Medicare Reimbursement for CPT 15152

CPT 15152 is a procedure code billed under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code at the national level and by locality, broken out by non-facility (office) and facility (hospital/ASC) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$154.31	$122.58
ALASKA* (AK)	$188.81	$155.01
ALABAMA (AL)	$138.61	$110.84
ARKANSAS (AR)	$136.69	$109.44
ARIZONA (AZ)	$149.64	$118.89
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$170.85	$126.11
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$173.12	$127.37
OXNARD-THOUSAND OAKS-VENTURA (CA)	$157.90	$120.39
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$159.88	$122.35
NAPA (CA)	$165.29	$123.47
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$171.58	$126.84
VALLEJO (CA)	$164.24	$122.42
BAKERSFIELD (CA)	$152.44	$117.66
CHICO (CA)	$150.72	$115.94
FRESNO (CA)	$150.72	$115.94
HANFORD-CORCORAN (CA)	$150.72	$115.94
MADERA (CA)	$150.72	$115.94
MERCED (CA)	$150.72	$115.94
MODESTO (CA)	$150.72	$115.94
REDDING (CA)	$150.72	$115.94
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$157.57	$122.80
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$155.71	$118.81
SALINAS (CA)	$155.10	$118.32
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$176.09	$130.34
SANTA CRUZ-WATSONVILLE (CA)	$157.16	$118.61
SANTA ROSA-PETALUMA (CA)	$158.57	$119.60
STOCKTON (CA)	$150.72	$115.94
VISALIA (CA)	$150.72	$115.94
YUBA CITY (CA)	$150.72	$115.94
EL CENTRO (CA)	$150.82	$116.05
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$157.05	$119.10
SAN LUIS OBISPO-PASO ROBLES (CA)	$152.93	$116.79
SANTA MARIA-SANTA BARBARA (CA)	$155.21	$118.22
REST OF CALIFORNIA (CA)	$150.72	$115.94
COLORADO (CO)	$153.90	$120.14
CONNECTICUT (CT)	$164.39	$130.22
DC + MD/VA SUBURBS (DC)	$170.28	$132.91
DELAWARE (DE)	$151.94	$120.59
FORT LAUDERDALE (FL)	$172.25	$140.11
MIAMI (FL)	$189.11	$156.07
REST OF FLORIDA (FL)	$162.80	$132.47
ATLANTA (GA)	$159.68	$127.44
REST OF GEORGIA (GA)	$152.86	$124.56
HAWAII, GUAM (HI)	$152.36	$116.28
IOWA (IA)	$137.05	$108.02
IDAHO (ID)	$138.93	$109.74
EAST ST. LOUIS (IL)	$171.87	$142.68
SUBURBAN CHICAGO (IL)	$172.77	$140.19
CHICAGO (IL)	$182.82	$150.93
REST OF ILLINOIS (IL)	$161.87	$132.90
INDIANA (IN)	$139.57	$110.16
KANSAS (KS)	$138.77	$110.09
KENTUCKY (KY)	$146.79	$118.58
NEW ORLEANS (LA)	$154.18	$124.33
REST OF LOUISIANA (LA)	$147.50	$119.42
METROPOLITAN BOSTON (MA)	$165.28	$127.39
REST OF MASSACHUSETTS (MA)	$154.00	$120.59
BALTIMORE/SURR. CNTYS (MD)	$164.44	$130.39
REST OF MARYLAND (MD)	$153.99	$121.88
SOUTHERN MAINE (ME)	$145.96	$114.52
REST OF MAINE (ME)	$142.12	$112.92
DETROIT (MI)	$167.18	$136.56
REST OF MICHIGAN (MI)	$152.59	$123.62
MINNESOTA (MN)	$140.75	$108.10
METROPOLITAN ST. LOUIS (MO)	$151.89	$121.68
METROPOLITAN KANSAS CITY (MO)	$150.68	$120.89
REST OF MISSOURI (MO)	$146.66	$119.31
MISSISSIPPI (MS)	$141.58	$114.26
MONTANA** (MT)	$154.27	$122.54
NORTH CAROLINA (NC)	$143.15	$113.54
NORTH DAKOTA** (ND)	$141.61	$109.88
NEBRASKA (NE)	$137.06	$107.77
NEW HAMPSHIRE (NH)	$153.75	$120.72
NORTHERN NJ (NJ)	$169.13	$132.32
REST OF NEW JERSEY (NJ)	$164.38	$129.73
NEW MEXICO (NM)	$154.34	$125.24
NEVADA** (NV)	$150.79	$119.03
MANHATTAN (NY)	$180.39	$143.52
NYC SUBURBS/LONG ISLAND (NY)	$187.57	$149.84
POUGHKPSIE/N NYC SUBURBS (NY)	$167.36	$132.61
QUEENS (NY)	$178.34	$140.83
REST OF NEW YORK (NY)	$145.39	$115.25
OHIO (OH)	$150.01	$121.04
OKLAHOMA (OK)	$144.04	$115.71
PORTLAND (OR)	$155.85	$120.60
REST OF OREGON (OR)	$147.76	$116.15
METROPOLITAN PHILADELPHIA (PA)	$162.01	$128.98
REST OF PENNSYLVANIA (PA)	$148.92	$119.79
PUERTO RICO (PR)	$154.56	$122.48
RHODE ISLAND (RI)	$155.25	$122.47
SOUTH CAROLINA (SC)	$147.20	$117.88
SOUTH DAKOTA** (SD)	$140.12	$108.39
TENNESSEE (TN)	$139.73	$110.89
BRAZORIA (TX)	$149.80	$118.35
DALLAS (TX)	$151.80	$120.20
GALVESTON (TX)	$150.93	$119.42
HOUSTON (TX)	$162.64	$131.13
BEAUMONT (TX)	$148.17	$119.29
FORT WORTH (TX)	$151.57	$120.28
AUSTIN (TX)	$155.02	$121.45
REST OF TEXAS (TX)	$149.62	$119.50
UTAH (UT)	$149.05	$119.22
VIRGINIA (VA)	$147.15	$115.96
VIRGIN ISLANDS (VI)	$154.56	$122.48
VERMONT (VT)	$143.24	$111.82
SEATTLE (KING CNTY) (WA)	$166.15	$127.22
REST OF WASHINGTON (WA)	$152.99	$119.58
WISCONSIN (WI)	$137.36	$106.96
WEST VIRGINIA (WV)	$156.79	$129.21
WYOMING** (WY)	$148.75	$117.02

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 5 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 (MP) — assigned to the 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 Medicare conversion factor to produce a dollar amount. Non-facility and facility amounts differ mainly because the PE RVU is higher in non-facility settings (reflecting the practice's overhead) and lower in facility settings (where the facility bears more of the overhead cost). The resulting national figures are averages; actual payment varies once locality-specific GPCIs are applied.

RVUs — work 2.44, practice expense 1.54 (non-facility) / 0.59 (facility), malpractice 0.64 — × 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 the annual Part B deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment varies by locality GPCIs, applicable modifiers, place of service, and claim-specific adjustments.
Amounts may be affected by sequestration, annual budget-neutrality adjustments, and mid-year CMS corrections.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why is the facility amount lower than the non-facility amount for this code?

The practice expense RVU is reduced in the facility setting because the hospital or ASC — not the billing physician's practice — covers overhead costs like equipment, staff, and supplies for that visit.

Does this amount reflect what my specific practice will be paid?

Not exactly. The figures shown are calculated using GPCIs for a selected locality and the national conversion factor; your actual payment depends on your specific locality, any modifiers applied, and MAC-specific processing.

Why might the amount change next year?

CMS updates RVUs, GPCIs, and the conversion factor annually, and may apply budget-neutrality adjustments, so the allowed amount for the same code can rise or fall year to year.

Is this the total amount Medicare pays, or just the allowed amount?

It's the Medicare-allowed amount. Medicare generally reimburses 80% of this figure after the deductible is met, with the remaining 20% owed by the patient or a secondary payer.

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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.