Medicare Reimbursement for CPT 15271

CPT 15271 is a procedure code reported to Medicare for physician and outpatient services; the exact clinical description is maintained by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount nationally and lists how it can vary by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$157.99	$75.15
ALASKA* (AK)	$185.86	$97.64
ALABAMA (AL)	$142.17	$69.69
ARKANSAS (AR)	$140.17	$69.02
ARIZONA (AZ)	$153.81	$73.54
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$200.49	$83.69
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$204.30	$84.85
OXNARD-THOUSAND OAKS-VENTURA (CA)	$175.31	$77.40
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$176.33	$78.34
NAPA (CA)	$190.11	$80.93
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$200.73	$83.93
VALLEJO (CA)	$189.77	$80.59
BAKERSFIELD (CA)	$165.98	$75.20
CHICO (CA)	$165.37	$74.59
FRESNO (CA)	$165.37	$74.59
HANFORD-CORCORAN (CA)	$165.37	$74.59
MADERA (CA)	$165.37	$74.59
MERCED (CA)	$165.37	$74.59
MODESTO (CA)	$165.37	$74.59
REDDING (CA)	$165.37	$74.59
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$167.64	$76.86
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$173.15	$76.81
SALINAS (CA)	$172.49	$76.49
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$205.27	$85.82
SANTA CRUZ-WATSONVILLE (CA)	$177.73	$77.09
SANTA ROSA-PETALUMA (CA)	$179.50	$77.78
STOCKTON (CA)	$165.37	$74.59
VISALIA (CA)	$165.37	$74.59
YUBA CITY (CA)	$165.37	$74.59
EL CENTRO (CA)	$165.41	$74.62
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$176.27	$77.20
SAN LUIS OBISPO-PASO ROBLES (CA)	$169.77	$75.42
SANTA MARIA-SANTA BARBARA (CA)	$173.06	$76.48
REST OF CALIFORNIA (CA)	$165.37	$74.59
COLORADO (CO)	$163.58	$75.44
CONNECTICUT (CT)	$168.30	$79.09
DC + MD/VA SUBURBS (DC)	$179.60	$82.03
DELAWARE (DE)	$156.30	$74.45
FORT LAUDERDALE (FL)	$164.98	$81.07
MIAMI (FL)	$172.90	$86.67
REST OF FLORIDA (FL)	$157.02	$77.83
ATLANTA (GA)	$161.18	$77.02
REST OF GEORGIA (GA)	$148.29	$74.41
HAWAII, GUAM (HI)	$169.04	$74.85
IOWA (IA)	$145.07	$69.28
IDAHO (ID)	$146.11	$69.91
EAST ST. LOUIS (IL)	$156.92	$80.71
SUBURBAN CHICAGO (IL)	$166.50	$81.43
CHICAGO (IL)	$167.92	$84.67
REST OF ILLINOIS (IL)	$153.04	$77.42
INDIANA (IN)	$146.92	$70.13
KANSAS (KS)	$144.70	$69.81
KENTUCKY (KY)	$146.05	$72.41
NEW ORLEANS (LA)	$152.91	$74.96
REST OF LOUISIANA (LA)	$145.94	$72.63
METROPOLITAN BOSTON (MA)	$179.04	$80.14
REST OF MASSACHUSETTS (MA)	$162.76	$75.54
BALTIMORE/SURR. CNTYS (MD)	$167.89	$79.01
REST OF MARYLAND (MD)	$159.13	$75.30
SOUTHERN MAINE (ME)	$154.48	$72.39
REST OF MAINE (ME)	$147.16	$70.95
DETROIT (MI)	$159.22	$79.29
REST OF MICHIGAN (MI)	$150.00	$74.37
MINNESOTA (MN)	$156.01	$70.78
METROPOLITAN ST. LOUIS (MO)	$153.09	$74.24
METROPOLITAN KANSAS CITY (MO)	$151.59	$73.81
REST OF MISSOURI (MO)	$143.70	$72.30
MISSISSIPPI (MS)	$141.95	$70.63
MONTANA** (MT)	$157.97	$75.14
NORTH CAROLINA (NC)	$148.61	$71.32
NORTH DAKOTA** (ND)	$153.82	$70.99
NEBRASKA (NE)	$145.75	$69.30
NEW HAMPSHIRE (NH)	$161.30	$75.07
NORTHERN NJ (NJ)	$177.89	$81.80
REST OF NEW JERSEY (NJ)	$170.02	$79.57
NEW MEXICO (NM)	$150.91	$74.95
NEVADA** (NV)	$156.92	$74.00
MANHATTAN (NY)	$181.78	$85.52
NYC SUBURBS/LONG ISLAND (NY)	$186.44	$87.95
POUGHKPSIE/N NYC SUBURBS (NY)	$171.36	$80.66
QUEENS (NY)	$182.81	$84.90
REST OF NEW YORK (NY)	$150.79	$72.10
OHIO (OH)	$149.15	$73.52
OKLAHOMA (OK)	$145.49	$71.52
PORTLAND (OR)	$168.32	$76.29
REST OF OREGON (OR)	$155.49	$72.99
METROPOLITAN PHILADELPHIA (PA)	$164.41	$78.18
REST OF PENNSYLVANIA (PA)	$149.22	$73.18
PUERTO RICO (PR)	$159.01	$75.26
RHODE ISLAND (RI)	$161.53	$75.96
SOUTH CAROLINA (SC)	$149.17	$72.63
SOUTH DAKOTA** (SD)	$153.33	$70.49
TENNESSEE (TN)	$145.44	$70.14
BRAZORIA (TX)	$155.91	$73.82
DALLAS (TX)	$157.02	$74.52
GALVESTON (TX)	$156.45	$74.20
HOUSTON (TX)	$160.30	$78.04
BEAUMONT (TX)	$148.29	$72.91
FORT WORTH (TX)	$156.09	$74.41
AUSTIN (TX)	$163.21	$75.57
REST OF TEXAS (TX)	$152.09	$73.48
UTAH (UT)	$151.14	$73.27
VIRGINIA (VA)	$154.19	$72.76
VIRGIN ISLANDS (VI)	$159.01	$75.26
VERMONT (VT)	$153.50	$71.49
SEATTLE (KING CNTY) (WA)	$182.34	$80.70
REST OF WASHINGTON (WA)	$162.36	$75.14
WISCONSIN (WI)	$148.84	$69.48
WEST VIRGINIA (WV)	$147.62	$75.64
WYOMING** (WY)	$156.16	$73.33

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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) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because the resource costs borne by the practice differ, which is why the same code can show two different national amounts. Locality-specific GPCIs mean the same code can price differently from one region to another even though the RVUs and conversion factor are the same nationwide.

RVUs — work 1.46, practice expense 3.06 (non-facility) / 0.58 (facility), malpractice 0.21 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

These figures are estimates only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the beneficiary meets the annual Part B deductible; the patient or secondary payer is generally responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Amounts can differ by Medicare Administrative Contractor (MAC) and locality; always verify current rates with your MAC before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The practice-expense RVU is lower in the facility setting because the hospital or facility—not the physician's office—bears many of the overhead and supply costs, so Medicare pays less to the billing provider for that portion.

Will I actually receive the national amount shown?

No. The national figure is a baseline calculated before locality GPCI adjustments; your actual payment depends on the specific locality, any applicable modifiers, and current sequestration or budget-neutrality adjustments in effect.

Does this page tell me if a claim for 15271 will be approved?

No. This page only estimates the PFS allowed amount if the service is covered and paid; coverage determinations, medical necessity, and documentation requirements are separate from fee-schedule pricing.

Where can I find the official Medicare amount for my area?

Check your MAC's published fee schedule or the CMS Physician Fee Schedule Look-Up Tool, which reflects the current year's locality-specific GPCI adjustments and conversion factor.

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.