Was the hot end pre-assembled or did you assemble it? I suspect you have a mechanical issue, but it might just be e-steps.

Suggestions:

Pull the nozzle off, measure say 110 mm of filament upstream of your extruder motor, make a line or attach a piece of tape, extruder 100mm, and see how close to 100mm you are. No nozzle means you can do this cold so you’ve eliminated 2 variables: a nozzle clog and temp. More detailed instructions

Once you get that sorted, do a PID tune and run the 100mm extrusion test again with your nozzle attached at say 230. Different number? My money would be on a partial nozzle clog.

Finally, temp tower. Not being able to extrude below 220 seems very weird. How fast are you trying to print?