Medicare Reimbursement for CPT 15135

CPT 15135 is a procedure code reported to Medicare for physician and outpatient billing purposes. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both at the national level and adjusted for your locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$901.49	$674.03
ALASKA* (AK)	$1088.64	$846.39
ALABAMA (AL)	$817.07	$618.04
ARKANSAS (AR)	$806.51	$611.12
ARIZONA (AZ)	$878.60	$658.19
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1105.03	$784.31
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1124.55	$796.55
OXNARD-THOUSAND OAKS-VENTURA (CA)	$980.21	$711.35
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$987.57	$718.48
NAPA (CA)	$1053.05	$753.25
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1106.86	$786.14
VALLEJO (CA)	$1050.41	$750.62
BAKERSFIELD (CA)	$934.20	$684.90
CHICO (CA)	$929.55	$680.26
FRESNO (CA)	$929.55	$680.26
HANFORD-CORCORAN (CA)	$929.55	$680.26
MADERA (CA)	$929.55	$680.26
MERCED (CA)	$929.55	$680.26
MODESTO (CA)	$929.55	$680.26
REDDING (CA)	$929.55	$680.26
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$946.96	$697.66
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$969.12	$704.58
SALINAS (CA)	$965.37	$701.74
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1132.02	$804.02
SANTA CRUZ-WATSONVILLE (CA)	$989.14	$712.78
SANTA ROSA-PETALUMA (CA)	$998.72	$719.40
STOCKTON (CA)	$929.55	$680.26
VISALIA (CA)	$929.55	$680.26
YUBA CITY (CA)	$929.55	$680.26
EL CENTRO (CA)	$929.82	$680.53
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$983.41	$711.37
SAN LUIS OBISPO-PASO ROBLES (CA)	$950.57	$691.49
SANTA MARIA-SANTA BARBARA (CA)	$967.71	$702.49
REST OF CALIFORNIA (CA)	$929.55	$680.26
COLORADO (CO)	$925.30	$683.28
CONNECTICUT (CT)	$957.59	$712.62
DC + MD/VA SUBURBS (DC)	$1013.94	$745.99
DELAWARE (DE)	$891.99	$667.26
FORT LAUDERDALE (FL)	$951.29	$720.88
MIAMI (FL)	$1003.75	$766.96
REST OF FLORIDA (FL)	$907.04	$689.59
ATLANTA (GA)	$921.19	$690.10
REST OF GEORGIA (GA)	$859.04	$656.15
HAWAII, GUAM (HI)	$945.80	$687.17
IOWA (IA)	$827.53	$619.40
IDAHO (ID)	$834.06	$624.79
EAST ST. LOUIS (IL)	$916.93	$707.66
SUBURBAN CHICAGO (IL)	$958.71	$725.11
CHICAGO (IL)	$976.09	$747.49
REST OF ILLINOIS (IL)	$889.25	$681.58
INDIANA (IN)	$838.18	$627.32
KANSAS (KS)	$827.91	$622.28
KENTUCKY (KY)	$842.68	$640.47
NEW ORLEANS (LA)	$879.97	$665.93
REST OF LOUISIANA (LA)	$843.04	$641.73
METROPOLITAN BOSTON (MA)	$1005.10	$733.51
REST OF MASSACHUSETTS (MA)	$922.22	$682.70
BALTIMORE/SURR. CNTYS (MD)	$955.65	$711.59
REST OF MARYLAND (MD)	$906.54	$676.35
SOUTHERN MAINE (ME)	$877.25	$651.84
REST OF MAINE (ME)	$842.07	$632.81
DETROIT (MI)	$921.28	$701.78
REST OF MICHIGAN (MI)	$865.91	$658.24
MINNESOTA (MN)	$877.80	$643.75
METROPOLITAN ST. LOUIS (MO)	$878.14	$661.60
METROPOLITAN KANSAS CITY (MO)	$870.45	$656.86
REST OF MISSOURI (MO)	$832.66	$636.59
MISSISSIPPI (MS)	$819.53	$623.69
MONTANA** (MT)	$901.38	$673.92
NORTH CAROLINA (NC)	$849.34	$637.12
NORTH DAKOTA** (ND)	$869.55	$642.09
NEBRASKA (NE)	$830.42	$620.47
NEW HAMPSHIRE (NH)	$914.80	$678.02
NORTHERN NJ (NJ)	$1005.95	$742.10
REST OF NEW JERSEY (NJ)	$966.03	$717.64
NEW MEXICO (NM)	$871.74	$663.16
NEVADA** (NV)	$893.00	$665.31
MANHATTAN (NY)	$1035.14	$770.84
NYC SUBURBS/LONG ISLAND (NY)	$1062.91	$792.46
POUGHKPSIE/N NYC SUBURBS (NY)	$975.36	$726.29
QUEENS (NY)	$1037.17	$768.32
REST OF NEW YORK (NY)	$861.09	$645.00
OHIO (OH)	$859.41	$651.74
OKLAHOMA (OK)	$837.21	$634.09
PORTLAND (OR)	$947.71	$695.00
REST OF OREGON (OR)	$883.56	$657.01
METROPOLITAN PHILADELPHIA (PA)	$938.37	$701.58
REST OF PENNSYLVANIA (PA)	$858.46	$649.65
PUERTO RICO (PR)	$906.06	$676.10
RHODE ISLAND (RI)	$918.63	$683.66
SOUTH CAROLINA (SC)	$856.29	$646.11
SOUTH DAKOTA** (SD)	$865.78	$638.32
TENNESSEE (TN)	$832.12	$625.36
BRAZORIA (TX)	$888.13	$662.72
DALLAS (TX)	$895.13	$668.58
GALVESTON (TX)	$891.69	$665.82
HOUSTON (TX)	$921.16	$695.29
BEAUMONT (TX)	$853.69	$646.70
FORT WORTH (TX)	$890.94	$666.67
AUSTIN (TX)	$924.42	$683.77
REST OF TEXAS (TX)	$871.35	$655.49
UTAH (UT)	$866.69	$652.87
VIRGINIA (VA)	$877.37	$653.78
VIRGIN ISLANDS (VI)	$906.06	$676.10
VERMONT (VT)	$870.04	$644.85
SEATTLE (KING CNTY) (WA)	$1020.53	$741.43
REST OF WASHINGTON (WA)	$919.20	$679.69
WISCONSIN (WI)	$843.75	$625.85
WEST VIRGINIA (WV)	$860.65	$662.99
WYOMING** (WY)	$887.51	$660.05

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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 Physician Fee Schedule amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility and facility rates differ mainly because the practice-expense RVU is lower in facility settings, reflecting that the facility (not the physician's practice) incurs certain overhead costs. These RVUs and the conversion factor are updated annually by CMS and can shift due to policy, budget-neutrality adjustments, or legislative changes.

RVUs — work 10.75, practice expense 14.63 (non-facility) / 7.82 (facility), malpractice 1.61 — × 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 their deductible; the patient or secondary payer is generally responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, place of service, sequestration reductions, and annual CMS budget-neutrality adjustments.
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?

The practice-expense RVU is lower in the facility setting because the facility, rather than the physician's office, bears many of the overhead costs for the procedure.

Does this amount reflect what the patient will owe?

No. This figure represents the Medicare-allowed amount before cost-sharing; after the deductible, Medicare generally pays 80%, leaving a 20% coinsurance plus any unmet deductible to the patient or secondary payer.

Will this amount be the same in every state?

No. The national amount shown is adjusted locally by GPCIs, so the actual PFS rate varies by Medicare locality.

Can modifiers or policy changes affect this estimate?

Yes. Modifiers, multiple-procedure reductions, sequestration, and annual CMS rule updates can all change the final paid amount relative to this estimate.

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.