Medicare Reimbursement for CPT 15570

CPT 15570 is a surgical procedure code reported to Medicare for payment under the Physician Fee Schedule (PFS). This page shows the estimated Medicare PFS allowed amount for this code, both at the national level and adjusted by locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$981.32	$672.69
ALASKA* (AK)	$1155.51	$826.82
ALABAMA (AL)	$879.66	$609.61
ARKANSAS (AR)	$866.95	$601.84
ARIZONA (AZ)	$953.69	$654.63
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1213.50	$778.34
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1235.27	$790.23
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1071.58	$706.79
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1079.21	$714.11
NAPA (CA)	$1154.79	$748.03
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1215.76	$780.60
VALLEJO (CA)	$1151.54	$744.77
BAKERSFIELD (CA)	$1017.57	$679.31
CHICO (CA)	$1012.05	$673.80
FRESNO (CA)	$1012.05	$673.80
HANFORD-CORCORAN (CA)	$1012.05	$673.80
MADERA (CA)	$1012.05	$673.80
MERCED (CA)	$1012.05	$673.80
MODESTO (CA)	$1012.05	$673.80
REDDING (CA)	$1012.05	$673.80
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1033.45	$695.20
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1057.39	$698.46
SALINAS (CA)	$1053.40	$695.70
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1244.50	$799.47
SANTA CRUZ-WATSONVILLE (CA)	$1082.70	$707.72
SANTA ROSA-PETALUMA (CA)	$1093.26	$714.27
STOCKTON (CA)	$1012.05	$673.80
VISALIA (CA)	$1012.05	$673.80
YUBA CITY (CA)	$1012.05	$673.80
EL CENTRO (CA)	$1012.38	$674.13
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1075.02	$705.90
SAN LUIS OBISPO-PASO ROBLES (CA)	$1037.10	$685.57
SANTA MARIA-SANTA BARBARA (CA)	$1056.48	$696.62
REST OF CALIFORNIA (CA)	$1012.05	$673.80
COLORADO (CO)	$1008.03	$679.65
CONNECTICUT (CT)	$1046.78	$714.39
DC + MD/VA SUBURBS (DC)	$1110.46	$746.90
DELAWARE (DE)	$969.28	$664.36
FORT LAUDERDALE (FL)	$1042.60	$729.96
MIAMI (FL)	$1106.83	$785.55
REST OF FLORIDA (FL)	$989.12	$694.08
ATLANTA (GA)	$1005.00	$691.43
REST OF GEORGIA (GA)	$931.17	$655.88
HAWAII, GUAM (HI)	$1033.14	$682.23
IOWA (IA)	$891.72	$609.33
IDAHO (ID)	$899.69	$615.75
EAST ST. LOUIS (IL)	$1002.12	$718.18
SUBURBAN CHICAGO (IL)	$1050.69	$733.73
CHICAGO (IL)	$1072.63	$762.47
REST OF ILLINOIS (IL)	$968.06	$686.29
INDIANA (IN)	$904.63	$618.54
KANSAS (KS)	$892.43	$613.43
KENTUCKY (KY)	$911.01	$636.64
NEW ORLEANS (LA)	$955.99	$665.57
REST OF LOUISIANA (LA)	$911.54	$638.41
METROPOLITAN BOSTON (MA)	$1100.64	$732.14
REST OF MASSACHUSETTS (MA)	$1004.02	$679.03
BALTIMORE/SURR. CNTYS (MD)	$1044.91	$713.76
REST OF MARYLAND (MD)	$986.18	$673.85
SOUTHERN MAINE (ME)	$951.55	$645.70
REST OF MAINE (ME)	$909.59	$625.66
DETROIT (MI)	$1006.53	$708.70
REST OF MICHIGAN (MI)	$939.21	$657.44
MINNESOTA (MN)	$951.42	$633.84
METROPOLITAN ST. LOUIS (MO)	$953.49	$659.68
METROPOLITAN KANSAS CITY (MO)	$944.26	$654.46
REST OF MISSOURI (MO)	$899.20	$633.17
MISSISSIPPI (MS)	$883.00	$617.28
MONTANA** (MT)	$981.19	$672.56
NORTH CAROLINA (NC)	$918.30	$630.35
NORTH DAKOTA** (ND)	$941.84	$633.21
NEBRASKA (NE)	$895.12	$610.26
NEW HAMPSHIRE (NH)	$996.89	$675.62
NORTHERN NJ (NJ)	$1099.98	$741.97
REST OF NEW JERSEY (NJ)	$1054.65	$717.63
NEW MEXICO (NM)	$946.33	$663.32
NEVADA** (NV)	$970.80	$661.87
MANHATTAN (NY)	$1135.91	$777.28
NYC SUBURBS/LONG ISLAND (NY)	$1169.65	$802.69
POUGHKPSIE/N NYC SUBURBS (NY)	$1065.57	$727.63
QUEENS (NY)	$1137.98	$773.19
REST OF NEW YORK (NY)	$932.45	$639.26
OHIO (OH)	$931.17	$649.40
OKLAHOMA (OK)	$904.17	$628.57
PORTLAND (OR)	$1034.28	$691.40
REST OF OREGON (OR)	$959.25	$651.86
METROPOLITAN PHILADELPHIA (PA)	$1024.01	$702.73
REST OF PENNSYLVANIA (PA)	$929.90	$646.58
PUERTO RICO (PR)	$986.73	$674.71
RHODE ISLAND (RI)	$999.68	$680.87
SOUTH CAROLINA (SC)	$927.08	$641.91
SOUTH DAKOTA** (SD)	$937.18	$628.56
TENNESSEE (TN)	$897.54	$617.00
BRAZORIA (TX)	$964.11	$658.26
DALLAS (TX)	$972.54	$665.15
GALVESTON (TX)	$968.47	$662.00
HOUSTON (TX)	$1004.89	$698.43
BEAUMONT (TX)	$924.17	$643.33
FORT WORTH (TX)	$967.58	$663.28
AUSTIN (TX)	$1008.19	$681.67
REST OF TEXAS (TX)	$945.16	$652.28
UTAH (UT)	$939.59	$649.48
VIRGINIA (VA)	$951.87	$648.50
VIRGIN ISLANDS (VI)	$986.73	$674.71
VERMONT (VT)	$942.66	$637.12
SEATTLE (KING CNTY) (WA)	$1118.00	$739.32
REST OF WASHINGTON (WA)	$1000.63	$675.64
WISCONSIN (WI)	$910.86	$615.20
WEST VIRGINIA (WV)	$933.66	$665.46
WYOMING** (WY)	$964.04	$655.41

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 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 — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, accounting for local cost-of-living and practice cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the dollar amount. Practice-expense RVUs differ between non-facility (e.g., physician office) and facility (e.g., hospital or ASC) settings because overhead costs differ, which is why two separate allowed amounts are shown.

RVUs — work 9.95, practice expense 17.44 (non-facility) / 8.2 (facility), malpractice 1.99 — × 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 beneficiary or secondary insurer is responsible for the remainder.
Actual payment can vary based on modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
GPCI values and the conversion factor are updated annually and can change the final amount.
Always verify the exact allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

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

The facility amount uses lower practice-expense RVUs because overhead costs (equipment, supplies, staff time) are assumed to be borne by the facility rather than the billing physician's practice.

Does this amount reflect what Medicare will actually pay?

No. It's an estimated PFS allowed amount. Medicare pays 80% of the allowed amount after the deductible, and the final payment can be affected by modifiers, sequestration, and locality-specific adjustments.

Why does the amount differ by locality?

Geographic Practice Cost Indices (GPCIs) adjust the work, practice expense, and malpractice RVUs to reflect regional differences in wages, rents, and other costs, so the same code can have different allowed amounts in different areas.

Can I use this figure to predict my exact reimbursement?

Use it only as a general estimate. Your actual reimbursement depends on your specific locality, any applicable modifiers, secondary payer rules, and current-year policy changes, so confirm details with your MAC.

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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.