Medicare Reimbursement for CPT 15050

This page covers CPT code 15050, a procedure code defined by the American Medical Association. It shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount at the national level and by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$605.89	$428.53
ALASKA* (AK)	$708.38	$519.49
ALABAMA (AL)	$543.33	$388.14
ARKANSAS (AR)	$535.46	$383.11
ARIZONA (AZ)	$589.26	$417.40
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$766.91	$516.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$781.37	$525.62
OXNARD-THOUSAND OAKS-VENTURA (CA)	$671.06	$461.42
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$675.07	$465.25
NAPA (CA)	$727.43	$493.67
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$767.95	$517.88
VALLEJO (CA)	$725.92	$492.16
BAKERSFIELD (CA)	$635.13	$440.74
CHICO (CA)	$632.52	$438.14
FRESNO (CA)	$632.52	$438.14
HANFORD-CORCORAN (CA)	$632.52	$438.14
MADERA (CA)	$632.52	$438.14
MERCED (CA)	$632.52	$438.14
MODESTO (CA)	$632.52	$438.14
REDDING (CA)	$632.52	$438.14
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$642.44	$448.06
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$662.35	$456.08
SALINAS (CA)	$659.87	$454.31
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$785.64	$529.89
SANTA CRUZ-WATSONVILLE (CA)	$680.11	$464.62
SANTA ROSA-PETALUMA (CA)	$686.86	$469.06
STOCKTON (CA)	$632.52	$438.14
VISALIA (CA)	$632.52	$438.14
YUBA CITY (CA)	$632.52	$438.14
EL CENTRO (CA)	$632.68	$438.29
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$674.44	$462.32
SAN LUIS OBISPO-PASO ROBLES (CA)	$649.46	$447.44
SANTA MARIA-SANTA BARBARA (CA)	$662.08	$455.28
REST OF CALIFORNIA (CA)	$632.52	$438.14
COLORADO (CO)	$626.54	$437.83
CONNECTICUT (CT)	$646.30	$455.28
DC + MD/VA SUBURBS (DC)	$689.25	$480.33
DELAWARE (DE)	$598.97	$423.74
FORT LAUDERDALE (FL)	$635.84	$456.18
MIAMI (FL)	$669.02	$484.39
REST OF FLORIDA (FL)	$604.02	$434.47
ATLANTA (GA)	$618.91	$438.72
REST OF GEORGIA (GA)	$569.26	$411.06
HAWAII, GUAM (HI)	$646.91	$445.25
IOWA (IA)	$553.89	$391.61
IDAHO (ID)	$558.19	$395.02
EAST ST. LOUIS (IL)	$605.55	$442.38
SUBURBAN CHICAGO (IL)	$641.52	$459.37
CHICAGO (IL)	$648.92	$470.68
REST OF ILLINOIS (IL)	$588.93	$427.00
INDIANA (IN)	$561.35	$396.94
KANSAS (KS)	$552.85	$392.51
KENTUCKY (KY)	$559.57	$401.90
NEW ORLEANS (LA)	$586.84	$419.94
REST OF LOUISIANA (LA)	$559.32	$402.35
METROPOLITAN BOSTON (MA)	$686.34	$474.58
REST OF MASSACHUSETTS (MA)	$623.43	$436.67
BALTIMORE/SURR. CNTYS (MD)	$644.82	$454.52
REST OF MARYLAND (MD)	$609.91	$430.42
SOUTHERN MAINE (ME)	$591.01	$415.25
REST OF MAINE (ME)	$562.77	$399.60
DETROIT (MI)	$613.19	$442.04
REST OF MICHIGAN (MI)	$575.60	$413.67
MINNESOTA (MN)	$595.68	$413.18
METROPOLITAN ST. LOUIS (MO)	$587.05	$418.21
METROPOLITAN KANSAS CITY (MO)	$581.16	$414.62
REST OF MISSOURI (MO)	$550.75	$397.87
MISSISSIPPI (MS)	$543.13	$390.43
MONTANA** (MT)	$605.83	$428.47
NORTH CAROLINA (NC)	$568.41	$402.94
NORTH DAKOTA** (ND)	$587.64	$410.28
NEBRASKA (NE)	$556.46	$392.75
NEW HAMPSHIRE (NH)	$618.20	$433.57
NORTHERN NJ (NJ)	$682.42	$476.68
REST OF NEW JERSEY (NJ)	$652.36	$458.68
NEW MEXICO (NM)	$579.38	$416.75
NEVADA** (NV)	$601.15	$423.62
MANHATTAN (NY)	$699.30	$493.21
NYC SUBURBS/LONG ISLAND (NY)	$718.26	$507.38
POUGHKPSIE/N NYC SUBURBS (NY)	$657.92	$463.71
QUEENS (NY)	$702.75	$493.11
REST OF NEW YORK (NY)	$577.08	$408.59
OHIO (OH)	$571.88	$409.95
OKLAHOMA (OK)	$556.90	$398.52
PORTLAND (OR)	$644.64	$447.59
REST OF OREGON (OR)	$595.19	$418.54
METROPOLITAN PHILADELPHIA (PA)	$631.23	$446.60
REST OF PENNSYLVANIA (PA)	$571.91	$409.10
PUERTO RICO (PR)	$609.76	$430.45
RHODE ISLAND (RI)	$619.01	$435.80
SOUTH CAROLINA (SC)	$571.35	$407.47
SOUTH DAKOTA** (SD)	$585.49	$408.13
TENNESSEE (TN)	$555.83	$394.61
BRAZORIA (TX)	$597.04	$421.28
DALLAS (TX)	$601.59	$424.94
GALVESTON (TX)	$599.30	$423.18
HOUSTON (TX)	$616.14	$440.02
BEAUMONT (TX)	$568.27	$406.87
FORT WORTH (TX)	$598.05	$423.17
AUSTIN (TX)	$625.59	$437.95
REST OF TEXAS (TX)	$582.83	$414.51
UTAH (UT)	$579.13	$412.41
VIRGINIA (VA)	$590.16	$415.82
VIRGIN ISLANDS (VI)	$609.76	$430.45
VERMONT (VT)	$586.77	$411.19
SEATTLE (KING CNTY) (WA)	$698.73	$481.11
REST OF WASHINGTON (WA)	$621.78	$435.02
WISCONSIN (WI)	$568.09	$398.18
WEST VIRGINIA (WV)	$567.55	$413.42
WYOMING** (WY)	$597.90	$420.54

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Clinical. 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) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost-of-living and labor differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility and facility settings because overhead costs (e.g., supplies, staff time) are assumed to be lower when the service is furnished in a facility such as a hospital, where the facility itself bears some costs.

RVUs — work 5.43, practice expense 11.79 (non-facility) / 6.48 (facility), malpractice 0.92 — × 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 Part B deductible is met; the patient or secondary insurer is responsible for the rest.
Actual payment can vary by locality, modifiers appended to the code, claim-specific circumstances, and federal sequestration reductions.
Annual budget-neutrality adjustments and rule changes can shift RVUs and the conversion factor year to year.
Always verify the final allowed amount and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why is the facility amount lower than the non-facility amount?

The facility rate uses a lower practice-expense RVU because the billing facility (such as a hospital) is assumed to absorb certain overhead costs, so the physician payment reflects only the professional work in that setting.

Does this amount reflect what my practice will actually collect?

No. It's a national or locality-adjusted estimate. Actual reimbursement depends on your specific locality GPCIs, any modifiers used, secondary payer rules, and sequestration.

Why do these amounts change every year?

CMS updates the conversion factor annually and may revise RVUs or GPCIs as part of budget-neutrality requirements and rulemaking, which shifts the calculated fee.

Can I use this figure to bill patients directly?

No. This is a reference estimate for understanding Medicare pricing mechanics, not a substitute for your MAC's official fee schedule lookup or your billing software's calculation.

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.