Medicare Reimbursement for CPT 15241

CPT 15241 is a procedure code reported to Medicare for physician and outpatient billing purposes. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$179.70	$89.51
ALASKA* (AK)	$212.70	$116.65
ALABAMA (AL)	$161.80	$82.89
ARKANSAS (AR)	$159.55	$82.09
ARIZONA (AZ)	$174.91	$87.52
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$224.79	$97.63
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$228.93	$98.89
OXNARD-THOUSAND OAKS-VENTURA (CA)	$197.68	$91.08
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$198.97	$92.28
NAPA (CA)	$213.58	$94.72
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$225.12	$97.96
VALLEJO (CA)	$213.10	$94.24
BAKERSFIELD (CA)	$187.58	$88.74
CHICO (CA)	$186.75	$87.91
FRESNO (CA)	$186.75	$87.91
HANFORD-CORCORAN (CA)	$186.75	$87.91
MADERA (CA)	$186.75	$87.91
MERCED (CA)	$186.75	$87.91
MODESTO (CA)	$186.75	$87.91
REDDING (CA)	$186.75	$87.91
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$189.88	$91.04
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$195.24	$90.35
SALINAS (CA)	$194.50	$89.97
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$230.28	$100.23
SANTA CRUZ-WATSONVILLE (CA)	$200.03	$90.45
SANTA ROSA-PETALUMA (CA)	$201.99	$91.25
STOCKTON (CA)	$186.75	$87.91
VISALIA (CA)	$186.75	$87.91
YUBA CITY (CA)	$186.75	$87.91
EL CENTRO (CA)	$186.80	$87.96
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$198.55	$90.69
SAN LUIS OBISPO-PASO ROBLES (CA)	$191.46	$88.74
SANTA MARIA-SANTA BARBARA (CA)	$195.08	$89.93
REST OF CALIFORNIA (CA)	$186.75	$87.91
COLORADO (CO)	$185.31	$89.36
CONNECTICUT (CT)	$191.38	$94.25
DC + MD/VA SUBURBS (DC)	$203.56	$97.32
DELAWARE (DE)	$177.71	$88.61
FORT LAUDERDALE (FL)	$188.95	$97.59
MIAMI (FL)	$199.00	$105.12
REST OF FLORIDA (FL)	$179.75	$93.53
ATLANTA (GA)	$183.58	$91.95
REST OF GEORGIA (GA)	$169.72	$89.28
HAWAII, GUAM (HI)	$190.63	$88.09
IOWA (IA)	$164.54	$82.03
IDAHO (ID)	$165.83	$82.86
EAST ST. LOUIS (IL)	$180.75	$97.79
SUBURBAN CHICAGO (IL)	$190.56	$97.94
CHICAGO (IL)	$193.21	$102.58
REST OF ILLINOIS (IL)	$175.62	$93.28
INDIANA (IN)	$166.72	$83.12
KANSAS (KS)	$164.38	$82.85
KENTUCKY (KY)	$166.71	$86.54
NEW ORLEANS (LA)	$174.55	$89.69
REST OF LOUISIANA (LA)	$166.69	$86.88
METROPOLITAN BOSTON (MA)	$202.36	$94.69
REST OF MASSACHUSETTS (MA)	$184.50	$89.54
BALTIMORE/SURR. CNTYS (MD)	$190.96	$94.19
REST OF MARYLAND (MD)	$180.82	$89.56
SOUTHERN MAINE (ME)	$175.14	$85.77
REST OF MAINE (ME)	$167.27	$84.30
DETROIT (MI)	$182.51	$95.48
REST OF MICHIGAN (MI)	$171.42	$89.08
MINNESOTA (MN)	$176.05	$83.26
METROPOLITAN ST. LOUIS (MO)	$174.46	$88.60
METROPOLITAN KANSAS CITY (MO)	$172.79	$88.11
REST OF MISSOURI (MO)	$164.33	$86.59
MISSISSIPPI (MS)	$161.94	$84.29
MONTANA** (MT)	$179.68	$89.50
NORTH CAROLINA (NC)	$168.86	$84.72
NORTH DAKOTA** (ND)	$173.94	$83.76
NEBRASKA (NE)	$165.24	$82.00
NEW HAMPSHIRE (NH)	$182.98	$89.10
NORTHERN NJ (NJ)	$201.69	$97.08
REST OF NEW JERSEY (NJ)	$193.13	$94.65
NEW MEXICO (NM)	$172.55	$89.85
NEVADA** (NV)	$178.19	$87.92
MANHATTAN (NY)	$206.99	$102.20
NYC SUBURBS/LONG ISLAND (NY)	$212.57	$105.35
POUGHKPSIE/N NYC SUBURBS (NY)	$194.86	$96.11
QUEENS (NY)	$207.79	$101.19
REST OF NEW YORK (NY)	$171.34	$85.67
OHIO (OH)	$170.24	$87.91
OKLAHOMA (OK)	$165.81	$85.28
PORTLAND (OR)	$190.35	$90.15
REST OF OREGON (OR)	$176.38	$86.56
METROPOLITAN PHILADELPHIA (PA)	$187.15	$93.27
REST OF PENNSYLVANIA (PA)	$170.18	$87.39
PUERTO RICO (PR)	$180.76	$89.58
RHODE ISLAND (RI)	$183.41	$90.26
SOUTH CAROLINA (SC)	$169.92	$86.59
SOUTH DAKOTA** (SD)	$173.27	$83.08
TENNESSEE (TN)	$165.24	$83.27
BRAZORIA (TX)	$177.06	$87.69
DALLAS (TX)	$178.43	$88.61
GALVESTON (TX)	$177.75	$88.20
HOUSTON (TX)	$183.06	$93.50
BEAUMONT (TX)	$169.15	$87.08
FORT WORTH (TX)	$177.46	$88.54
AUSTIN (TX)	$185.07	$89.65
REST OF TEXAS (TX)	$173.17	$87.59
UTAH (UT)	$172.14	$87.36
VIRGINIA (VA)	$174.99	$86.34
VIRGIN ISLANDS (VI)	$180.76	$89.58
VERMONT (VT)	$173.82	$84.54
SEATTLE (KING CNTY) (WA)	$205.82	$95.16
REST OF WASHINGTON (WA)	$183.97	$89.01
WISCONSIN (WI)	$168.39	$82.00
WEST VIRGINIA (WV)	$169.52	$91.15
WYOMING** (WY)	$177.18	$87.00

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 9 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) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed. These geographically adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs, which is why the two amounts differ — non-facility rates typically reflect the overhead of running an office, while facility rates assume the facility bears those costs.

RVUs — work 1.81, practice expense 3.28 (non-facility) / 0.58 (facility), malpractice 0.29 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Amounts vary by locality due to GPCI adjustments and may differ from what your specific Medicare Administrative Contractor (MAC) processes.
Always verify current rates and policy with your MAC before billing or appealing a claim.

Frequently asked

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

The facility rate uses a lower practice-expense RVU because the facility (e.g., hospital) — not the billing physician — is assumed to cover overhead costs like staff, equipment, and supplies for that setting.

Does this fee schedule amount reflect what will actually be paid?

No. It reflects the Medicare-allowed amount before cost-sharing, modifiers, sequestration, and any site-specific or payer-specific adjustments are applied.

Why does the amount change by locality?

Each locality has its own Geographic Practice Cost Indices (GPCIs) for work, practice expense, and malpractice, which adjust the RVUs to reflect regional cost differences before the conversion factor is applied.

Where can I find the official CPT descriptor for this code?

CPT code descriptors are copyrighted by the American Medical Association (AMA) and are not reproduced here; consult your CPT codebook or AMA resources for the official description.

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.