Medicare Reimbursement for CPT 15121

This page covers a CPT procedure code (descriptor not shown due to AMA licensing restrictions). It displays the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and shows how the amount differs for non-facility versus facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$221.11	$119.24
ALASKA* (AK)	$256.61	$148.11
ALABAMA (AL)	$197.28	$108.14
ARKANSAS (AR)	$194.29	$106.79
ARIZONA (AZ)	$214.69	$115.98
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$277.44	$133.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$282.56	$135.66
OXNARD-THOUSAND OAKS-VENTURA (CA)	$243.48	$123.07
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$245.05	$124.53
NAPA (CA)	$263.46	$129.19
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$277.91	$134.27
VALLEJO (CA)	$262.77	$128.50
BAKERSFIELD (CA)	$230.49	$118.84
CHICO (CA)	$229.34	$117.69
FRESNO (CA)	$229.34	$117.69
HANFORD-CORCORAN (CA)	$229.34	$117.69
MADERA (CA)	$229.34	$117.69
MERCED (CA)	$229.34	$117.69
MODESTO (CA)	$229.34	$117.69
REDDING (CA)	$229.34	$117.69
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$233.85	$122.20
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$240.09	$121.61
SALINAS (CA)	$239.19	$121.12
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$284.51	$137.61
SANTA CRUZ-WATSONVILLE (CA)	$246.49	$122.72
SANTA ROSA-PETALUMA (CA)	$248.92	$123.82
STOCKTON (CA)	$229.34	$117.69
VISALIA (CA)	$229.34	$117.69
YUBA CITY (CA)	$229.34	$117.69
EL CENTRO (CA)	$229.41	$117.76
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$244.47	$122.63
SAN LUIS OBISPO-PASO ROBLES (CA)	$235.44	$119.41
SANTA MARIA-SANTA BARBARA (CA)	$239.99	$121.21
REST OF CALIFORNIA (CA)	$229.34	$117.69
COLORADO (CO)	$227.91	$119.52
CONNECTICUT (CT)	$236.29	$126.58
DC + MD/VA SUBURBS (DC)	$251.48	$131.48
DELAWARE (DE)	$218.32	$117.67
FORT LAUDERDALE (FL)	$234.29	$131.10
MIAMI (FL)	$248.38	$142.33
REST OF FLORIDA (FL)	$221.92	$124.53
ATLANTA (GA)	$226.40	$122.90
REST OF GEORGIA (GA)	$208.48	$117.61
HAWAII, GUAM (HI)	$234.66	$118.83
IOWA (IA)	$200.59	$107.38
IDAHO (ID)	$202.36	$108.64
EAST ST. LOUIS (IL)	$223.98	$130.26
SUBURBAN CHICAGO (IL)	$236.23	$131.61
CHICAGO (IL)	$240.45	$138.06
REST OF ILLINOIS (IL)	$216.66	$123.65
INDIANA (IN)	$203.54	$109.10
KANSAS (KS)	$200.53	$108.44
KENTUCKY (KY)	$204.16	$113.60
NEW ORLEANS (LA)	$214.65	$118.78
REST OF LOUISIANA (LA)	$204.20	$114.04
METROPOLITAN BOSTON (MA)	$249.78	$128.14
REST OF MASSACHUSETTS (MA)	$226.83	$119.56
BALTIMORE/SURR. CNTYS (MD)	$235.84	$126.53
REST OF MARYLAND (MD)	$222.32	$119.22
SOUTHERN MAINE (ME)	$214.66	$113.70
REST OF MAINE (ME)	$204.45	$110.73
DETROIT (MI)	$225.77	$127.46
REST OF MICHIGAN (MI)	$210.57	$117.56
MINNESOTA (MN)	$215.35	$110.53
METROPOLITAN ST. LOUIS (MO)	$214.33	$117.35
METROPOLITAN KANSAS CITY (MO)	$212.13	$116.47
REST OF MISSOURI (MO)	$201.16	$113.35
MISSISSIPPI (MS)	$197.72	$110.01
MONTANA** (MT)	$221.09	$119.21
NORTH CAROLINA (NC)	$206.54	$111.49
NORTH DAKOTA** (ND)	$212.78	$110.91
NEBRASKA (NE)	$201.46	$107.43
NEW HAMPSHIRE (NH)	$225.18	$119.13
NORTHERN NJ (NJ)	$248.88	$130.71
REST OF NEW JERSEY (NJ)	$238.14	$126.89
NEW MEXICO (NM)	$212.15	$118.73
NEVADA** (NV)	$218.91	$116.94
MANHATTAN (NY)	$256.50	$138.12
NYC SUBURBS/LONG ISLAND (NY)	$264.13	$143.01
POUGHKPSIE/N NYC SUBURBS (NY)	$240.48	$128.93
QUEENS (NY)	$257.32	$136.90
REST OF NEW YORK (NY)	$209.85	$113.07
OHIO (OH)	$208.88	$115.87
OKLAHOMA (OK)	$202.80	$111.82
PORTLAND (OR)	$234.32	$121.14
REST OF OREGON (OR)	$216.38	$114.91
METROPOLITAN PHILADELPHIA (PA)	$230.81	$124.76
REST OF PENNSYLVANIA (PA)	$208.70	$115.18
PUERTO RICO (PR)	$222.47	$119.47
RHODE ISLAND (RI)	$225.52	$120.29
SOUTH CAROLINA (SC)	$208.22	$114.09
SOUTH DAKOTA** (SD)	$211.80	$109.93
TENNESSEE (TN)	$201.70	$109.10
BRAZORIA (TX)	$217.27	$116.32
DALLAS (TX)	$219.14	$117.68
GALVESTON (TX)	$218.23	$117.07
HOUSTON (TX)	$225.92	$124.76
BEAUMONT (TX)	$207.34	$114.64
FORT WORTH (TX)	$217.90	$117.46
AUSTIN (TX)	$227.88	$120.10
REST OF TEXAS (TX)	$212.51	$115.84
UTAH (UT)	$211.17	$115.41
VIRGINIA (VA)	$214.58	$114.44
VIRGIN ISLANDS (VI)	$222.47	$119.47
VERMONT (VT)	$212.76	$111.91
SEATTLE (KING CNTY) (WA)	$254.03	$129.03
REST OF WASHINGTON (WA)	$226.13	$118.86
WISCONSIN (WI)	$205.44	$107.85
WEST VIRGINIA (WV)	$208.56	$120.04
WYOMING** (WY)	$217.47	$115.59

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 8 units 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) — work, practice expense (PE), 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 furnished, accounting for regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility PE RVUs are typically higher than facility PE RVUs because they reflect the overhead of performing the service in an office versus a hospital or ambulatory surgical center, which is why non-facility and facility rates differ.

RVUs — work 1.95, practice expense 4.25 (non-facility) / 1.2 (facility), malpractice 0.42 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only — actual payment can vary by locality, contractor, and claim-specific factors.
Medicare typically pays 80% of the allowed amount after the patient meets the Part B deductible; the patient or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final payment.
Always verify current rates and local adjustments with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount for this code?

The facility rate uses lower practice-expense RVUs because Medicare assumes the facility (not the physician's office) incurs most of the overhead costs, such as equipment and supplies, when the service is performed in a hospital or ASC setting.

Does this amount reflect what Medicare will actually pay?

No. The figures shown are national or locality-adjusted PFS allowed amounts before the 80/20 coinsurance split, deductible application, and any claim-specific adjustments like sequestration or modifiers.

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

CPT codes and their descriptors are copyrighted by the American Medical Association (AMA) and require a separate license to display, so this page refers to the code generically.

Will this amount change next year?

Yes. CMS updates RVUs, GPCIs, and the conversion factor annually, and budget-neutrality adjustments can shift payment amounts even if the RVUs for a specific code stay the same.

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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.