93	$1281.93
REST OF CALIFORNIA (CA)	$1243.81	$1243.81
COLORADO (CO)	$1261.59	$1261.59
CONNECTICUT (CT)	$1334.30	$1334.30
DC + MD/VA SUBURBS (DC)	$1387.60	$1387.60
DELAWARE (DE)	$1240.48	$1240.48
FORT LAUDERDALE (FL)	$1378.63	$1378.63
MIAMI (FL)	$1494.46	$1494.46
REST OF FLORIDA (FL)	$1309.82	$1309.82
ATLANTA (GA)	$1294.79	$1294.79
REST OF GEORGIA (GA)	$1237.09	$1237.09
HAWAII, GUAM (HI)	$1256.49	$1256.49
IOWA (IA)	$1132.99	$1132.99
IDAHO (ID)	$1146.10	$1146.10
EAST ST. LOUIS (IL)	$1367.43	$1367.43
SUBURBAN CHICAGO (IL)	$1384.32	$1384.32
CHICAGO (IL)	$1449.78	$1449.78
REST OF ILLINOIS (IL)	$1299.58	$1299.58
INDIANA (IN)	$1151.04	$1151.04
KANSAS (KS)	$1143.54	$1143.54
KENTUCKY (KY)	$1195.99	$1195.99
NEW ORLEANS (LA)	$1250.53	$1250.53
REST OF LOUISIANA (LA)	$1200.41	$1200.41
METROPOLITAN BOSTON (MA)	$1353.82	$1353.82
REST OF MASSACHUSETTS (MA)	$1261.76	$1261.76
BALTIMORE/SURR. CNTYS (MD)	$1333.72	$1333.72
REST OF MARYLAND (MD)	$1257.11	$1257.11
SOUTHERN MAINE (ME)	$1199.93	$1199.93
REST OF MAINE (ME)	$1167.50	$1167.50
DETROIT (MI)	$1340.05	$1340.05
REST OF MICHIGAN (MI)	$1237.25	$1237.25
MINNESOTA (MN)	$1168.48	$1168.48
METROPOLITAN ST. LOUIS (MO)	$1236.11	$1236.11
METROPOLITAN KANSAS CITY (MO)	$1226.82	$1226.82
REST OF MISSOURI (MO)	$1192.62	$1192.62
MISSISSIPPI (MS)	$1158.43	$1158.43
MONTANA** (MT)	$1256.59	$1256.59
NORTH CAROLINA (NC)	$1175.64	$1175.64
NORTH DAKOTA** (ND)	$1171.56	$1171.56
NEBRASKA (NE)	$1133.77	$1133.77
NEW HAMPSHIRE (NH)	$1256.90	$1256.90
NORTHERN NJ (NJ)	$1379.32	$1379.32
REST OF NEW JERSEY (NJ)	$1338.14	$1338.14
NEW MEXICO (NM)	$1249.34	$1249.34
NEVADA** (NV)	$1233.33	$1233.33
MANHATTAN (NY)	$1455.27	$1455.27
NYC SUBURBS/LONG ISLAND (NY)	$1506.03	$1506.03
POUGHKPSIE/N NYC SUBURBS (NY)	$1359.06	$1359.06
QUEENS (NY)	$1443.36	$1443.36
REST OF NEW YORK (NY)	$1192.29	$1192.29
OHIO (OH)	$1219.87	$1219.87
OKLAHOMA (OK)	$1177.92	$1177.92
PORTLAND (OR)	$1279.58	$1279.58
REST OF OREGON (OR)	$1212.47	$1212.47
METROPOLITAN PHILADELPHIA (PA)	$1314.72	$1314.72
REST OF PENNSYLVANIA (PA)	$1213.02	$1213.02
PUERTO RICO (PR)	$1259.55	$1259.55
RHODE ISLAND (RI)	$1268.66	$1268.66
SOUTH CAROLINA (SC)	$1202.00	$1202.00
SOUTH DAKOTA** (SD)	$1161.51	$1161.51
TENNESSEE (TN)	$1150.47	$1150.47
BRAZORIA (TX)	$1226.73	$1226.73
DALLAS (TX)	$1240.80	$1240.80
GALVESTON (TX)	$1234.50	$1234.50
HOUSTON (TX)	$1313.21	$1313.21
BEAUMONT (TX)	$1207.21	$1207.21
FORT WORTH (TX)	$1238.28	$1238.28
AUSTIN (TX)	$1267.29	$1267.29
REST OF TEXAS (TX)	$1220.58	$1220.58
UTAH (UT)	$1215.91	$1215.91
VIRGINIA (VA)	$1207.20	$1207.20
VIRGIN ISLANDS (VI)	$1259.55	$1259.55
VERMONT (VT)	$1181.54	$1181.54
SEATTLE (KING CNTY) (WA)	$1363.88	$1363.88
REST OF WASHINGTON (WA)	$1254.56	$1254.56
WISCONSIN (WI)	$1139.07	$1139.07
WEST VIRGINIA (WV)	$1261.33	$1261.33
WYOMING** (WY)	$1219.53	$1219.53

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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 Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. The geographically adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which can change the total payment depending on place of service. For this code, the non-facility and facility PE RVUs shown are identical, so the national amounts match, but locality-adjusted figures may still vary by GPCI.

RVUs — work 20.2, practice expense 13.13 (non-facility) / 13.13 (facility), malpractice 4.3 — × 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 the annual deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment can be affected by modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Amounts shown use national or locality-specific GPCIs and the applicable year's conversion factor; your Medicare Administrative Contractor (MAC) may apply additional local policies.
Always verify current rates and coverage rules with your MAC before billing or appealing a denial.

Frequently asked

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

Facility and non-facility rates can differ because Medicare uses different practice-expense RVUs depending on where the service is performed, reflecting the fact that facilities (like hospitals) absorb some overhead costs directly.

Does this amount reflect what the patient will actually pay?

No. The figure shown is the Medicare-allowed amount before cost-sharing. Patients typically owe 20% coinsurance after meeting their deductible, and secondary insurance may cover some or all of that balance.

Why might my MAC pay a different amount than what's shown here?

Locality-specific GPCIs, claim modifiers, multiple-procedure payment reductions, and annual budget-neutrality adjustments can all cause the actual paid amount to differ from the general estimate shown here.

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

No. This page provides a pricing estimate only. Coverage determinations, medical necessity, and denial reasons are governed by separate Medicare policies and should be confirmed with your MAC or local coverage determination (LCD).

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.