Medicare Reimbursement for CPT 15574

CPT 15574 is a procedure code defined by the American Medical Association; its descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$875.44	$639.63
ALASKA* (AK)	$1057.62	$806.48
ALABAMA (AL)	$793.76	$587.43
ARKANSAS (AR)	$783.54	$580.98
ARIZONA (AZ)	$853.32	$624.82
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1074.29	$741.80
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1093.32	$753.28
OXNARD-THOUSAND OAKS-VENTURA (CA)	$952.55	$673.82
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$959.65	$680.69
NAPA (CA)	$1023.60	$712.80
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1076.03	$743.54
VALLEJO (CA)	$1021.09	$710.30
BAKERSFIELD (CA)	$907.77	$649.32
CHICO (CA)	$903.34	$644.89
FRESNO (CA)	$903.34	$644.89
HANFORD-CORCORAN (CA)	$903.34	$644.89
MADERA (CA)	$903.34	$644.89
MERCED (CA)	$903.34	$644.89
MODESTO (CA)	$903.34	$644.89
REDDING (CA)	$903.34	$644.89
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$919.89	$661.44
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$941.85	$667.60
SALINAS (CA)	$938.20	$664.90
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1100.42	$760.38
SANTA CRUZ-WATSONVILLE (CA)	$961.37	$674.86
SANTA ROSA-PETALUMA (CA)	$970.70	$681.12
STOCKTON (CA)	$903.34	$644.89
VISALIA (CA)	$903.34	$644.89
YUBA CITY (CA)	$903.34	$644.89
EL CENTRO (CA)	$903.60	$645.15
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$955.77	$673.74
SAN LUIS OBISPO-PASO ROBLES (CA)	$923.81	$655.22
SANTA MARIA-SANTA BARBARA (CA)	$940.49	$665.53
REST OF CALIFORNIA (CA)	$903.34	$644.89
COLORADO (CO)	$898.89	$647.99
CONNECTICUT (CT)	$929.79	$675.82
DC + MD/VA SUBURBS (DC)	$984.75	$706.96
DELAWARE (DE)	$866.31	$633.33
FORT LAUDERDALE (FL)	$922.92	$684.04
MIAMI (FL)	$973.09	$727.61
REST OF FLORIDA (FL)	$880.20	$654.77
ATLANTA (GA)	$894.37	$654.79
REST OF GEORGIA (GA)	$833.85	$623.50
HAWAII, GUAM (HI)	$919.13	$651.01
IOWA (IA)	$804.17	$588.40
IDAHO (ID)	$810.43	$593.48
EAST ST. LOUIS (IL)	$889.18	$672.23
SUBURBAN CHICAGO (IL)	$930.18	$688.00
CHICAGO (IL)	$946.43	$709.45
REST OF ILLINOIS (IL)	$862.80	$647.51
INDIANA (IN)	$814.43	$595.83
KANSAS (KS)	$804.40	$591.23
KENTUCKY (KY)	$818.26	$608.63
NEW ORLEANS (LA)	$854.31	$632.41
REST OF LOUISIANA (LA)	$818.56	$609.86
METROPOLITAN BOSTON (MA)	$976.44	$694.88
REST OF MASSACHUSETTS (MA)	$895.86	$647.56
BALTIMORE/SURR. CNTYS (MD)	$927.87	$674.84
REST OF MARYLAND (MD)	$880.44	$641.80
SOUTHERN MAINE (ME)	$852.30	$618.61
REST OF MAINE (ME)	$818.04	$601.10
DETROIT (MI)	$893.84	$666.28
REST OF MICHIGAN (MI)	$840.62	$625.33
MINNESOTA (MN)	$853.26	$610.61
METROPOLITAN ST. LOUIS (MO)	$852.69	$628.20
METROPOLITAN KANSAS CITY (MO)	$845.23	$623.80
REST OF MISSOURI (MO)	$808.43	$605.16
MISSISSIPPI (MS)	$795.94	$592.91
MONTANA** (MT)	$875.34	$639.53
NORTH CAROLINA (NC)	$825.10	$605.09
NORTH DAKOTA** (ND)	$845.08	$609.27
NEBRASKA (NE)	$807.00	$589.35
NEW HAMPSHIRE (NH)	$888.56	$643.09
NORTHERN NJ (NJ)	$977.01	$703.47
REST OF NEW JERSEY (NJ)	$938.12	$680.61
NEW MEXICO (NM)	$846.20	$629.97
NEVADA** (NV)	$867.38	$631.33
MANHATTAN (NY)	$1004.79	$730.77
NYC SUBURBS/LONG ISLAND (NY)	$1031.49	$751.11
POUGHKPSIE/N NYC SUBURBS (NY)	$947.06	$688.85
QUEENS (NY)	$1006.95	$728.22
REST OF NEW YORK (NY)	$836.46	$612.44
OHIO (OH)	$834.44	$619.14
OKLAHOMA (OK)	$813.11	$602.53
PORTLAND (OR)	$920.76	$658.78
REST OF OREGON (OR)	$858.36	$623.49
METROPOLITAN PHILADELPHIA (PA)	$911.09	$665.61
REST OF PENNSYLVANIA (PA)	$833.60	$617.12
PUERTO RICO (PR)	$879.91	$641.50
RHODE ISLAND (RI)	$892.24	$648.65
SOUTH CAROLINA (SC)	$831.60	$613.71
SOUTH DAKOTA** (SD)	$841.50	$605.69
TENNESSEE (TN)	$808.46	$594.11
BRAZORIA (TX)	$862.70	$629.01
DALLAS (TX)	$869.41	$634.55
GALVESTON (TX)	$866.10	$631.94
HOUSTON (TX)	$894.11	$659.95
BEAUMONT (TX)	$828.97	$614.39
FORT WORTH (TX)	$865.32	$632.81
AUSTIN (TX)	$897.91	$648.43
REST OF TEXAS (TX)	$846.21	$622.42
UTAH (UT)	$841.67	$620.01
VIRGINIA (VA)	$852.32	$620.52
VIRGIN ISLANDS (VI)	$879.91	$641.50
VERMONT (VT)	$845.43	$611.98
SEATTLE (KING CNTY) (WA)	$991.55	$702.21
REST OF WASHINGTON (WA)	$892.98	$644.67
WISCONSIN (WI)	$820.08	$594.18
WEST VIRGINIA (WV)	$835.11	$630.19
WYOMING** (WY)	$862.15	$626.34

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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 furnished, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual conversion factor (a dollar figure set by CMS) to produce the allowed amount. Practice-expense RVUs differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings, which is why the two amounts shown on this page differ.

RVUs — work 10.43, practice expense 14.25 (non-facility) / 7.19 (facility), malpractice 1.53 — × 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 deductible is met; the patient or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, sequestration, and annual budget-neutrality adjustments made by CMS.
Confirm the exact allowed amount and any site-of-service or modifier rules with your Medicare Administrative Contractor (MAC).

Frequently asked

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

Facility rates use lower practice-expense RVUs because the facility (e.g., hospital) is assumed to absorb certain overhead costs separately, while non-facility rates assume the billing provider covers those costs directly.

Does this amount reflect what Medicare actually pays?

No. The figure shown is the full allowed amount before the standard 80/20 split; Medicare generally reimburses 80% after the deductible, with the remainder billed to the patient or a secondary payer.

Why might my MAC's payment differ from this estimate?

Local GPCI adjustments, applied modifiers, sequestration cuts, and annual budget-neutrality changes to the conversion factor can all cause the actual paid amount to differ from this national estimate.

Can I see the CPT code's official descriptor here?

No. CPT descriptors are licensed by the American Medical Association and are not reproduced on this page; only the code number and its fee schedule data are shown.

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.