Medicare Reimbursement for CPT 15156

CPT 15156 is a procedure code used in Medicare billing; the official descriptor is proprietary to the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$168.67	$134.94
ALASKA* (AK)	$206.39	$170.46
ALABAMA (AL)	$151.45	$121.93
ARKANSAS (AR)	$149.36	$120.38
ARIZONA (AZ)	$163.54	$130.85
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$186.28	$138.71
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$188.73	$140.08
OXNARD-THOUSAND OAKS-VENTURA (CA)	$172.33	$132.46
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$174.52	$134.61
NAPA (CA)	$180.28	$135.82
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$187.08	$139.52
VALLEJO (CA)	$179.12	$134.65
BAKERSFIELD (CA)	$166.43	$129.45
CHICO (CA)	$164.52	$127.54
FRESNO (CA)	$164.52	$127.54
HANFORD-CORCORAN (CA)	$164.52	$127.54
MADERA (CA)	$164.52	$127.54
MERCED (CA)	$164.52	$127.54
MODESTO (CA)	$164.52	$127.54
REDDING (CA)	$164.52	$127.54
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$172.12	$135.15
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$169.93	$130.70
SALINAS (CA)	$169.26	$130.16
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$192.02	$143.38
SANTA CRUZ-WATSONVILLE (CA)	$171.47	$130.48
SANTA ROSA-PETALUMA (CA)	$173.00	$131.57
STOCKTON (CA)	$164.52	$127.54
VISALIA (CA)	$164.52	$127.54
YUBA CITY (CA)	$164.52	$127.54
EL CENTRO (CA)	$164.63	$127.66
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$171.37	$131.02
SAN LUIS OBISPO-PASO ROBLES (CA)	$166.90	$128.48
SANTA MARIA-SANTA BARBARA (CA)	$169.38	$130.05
REST OF CALIFORNIA (CA)	$164.52	$127.54
COLORADO (CO)	$168.10	$132.21
CONNECTICUT (CT)	$179.71	$143.38
DC + MD/VA SUBURBS (DC)	$186.06	$146.32
DELAWARE (DE)	$166.06	$132.73
FORT LAUDERDALE (FL)	$188.56	$154.38
MIAMI (FL)	$207.21	$172.09
REST OF FLORIDA (FL)	$178.16	$145.91
ATLANTA (GA)	$174.60	$140.32
REST OF GEORGIA (GA)	$167.24	$137.15
HAWAII, GUAM (HI)	$166.29	$127.93
IOWA (IA)	$149.66	$118.79
IDAHO (ID)	$151.74	$120.71
EAST ST. LOUIS (IL)	$188.29	$157.25
SUBURBAN CHICAGO (IL)	$189.11	$154.46
CHICAGO (IL)	$200.29	$166.39
REST OF ILLINOIS (IL)	$177.20	$146.40
INDIANA (IN)	$152.44	$121.17
KANSAS (KS)	$151.59	$121.09
KENTUCKY (KY)	$160.50	$130.51
NEW ORLEANS (LA)	$168.63	$136.88
REST OF LOUISIANA (LA)	$161.30	$131.45
METROPOLITAN BOSTON (MA)	$180.49	$140.21
REST OF MASSACHUSETTS (MA)	$168.23	$132.71
BALTIMORE/SURR. CNTYS (MD)	$179.77	$143.58
REST OF MARYLAND (MD)	$168.29	$134.15
SOUTHERN MAINE (ME)	$159.42	$125.99
REST OF MAINE (ME)	$155.27	$124.24
DETROIT (MI)	$183.00	$150.45
REST OF MICHIGAN (MI)	$166.91	$136.11
MINNESOTA (MN)	$153.59	$118.87
METROPOLITAN ST. LOUIS (MO)	$166.06	$133.94
METROPOLITAN KANSAS CITY (MO)	$164.75	$133.07
REST OF MISSOURI (MO)	$160.41	$131.33
MISSISSIPPI (MS)	$154.78	$125.73
MONTANA** (MT)	$168.63	$134.89
NORTH CAROLINA (NC)	$156.40	$124.92
NORTH DAKOTA** (ND)	$154.59	$120.85
NEBRASKA (NE)	$149.65	$118.52
NEW HAMPSHIRE (NH)	$167.98	$132.87
NORTHERN NJ (NJ)	$184.80	$145.67
REST OF NEW JERSEY (NJ)	$179.66	$142.82
NEW MEXICO (NM)	$168.84	$137.90
NEVADA** (NV)	$164.77	$131.00
MANHATTAN (NY)	$197.28	$158.08
NYC SUBURBS/LONG ISLAND (NY)	$205.21	$165.10
POUGHKPSIE/N NYC SUBURBS (NY)	$182.95	$146.01
QUEENS (NY)	$194.98	$155.10
REST OF NEW YORK (NY)	$158.86	$126.81
OHIO (OH)	$164.04	$133.24
OKLAHOMA (OK)	$157.45	$127.33
PORTLAND (OR)	$170.19	$132.71
REST OF OREGON (OR)	$161.41	$127.81
METROPOLITAN PHILADELPHIA (PA)	$177.14	$142.02
REST OF PENNSYLVANIA (PA)	$162.82	$131.86
PUERTO RICO (PR)	$168.93	$134.82
RHODE ISLAND (RI)	$169.64	$134.80
SOUTH CAROLINA (SC)	$160.90	$129.73
SOUTH DAKOTA** (SD)	$152.93	$119.19
TENNESSEE (TN)	$152.65	$121.98
BRAZORIA (TX)	$163.67	$130.24
DALLAS (TX)	$165.89	$132.29
GALVESTON (TX)	$164.92	$131.42
HOUSTON (TX)	$177.92	$144.42
BEAUMONT (TX)	$162.00	$131.30
FORT WORTH (TX)	$165.64	$132.38
AUSTIN (TX)	$169.37	$133.67
REST OF TEXAS (TX)	$163.55	$131.53
UTAH (UT)	$162.93	$131.22
VIRGINIA (VA)	$160.76	$127.60
VIRGIN ISLANDS (VI)	$168.93	$134.82
VERMONT (VT)	$156.41	$123.01
SEATTLE (KING CNTY) (WA)	$181.40	$140.00
REST OF WASHINGTON (WA)	$167.11	$131.59
WISCONSIN (WI)	$149.94	$117.62
WEST VIRGINIA (WV)	$171.63	$142.32
WYOMING** (WY)	$162.51	$128.77

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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 PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the provider's locality. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility and facility settings because facility settings (like hospitals) shift some overhead costs to the facility itself, typically resulting in a lower physician-side payment. The national amounts shown use national average GPCIs, while locality-specific amounts reflect regional cost adjustments.

RVUs — work 2.68, practice expense 1.66 (non-facility) / 0.65 (facility), malpractice 0.71 — × 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 annual Part B deductible is met; the beneficiary or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC), as fee schedules update annually and can be revised mid-year.

Frequently asked

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

Facility rates use a lower practice-expense RVU because the facility (e.g., hospital) — not the billing physician — absorbs certain overhead and equipment costs.

Does this fee schedule amount reflect what Medicare will actually pay?

No. It reflects the PFS allowed amount before deductible, coinsurance, modifiers, and other adjustments are applied. Actual payment may differ.

Why does the amount vary by locality?

Medicare adjusts payment using Geographic Practice Cost Indices (GPCIs) that account for regional differences in wages, rent, and malpractice costs.

Can modifiers change this amount?

Yes. Modifiers such as bilateral, multiple-procedure, or assistant-at-surgery modifiers can increase or decrease the allowed amount from the base PFS rate shown here.

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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.