Medicare Reimbursement for CPT 15576

CPT 15576 is a physician procedure code reported to Medicare for payment under the Physician Fee Schedule (PFS). This page shows the estimated PFS allowed amount at the national level and 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)	$794.61	$563.47
ALASKA* (AK)	$959.66	$713.50
ALABAMA (AL)	$721.78	$519.54
ARKANSAS (AR)	$712.63	$514.08
ARIZONA (AZ)	$775.17	$551.20
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$987.06	$661.16
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1005.03	$671.73
OXNARD-THOUSAND OAKS-VENTURA (CA)	$871.11	$597.91
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$877.08	$603.65
NAPA (CA)	$938.87	$634.24
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$988.34	$662.44
VALLEJO (CA)	$937.02	$632.39
BAKERSFIELD (CA)	$829.00	$575.68
CHICO (CA)	$825.64	$572.31
FRESNO (CA)	$825.64	$572.31
HANFORD-CORCORAN (CA)	$825.64	$572.31
MADERA (CA)	$825.64	$572.31
MERCED (CA)	$825.64	$572.31
MODESTO (CA)	$825.64	$572.31
REDDING (CA)	$825.64	$572.31
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$837.91	$584.58
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$861.69	$592.88
SALINAS (CA)	$858.36	$590.48
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1010.27	$676.98
SANTA CRUZ-WATSONVILLE (CA)	$880.60	$599.77
SANTA ROSA-PETALUMA (CA)	$889.21	$605.38
STOCKTON (CA)	$825.64	$572.31
VISALIA (CA)	$825.64	$572.31
YUBA CITY (CA)	$825.64	$572.31
EL CENTRO (CA)	$825.82	$572.50
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$874.99	$598.55
SAN LUIS OBISPO-PASO ROBLES (CA)	$845.05	$581.79
SANTA MARIA-SANTA BARBARA (CA)	$860.60	$591.10
REST OF CALIFORNIA (CA)	$825.64	$572.31
COLORADO (CO)	$818.91	$572.98
CONNECTICUT (CT)	$843.41	$594.48
DC + MD/VA SUBURBS (DC)	$895.74	$623.46
DELAWARE (DE)	$786.90	$558.54
FORT LAUDERDALE (FL)	$830.97	$596.84
MIAMI (FL)	$870.83	$630.22
REST OF FLORIDA (FL)	$793.72	$572.76
ATLANTA (GA)	$810.33	$575.50
REST OF GEORGIA (GA)	$753.08	$546.91
HAWAII, GUAM (HI)	$840.58	$577.78
IOWA (IA)	$733.46	$521.98
IDAHO (ID)	$738.59	$525.95
EAST ST. LOUIS (IL)	$796.75	$584.11
SUBURBAN CHICAGO (IL)	$838.07	$600.70
CHICAGO (IL)	$847.88	$615.59
REST OF ILLINOIS (IL)	$776.57	$565.54
INDIANA (IN)	$742.24	$527.98
KANSAS (KS)	$732.54	$523.59
KENTUCKY (KY)	$741.27	$535.80
NEW ORLEANS (LA)	$773.10	$555.60
REST OF LOUISIANA (LA)	$741.09	$536.54
METROPOLITAN BOSTON (MA)	$890.58	$614.60
REST OF MASSACHUSETTS (MA)	$815.76	$572.38
BALTIMORE/SURR. CNTYS (MD)	$841.40	$593.40
REST OF MARYLAND (MD)	$799.98	$566.08
SOUTHERN MAINE (ME)	$776.62	$547.56
REST OF MAINE (ME)	$744.21	$531.57
DETROIT (MI)	$804.69	$581.65
REST OF MICHIGAN (MI)	$760.19	$549.16
MINNESOTA (MN)	$781.13	$543.30
METROPOLITAN ST. LOUIS (MO)	$773.01	$552.97
METROPOLITAN KANSAS CITY (MO)	$766.19	$549.16
REST OF MISSOURI (MO)	$731.31	$532.07
MISSISSIPPI (MS)	$721.99	$522.98
MONTANA** (MT)	$794.53	$563.40
NORTH CAROLINA (NC)	$750.73	$535.08
NORTH DAKOTA** (ND)	$772.19	$541.05
NEBRASKA (NE)	$736.36	$523.02
NEW HAMPSHIRE (NH)	$808.40	$567.79
NORTHERN NJ (NJ)	$888.66	$620.54
REST OF NEW JERSEY (NJ)	$852.03	$599.63
NEW MEXICO (NM)	$764.71	$552.76
NEVADA** (NV)	$788.76	$557.39
MANHATTAN (NY)	$909.42	$640.84
NYC SUBURBS/LONG ISLAND (NY)	$931.84	$657.02
POUGHKPSIE/N NYC SUBURBS (NY)	$859.17	$606.08
QUEENS (NY)	$913.02	$639.81
REST OF NEW YORK (NY)	$760.82	$541.24
OHIO (OH)	$755.62	$544.60
OKLAHOMA (OK)	$737.87	$531.47
PORTLAND (OR)	$839.96	$583.17
REST OF OREGON (OR)	$781.59	$551.38
METROPOLITAN PHILADELPHIA (PA)	$825.90	$585.29
REST OF PENNSYLVANIA (PA)	$755.50	$543.32
PUERTO RICO (PR)	$799.01	$565.33
RHODE ISLAND (RI)	$811.23	$572.47
SOUTH CAROLINA (SC)	$754.63	$541.06
SOUTH DAKOTA** (SD)	$769.55	$538.41
TENNESSEE (TN)	$736.04	$525.94
BRAZORIA (TX)	$784.68	$555.63
DALLAS (TX)	$790.19	$559.98
GALVESTON (TX)	$787.40	$557.88
HOUSTON (TX)	$808.08	$578.56
BEAUMONT (TX)	$751.29	$540.95
FORT WORTH (TX)	$786.16	$558.27
AUSTIN (TX)	$817.11	$572.57
REST OF TEXAS (TX)	$767.92	$548.57
UTAH (UT)	$763.66	$546.40
VIRGINIA (VA)	$775.83	$548.63
VIRGIN ISLANDS (VI)	$799.01	$565.33
VERMONT (VT)	$771.45	$542.62
SEATTLE (KING CNTY) (WA)	$905.47	$621.87
REST OF WASHINGTON (WA)	$813.49	$570.10
WISCONSIN (WI)	$749.52	$528.10
WEST VIRGINIA (WV)	$751.72	$550.86
WYOMING** (WY)	$784.79	$553.66

Look up another code or locality →

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) for this procedure code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is furnished, since costs vary by region. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility and facility settings use different practice-expense RVUs, which is why the allowed amount differs depending on where the procedure is performed.

RVUs — work 9.14, practice expense 13.52 (non-facility) / 6.6 (facility), malpractice 1.13 — × 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 deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Locality-specific GPCIs and the conversion factor are updated periodically and may change from the figures shown here.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

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

In a facility setting (e.g., hospital), the facility itself bears many of the overhead costs, so the practice-expense RVU used for this code is lower than when the same service is performed in a non-facility setting like a physician's office.

Why does the allowed amount differ by locality?

Medicare adjusts each RVU component (work, practice expense, malpractice) using locality-specific GPCI values to reflect differences in regional costs such as wages and rent, which changes the final calculated amount.

Does this amount include what the patient will owe?

No. The figures represent the total Medicare-allowed amount. After the deductible is met, Medicare generally pays 80%, and the patient or secondary insurance is typically responsible for the remaining 20%, subject to any applicable modifiers or adjustments.

Will this exact amount be paid on every claim?

Not necessarily. Modifiers, multiple-procedure payment rules, sequestration, and annual budget-neutrality adjustments can all cause the actual paid amount to differ from this estimate.

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.