Medicare Reimbursement for CPT 15120

CPT 15120 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$874.10	$614.91
ALASKA* (AK)	$1046.78	$770.74
ALABAMA (AL)	$789.35	$562.56
ARKANSAS (AR)	$778.75	$556.10
ARIZONA (AZ)	$851.10	$599.95
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1074.70	$709.24
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1093.78	$720.03
OXNARD-THOUSAND OAKS-VENTURA (CA)	$951.83	$645.47
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$958.85	$652.23
NAPA (CA)	$1023.65	$682.03
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1076.55	$711.09
VALLEJO (CA)	$1020.98	$679.36
BAKERSFIELD (CA)	$906.04	$621.97
CHICO (CA)	$901.40	$617.33
FRESNO (CA)	$901.40	$617.33
HANFORD-CORCORAN (CA)	$901.40	$617.33
MADERA (CA)	$901.40	$617.33
MERCED (CA)	$901.40	$617.33
MODESTO (CA)	$901.40	$617.33
REDDING (CA)	$901.40	$617.33
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$918.99	$634.92
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$940.45	$639.01
SALINAS (CA)	$936.84	$636.44
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1101.35	$727.59
SANTA CRUZ-WATSONVILLE (CA)	$960.92	$646.00
SANTA ROSA-PETALUMA (CA)	$970.25	$651.96
STOCKTON (CA)	$901.40	$617.33
VISALIA (CA)	$901.40	$617.33
YUBA CITY (CA)	$901.40	$617.33
EL CENTRO (CA)	$901.68	$617.60
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$954.93	$644.94
SAN LUIS OBISPO-PASO ROBLES (CA)	$922.43	$627.21
SANTA MARIA-SANTA BARBARA (CA)	$939.27	$637.05
REST OF CALIFORNIA (CA)	$901.40	$617.33
COLORADO (CO)	$897.44	$621.66
CONNECTICUT (CT)	$929.80	$650.65
DC + MD/VA SUBURBS (DC)	$985.15	$679.82
DELAWARE (DE)	$864.39	$608.31
FORT LAUDERDALE (FL)	$924.45	$661.89
MIAMI (FL)	$977.39	$707.58
REST OF FLORIDA (FL)	$879.97	$632.18
ATLANTA (GA)	$893.86	$630.52
REST OF GEORGIA (GA)	$831.74	$600.55
HAWAII, GUAM (HI)	$918.17	$623.47
IOWA (IA)	$799.71	$562.55
IDAHO (ID)	$806.29	$567.84
EAST ST. LOUIS (IL)	$890.19	$651.73
SUBURBAN CHICAGO (IL)	$931.65	$665.46
CHICAGO (IL)	$949.37	$688.88
REST OF ILLINOIS (IL)	$862.21	$625.57
INDIANA (IN)	$810.42	$570.15
KANSAS (KS)	$800.15	$565.85
KENTUCKY (KY)	$815.20	$584.78
NEW ORLEANS (LA)	$852.66	$608.76
REST OF LOUISIANA (LA)	$815.58	$586.20
METROPOLITAN BOSTON (MA)	$976.53	$667.06
REST OF MASSACHUSETTS (MA)	$894.26	$621.33
BALTIMORE/SURR. CNTYS (MD)	$927.99	$649.88
REST OF MARYLAND (MD)	$878.81	$616.51
SOUTHERN MAINE (ME)	$849.61	$592.75
REST OF MAINE (ME)	$814.40	$575.95
DETROIT (MI)	$894.34	$644.22
REST OF MICHIGAN (MI)	$838.58	$601.94
MINNESOTA (MN)	$849.95	$583.25
METROPOLITAN ST. LOUIS (MO)	$850.74	$603.99
METROPOLITAN KANSAS CITY (MO)	$843.02	$599.64
REST OF MISSOURI (MO)	$805.21	$581.78
MISSISSIPPI (MS)	$791.92	$568.76
MONTANA** (MT)	$873.99	$614.80
NORTH CAROLINA (NC)	$821.69	$579.86
NORTH DAKOTA** (ND)	$841.76	$582.57
NEBRASKA (NE)	$802.59	$563.35
NEW HAMPSHIRE (NH)	$887.34	$617.53
NORTHERN NJ (NJ)	$976.87	$676.21
REST OF NEW JERSEY (NJ)	$937.60	$654.56
NEW MEXICO (NM)	$844.46	$606.78
NEVADA** (NV)	$865.50	$606.05
MANHATTAN (NY)	$1006.38	$705.20
NYC SUBURBS/LONG ISLAND (NY)	$1034.34	$726.16
POUGHKPSIE/N NYC SUBURBS (NY)	$946.87	$663.05
QUEENS (NY)	$1008.32	$701.96
REST OF NEW YORK (NY)	$833.48	$587.25
OHIO (OH)	$832.00	$595.35
OKLAHOMA (OK)	$809.64	$578.18
PORTLAND (OR)	$919.73	$631.77
REST OF OREGON (OR)	$855.98	$597.82
METROPOLITAN PHILADELPHIA (PA)	$910.61	$640.79
REST OF PENNSYLVANIA (PA)	$831.01	$593.07
PUERTO RICO (PR)	$878.66	$616.62
RHODE ISLAND (RI)	$890.64	$622.90
SOUTH CAROLINA (SC)	$828.77	$589.28
SOUTH DAKOTA** (SD)	$837.95	$578.76
TENNESSEE (TN)	$804.40	$568.79
BRAZORIA (TX)	$860.37	$603.51
DALLAS (TX)	$867.39	$609.24
GALVESTON (TX)	$863.96	$606.58
HOUSTON (TX)	$893.79	$636.42
BEAUMONT (TX)	$826.23	$590.36
FORT WORTH (TX)	$863.21	$607.65
AUSTIN (TX)	$896.92	$622.69
REST OF TEXAS (TX)	$843.88	$597.91
UTAH (UT)	$839.21	$595.57
VIRGINIA (VA)	$849.78	$595.00
VIRGIN ISLANDS (VI)	$878.66	$616.62
VERMONT (VT)	$842.32	$585.72
SEATTLE (KING CNTY) (WA)	$991.67	$673.65
REST OF WASHINGTON (WA)	$891.30	$618.38
WISCONSIN (WI)	$815.89	$567.58
WEST VIRGINIA (WV)	$833.51	$608.27
WYOMING** (WY)	$859.95	$600.76

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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 the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is furnished. The geographically adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two allowed amounts differ. Because GPCIs and the conversion factor are updated periodically, the resulting dollar amount can change from year to year even if the RVUs stay the same.

RVUs — work 9.9, practice expense 14.64 (non-facility) / 6.88 (facility), malpractice 1.63 — × 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 annual Part B deductible is met; the patient or secondary insurer is generally responsible for the remainder.
Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Amounts vary by locality based on GPCI values; the figure shown for your area may differ from the national average.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility amount differ from the non-facility amount for CPT 15120?

The facility rate uses a lower practice-expense RVU because Medicare assumes the facility (e.g., hospital) absorbs certain overhead costs, whereas the non-facility rate reflects the provider's office bearing those costs directly.

Will my local Medicare payment match the national amount shown here?

Not exactly. The national figure uses a GPCI value of 1.0 for all components; your actual locality-adjusted payment will differ based on local wage and cost indices.

Does this page tell me what my patient will owe?

No. Patient responsibility depends on deductible status, secondary coverage, and any applicable coinsurance, which are not reflected in the PFS allowed amount alone.

Why wasn't the CPT code description shown on this page?

CPT code descriptors are copyrighted by the American Medical Association and cannot be reproduced here; only the numeric code and its associated Medicare pricing data are shown.

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.