Medicare Reimbursement for CPT 15155

CPT 15155 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 estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$848.38	$657.00
ALASKA* (AK)	$1015.81	$811.98
ALABAMA (AL)	$764.74	$597.28
ARKANSAS (AR)	$754.31	$589.91
ARIZONA (AZ)	$825.42	$639.96
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1031.96	$762.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1049.82	$773.84
OXNARD-THOUSAND OAKS-VENTURA (CA)	$917.75	$691.53
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$925.01	$698.60
NAPA (CA)	$984.42	$732.17
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1034.04	$764.18
VALLEJO (CA)	$981.43	$729.18
BAKERSFIELD (CA)	$874.62	$664.86
CHICO (CA)	$869.50	$659.74
FRESNO (CA)	$869.50	$659.74
HANFORD-CORCORAN (CA)	$869.50	$659.74
MADERA (CA)	$869.50	$659.74
MERCED (CA)	$869.50	$659.74
MODESTO (CA)	$869.50	$659.74
REDDING (CA)	$869.50	$659.74
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$889.21	$679.45
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$906.39	$683.81
SALINAS (CA)	$902.91	$681.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1058.32	$782.34
SANTA CRUZ-WATSONVILLE (CA)	$925.20	$692.66
SANTA ROSA-PETALUMA (CA)	$934.11	$699.09
STOCKTON (CA)	$869.50	$659.74
VISALIA (CA)	$869.50	$659.74
YUBA CITY (CA)	$869.50	$659.74
EL CENTRO (CA)	$869.81	$660.05
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$919.86	$690.96
SAN LUIS OBISPO-PASO ROBLES (CA)	$889.15	$671.16
SANTA MARIA-SANTA BARBARA (CA)	$905.12	$681.96
REST OF CALIFORNIA (CA)	$869.50	$659.74
COLORADO (CO)	$868.20	$664.57
CONNECTICUT (CT)	$903.01	$696.88
DC + MD/VA SUBURBS (DC)	$954.46	$729.01
DELAWARE (DE)	$838.38	$649.29
FORT LAUDERDALE (FL)	$903.71	$709.84
MIAMI (FL)	$960.57	$761.34
REST OF FLORIDA (FL)	$859.02	$676.06
ATLANTA (GA)	$868.97	$674.52
REST OF GEORGIA (GA)	$810.77	$640.05
HAWAII, GUAM (HI)	$885.25	$667.64
IOWA (IA)	$772.69	$597.57
IDAHO (ID)	$779.62	$603.54
EAST ST. LOUIS (IL)	$873.81	$697.73
SUBURBAN CHICAGO (IL)	$910.22	$713.67
CHICAGO (IL)	$932.13	$739.79
REST OF ILLINOIS (IL)	$843.04	$668.31
INDIANA (IN)	$783.61	$606.19
KANSAS (KS)	$774.20	$601.19
KENTUCKY (KY)	$792.47	$622.33
NEW ORLEANS (LA)	$829.74	$649.64
REST OF LOUISIANA (LA)	$793.27	$623.89
METROPOLITAN BOSTON (MA)	$943.85	$715.33
REST OF MASSACHUSETTS (MA)	$865.48	$663.95
BALTIMORE/SURR. CNTYS (MD)	$901.51	$696.15
REST OF MARYLAND (MD)	$852.16	$658.47
SOUTHERN MAINE (ME)	$821.72	$632.05
REST OF MAINE (ME)	$788.72	$612.65
DETROIT (MI)	$874.32	$689.63
REST OF MICHIGAN (MI)	$816.52	$641.78
MINNESOTA (MN)	$818.60	$621.67
METROPOLITAN ST. LOUIS (MO)	$826.57	$644.37
METROPOLITAN KANSAS CITY (MO)	$819.10	$639.39
REST OF MISSOURI (MO)	$783.74	$618.76
MISSISSIPPI (MS)	$768.92	$604.13
MONTANA** (MT)	$848.26	$656.87
NORTH CAROLINA (NC)	$795.70	$617.14
NORTH DAKOTA** (ND)	$812.08	$620.69
NEBRASKA (NE)	$775.18	$598.53
NEW HAMPSHIRE (NH)	$859.48	$660.24
NORTHERN NJ (NJ)	$946.46	$724.45
REST OF NEW JERSEY (NJ)	$909.56	$700.57
NEW MEXICO (NM)	$822.74	$647.24
NEVADA** (NV)	$838.63	$647.05
MANHATTAN (NY)	$979.36	$756.97
NYC SUBURBS/LONG ISLAND (NY)	$1008.27	$780.71
POUGHKPSIE/N NYC SUBURBS (NY)	$919.49	$709.92
QUEENS (NY)	$979.70	$753.48
REST OF NEW YORK (NY)	$807.38	$625.57
OHIO (OH)	$809.12	$634.38
OKLAHOMA (OK)	$785.86	$614.95
PORTLAND (OR)	$888.74	$676.11
REST OF OREGON (OR)	$828.40	$637.78
METROPOLITAN PHILADELPHIA (PA)	$884.86	$685.63
REST OF PENNSYLVANIA (PA)	$807.55	$631.86
PUERTO RICO (PR)	$852.49	$659.00
RHODE ISLAND (RI)	$863.14	$665.43
SOUTH CAROLINA (SC)	$804.49	$627.65
SOUTH DAKOTA** (SD)	$807.80	$616.41
TENNESSEE (TN)	$778.50	$604.53
BRAZORIA (TX)	$833.47	$643.80
DALLAS (TX)	$840.85	$650.23
GALVESTON (TX)	$837.31	$647.27
HOUSTON (TX)	$870.81	$680.76
BEAUMONT (TX)	$802.92	$628.76
FORT WORTH (TX)	$837.07	$648.37
AUSTIN (TX)	$868.58	$666.09
REST OF TEXAS (TX)	$819.15	$637.52
UTAH (UT)	$814.73	$634.83
VIRGINIA (VA)	$822.64	$634.51
VIRGIN ISLANDS (VI)	$852.49	$659.00
VERMONT (VT)	$813.62	$624.15
SEATTLE (KING CNTY) (WA)	$957.44	$722.60
REST OF WASHINGTON (WA)	$862.29	$660.75
WISCONSIN (WI)	$786.89	$603.55
WEST VIRGINIA (WV)	$814.87	$648.55
WYOMING** (WY)	$832.49	$641.10

Look up another code or locality →

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 — assigned to each 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 allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because overhead costs differ, which is why the two amounts shown differ.

RVUs — work 9.89, practice expense 13.68 (non-facility) / 7.95 (facility), malpractice 1.83 — × 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 responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates mean amounts can change year to year.
Always verify the current rate 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?

The two settings use different practice-expense RVUs because Medicare assumes the facility (e.g., hospital) absorbs certain overhead costs that a physician office would otherwise bear, so the facility amount is typically lower.

Why might my locality's rate differ from the national amount shown?

Local GPCIs adjust the work, practice-expense, and malpractice RVUs to reflect regional cost-of-living and practice-cost differences, so the final allowed amount varies by geographic area.

Does this amount reflect what Medicare will actually pay?

No. This is the PFS allowed amount before the standard 80/20 cost-sharing split, deductible application, and any modifier or sequestration adjustments are applied.

Where can I find the official rate for my area?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules that reflect the most current GPCIs and conversion factor for your region.

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.