Medicare Reimbursement for CPT 15136

This page covers CPT code 15136, a procedure code defined by the American Medical Association. It shows the Medicare Physician Fee Schedule (PFS) allowed amount at the national level and by 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)	$101.54	$75.15
ALASKA* (AK)	$124.89	$96.79
ALABAMA (AL)	$92.26	$69.17
ARKANSAS (AR)	$91.11	$68.44
ARIZONA (AZ)	$98.92	$73.35
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$119.25	$82.05
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$121.15	$83.10
OXNARD-THOUSAND OAKS-VENTURA (CA)	$107.65	$76.47
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$108.69	$77.47
NAPA (CA)	$114.36	$79.58
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$119.55	$82.34
VALLEJO (CA)	$113.93	$79.16
BAKERSFIELD (CA)	$103.30	$74.38
CHICO (CA)	$102.57	$73.65
FRESNO (CA)	$102.57	$73.65
HANFORD-CORCORAN (CA)	$102.57	$73.65
MADERA (CA)	$102.57	$73.65
MERCED (CA)	$102.57	$73.65
MODESTO (CA)	$102.57	$73.65
REDDING (CA)	$102.57	$73.65
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$105.37	$76.45
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$106.45	$75.76
SALINAS (CA)	$106.03	$75.45
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$122.36	$84.31
SANTA CRUZ-WATSONVILLE (CA)	$108.01	$75.95
SANTA ROSA-PETALUMA (CA)	$109.02	$76.62
STOCKTON (CA)	$102.57	$73.65
VISALIA (CA)	$102.57	$73.65
YUBA CITY (CA)	$102.57	$73.65
EL CENTRO (CA)	$102.61	$73.69
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$107.67	$76.11
SAN LUIS OBISPO-PASO ROBLES (CA)	$104.47	$74.41
SANTA MARIA-SANTA BARBARA (CA)	$106.19	$75.43
REST OF CALIFORNIA (CA)	$102.57	$73.65
COLORADO (CO)	$103.04	$74.97
CONNECTICUT (CT)	$107.73	$79.31
DC + MD/VA SUBURBS (DC)	$113.00	$81.92
DELAWARE (DE)	$100.38	$74.31
FORT LAUDERDALE (FL)	$109.13	$82.40
MIAMI (FL)	$116.62	$89.16
REST OF FLORIDA (FL)	$103.97	$78.74
ATLANTA (GA)	$104.14	$77.33
REST OF GEORGIA (GA)	$98.44	$74.91
HAWAII, GUAM (HI)	$103.92	$73.92
IOWA (IA)	$92.55	$68.41
IDAHO (ID)	$93.44	$69.16
EAST ST. LOUIS (IL)	$106.82	$82.54
SUBURBAN CHICAGO (IL)	$109.77	$82.68
CHICAGO (IL)	$113.35	$86.83
REST OF ILLINOIS (IL)	$102.59	$78.50
INDIANA (IN)	$93.86	$69.40
KANSAS (KS)	$93.00	$69.15
KENTUCKY (KY)	$95.91	$72.45
NEW ORLEANS (LA)	$100.12	$75.29
REST OF LOUISIANA (LA)	$96.10	$72.75
METROPOLITAN BOSTON (MA)	$111.14	$79.63
REST OF MASSACHUSETTS (MA)	$102.89	$75.11
BALTIMORE/SURR. CNTYS (MD)	$107.60	$79.28
REST OF MARYLAND (MD)	$101.84	$75.14
SOUTHERN MAINE (ME)	$97.94	$71.79
REST OF MAINE (ME)	$94.73	$70.45
DETROIT (MI)	$105.95	$80.49
REST OF MICHIGAN (MI)	$98.82	$74.73
MINNESOTA (MN)	$96.70	$69.55
METROPOLITAN ST. LOUIS (MO)	$99.44	$74.32
METROPOLITAN KANSAS CITY (MO)	$98.65	$73.87
REST OF MISSOURI (MO)	$95.23	$72.48
MISSISSIPPI (MS)	$93.14	$70.42
MONTANA** (MT)	$101.52	$75.13
NORTH CAROLINA (NC)	$95.45	$70.83
NORTH DAKOTA** (ND)	$96.38	$69.99
NEBRASKA (NE)	$92.74	$68.39
NEW HAMPSHIRE (NH)	$102.26	$74.79
NORTHERN NJ (NJ)	$112.26	$81.65
REST OF NEW JERSEY (NJ)	$108.39	$79.57
NEW MEXICO (NM)	$99.62	$75.43
NEVADA** (NV)	$100.13	$73.72
MANHATTAN (NY)	$116.89	$86.23
NYC SUBURBS/LONG ISLAND (NY)	$120.43	$89.06
POUGHKPSIE/N NYC SUBURBS (NY)	$109.75	$80.85
QUEENS (NY)	$116.52	$85.33
REST OF NEW YORK (NY)	$96.76	$71.69
OHIO (OH)	$97.77	$73.68
OKLAHOMA (OK)	$94.88	$71.32
PORTLAND (OR)	$104.99	$75.67
REST OF OREGON (OR)	$98.78	$72.50
METROPOLITAN PHILADELPHIA (PA)	$105.90	$78.43
REST OF PENNSYLVANIA (PA)	$97.45	$73.22
PUERTO RICO (PR)	$101.89	$75.22
RHODE ISLAND (RI)	$102.98	$75.72
SOUTH CAROLINA (SC)	$96.89	$72.50
SOUTH DAKOTA** (SD)	$95.77	$69.39
TENNESSEE (TN)	$93.51	$69.52
BRAZORIA (TX)	$99.62	$73.47
DALLAS (TX)	$100.57	$74.29
GALVESTON (TX)	$100.13	$73.92
HOUSTON (TX)	$104.89	$78.68
BEAUMONT (TX)	$96.95	$72.94
FORT WORTH (TX)	$100.24	$74.22
AUSTIN (TX)	$103.20	$75.29
REST OF TEXAS (TX)	$98.45	$73.41
UTAH (UT)	$98.01	$73.20
VIRGINIA (VA)	$98.24	$72.30
VIRGIN ISLANDS (VI)	$101.89	$75.22
VERMONT (VT)	$96.81	$70.68
SEATTLE (KING CNTY) (WA)	$112.40	$80.02
REST OF WASHINGTON (WA)	$102.43	$74.65
WISCONSIN (WI)	$93.68	$68.40
WEST VIRGINIA (WV)	$99.51	$76.58
WYOMING** (WY)	$99.28	$72.89

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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: 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) — physician work, practice expense, and malpractice — assigned to this procedure code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost 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 differ when a service is performed in a physician's office versus a hospital or other facility.

RVUs — work 1.46, practice expense 1.32 (non-facility) / 0.53 (facility), malpractice 0.26 — × 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 insurer is responsible for the remainder.
Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Local Medicare Administrative Contractor (MAC) policies and coverage determinations may affect payment and should be verified directly.
Rates shown apply to Medicare Part B fee-for-service and may not reflect Medicare Advantage or other payer rules.

Frequently asked

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

The facility rate uses a lower practice-expense RVU because Medicare assumes the facility (e.g., hospital) is covering overhead costs like equipment and staff, which are instead built into the facility's own payment.

Why does the Medicare amount vary by locality?

Geographic Practice Cost Indices (GPCIs) adjust the work, practice expense, and malpractice RVUs to reflect regional differences in wages, rents, and other costs, so the same code can price differently in different areas.

Does this amount reflect what I'll actually be paid?

No. This is an estimate based on standard PFS inputs. Actual payment can be affected by modifiers, secondary payers, claim-specific adjustments, and annual rule changes.

Where can I find the official CPT code description?

CPT code descriptors are copyrighted by the American Medical Association. Check your CPT codebook, encoder software, or AMA resources for the official language.

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.