Medicare Reimbursement for CPT 15572

CPT 15572 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated PFS allowed amount for 2026, both at the national level and adjustable 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)	$934.56	$670.02
ALASKA* (AK)	$1108.49	$826.76
ALABAMA (AL)	$840.78	$609.31
ARKANSAS (AR)	$829.05	$601.81
ARIZONA (AZ)	$909.16	$652.83
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1155.98	$782.98
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1176.75	$795.29
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1021.02	$708.34
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1028.26	$715.31
NAPA (CA)	$1100.06	$751.41
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1157.98	$784.98
VALLEJO (CA)	$1097.18	$748.53
BAKERSFIELD (CA)	$970.26	$680.33
CHICO (CA)	$965.31	$675.38
FRESNO (CA)	$965.31	$675.38
HANFORD-CORCORAN (CA)	$965.31	$675.38
MADERA (CA)	$965.31	$675.38
MERCED (CA)	$965.31	$675.38
MODESTO (CA)	$965.31	$675.38
REDDING (CA)	$965.31	$675.38
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$984.28	$694.35
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1008.16	$700.51
SALINAS (CA)	$1004.33	$697.73
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1184.92	$803.46
SANTA CRUZ-WATSONVILLE (CA)	$1031.62	$710.21
SANTA ROSA-PETALUMA (CA)	$1041.68	$716.83
STOCKTON (CA)	$965.31	$675.38
VISALIA (CA)	$965.31	$675.38
YUBA CITY (CA)	$965.31	$675.38
EL CENTRO (CA)	$965.60	$675.67
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1024.56	$708.18
SAN LUIS OBISPO-PASO ROBLES (CA)	$988.79	$687.49
SANTA MARIA-SANTA BARBARA (CA)	$1007.16	$698.72
REST OF CALIFORNIA (CA)	$965.31	$675.38
COLORADO (CO)	$960.59	$679.12
CONNECTICUT (CT)	$995.55	$710.64
DC + MD/VA SUBURBS (DC)	$1056.21	$744.59
DELAWARE (DE)	$923.71	$662.35
FORT LAUDERDALE (FL)	$989.16	$721.18
MIAMI (FL)	$1046.83	$771.45
REST OF FLORIDA (FL)	$940.10	$687.20
ATLANTA (GA)	$956.10	$687.33
REST OF GEORGIA (GA)	$886.86	$650.90
HAWAII, GUAM (HI)	$984.62	$683.85
IOWA (IA)	$852.69	$610.64
IDAHO (ID)	$859.89	$616.52
EAST ST. LOUIS (IL)	$950.48	$707.11
SUBURBAN CHICAGO (IL)	$996.99	$725.31
CHICAGO (IL)	$1015.72	$749.86
REST OF ILLINOIS (IL)	$920.14	$678.62
INDIANA (IN)	$864.48	$619.25
KANSAS (KS)	$852.97	$613.83
KENTUCKY (KY)	$868.94	$633.77
NEW ORLEANS (LA)	$910.33	$661.40
REST OF LOUISIANA (LA)	$869.29	$635.17
METROPOLITAN BOSTON (MA)	$1047.55	$731.70
REST OF MASSACHUSETTS (MA)	$956.84	$678.29
BALTIMORE/SURR. CNTYS (MD)	$993.63	$709.78
REST OF MARYLAND (MD)	$939.59	$671.88
SOUTHERN MAINE (ME)	$907.95	$645.80
REST OF MAINE (ME)	$868.65	$625.28
DETROIT (MI)	$955.77	$700.49
REST OF MICHIGAN (MI)	$894.63	$653.11
MINNESOTA (MN)	$909.01	$636.80
METROPOLITAN ST. LOUIS (MO)	$908.46	$656.62
METROPOLITAN KANSAS CITY (MO)	$899.89	$651.49
REST OF MISSOURI (MO)	$857.67	$629.64
MISSISSIPPI (MS)	$843.31	$615.54
MONTANA** (MT)	$934.44	$669.90
NORTH CAROLINA (NC)	$876.75	$629.94
NORTH DAKOTA** (ND)	$899.64	$635.10
NEBRASKA (NE)	$855.94	$611.78
NEW HAMPSHIRE (NH)	$949.60	$674.22
NORTHERN NJ (NJ)	$1046.70	$739.84
REST OF NEW JERSEY (NJ)	$1003.69	$714.82
NEW MEXICO (NM)	$901.05	$658.47
NEVADA** (NV)	$925.29	$660.49
MANHATTAN (NY)	$1078.57	$771.18
NYC SUBURBS/LONG ISLAND (NY)	$1109.25	$794.72
POUGHKPSIE/N NYC SUBURBS (NY)	$1013.62	$723.95
QUEENS (NY)	$1081.03	$768.35
REST OF NEW YORK (NY)	$889.79	$638.48
OHIO (OH)	$887.52	$646.00
OKLAHOMA (OK)	$863.01	$626.78
PORTLAND (OR)	$985.40	$691.50
REST OF OREGON (OR)	$914.91	$651.44
METROPOLITAN PHILADELPHIA (PA)	$974.23	$698.85
REST OF PENNSYLVANIA (PA)	$886.54	$643.70
PUERTO RICO (PR)	$939.68	$672.24
RHODE ISLAND (RI)	$952.49	$679.23
SOUTH CAROLINA (SC)	$884.24	$639.80
SOUTH DAKOTA** (SD)	$895.52	$630.99
TENNESSEE (TN)	$857.64	$617.18
BRAZORIA (TX)	$919.35	$657.19
DALLAS (TX)	$926.99	$663.52
GALVESTON (TX)	$923.26	$660.58
HOUSTON (TX)	$955.48	$692.79
BEAUMONT (TX)	$881.23	$640.51
FORT WORTH (TX)	$922.30	$661.46
AUSTIN (TX)	$960.19	$680.31
REST OF TEXAS (TX)	$901.00	$649.96
UTAH (UT)	$895.79	$647.13
VIRGINIA (VA)	$907.99	$647.95
VIRGIN ISLANDS (VI)	$939.68	$672.24
VERMONT (VT)	$900.06	$638.17
SEATTLE (KING CNTY) (WA)	$1064.25	$739.66
REST OF WASHINGTON (WA)	$953.74	$675.18
WISCONSIN (WI)	$870.94	$617.52
WEST VIRGINIA (WV)	$888.35	$658.47
WYOMING** (WY)	$919.27	$654.74

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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) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Non-facility and facility amounts differ primarily because the practice-expense RVU is lower when the service is performed in a facility setting, since the facility itself absorbs certain overhead costs.

RVUs — work 9.87, practice expense 16.35 (non-facility) / 8.43 (facility), malpractice 1.76 — × 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 insurer is responsible for the remainder.
Actual payment can vary by locality GPCI values, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
Always verify the exact allowed amount 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 practice-expense RVU is lower in the facility setting because overhead costs like supplies and staff time are attributed to the facility rather than the billing physician.

Does this amount apply everywhere in the country?

No. The national figure is a baseline; the actual payment is adjusted using locality-specific GPCIs, so amounts vary by region.

Will Medicare pay the full allowed amount?

No. Medicare generally pays 80% of the allowed amount after the annual Part B deductible is met; the beneficiary or secondary payer covers the rest.

Can modifiers change this amount?

Yes. Modifiers (e.g., for bilateral procedures, reduced services, or assistant-at-surgery) can increase or decrease the final payment relative to the base PFS amount shown here.

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.