Medicare Reimbursement for CPT 15610

CPT 15610 is a surgical procedure code reported to Medicare for payment. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, broken out separately for non-facility (office) and facility (hospital/ASC) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$391.46	$235.48
ALASKA* (AK)	$445.44	$279.31
ALABAMA (AL)	$348.46	$211.98
ARKANSAS (AR)	$343.02	$209.03
ARIZONA (AZ)	$380.29	$229.14
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$512.26	$292.32
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$522.54	$297.62
OXNARD-THOUSAND OAKS-VENTURA (CA)	$442.21	$257.84
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$444.15	$259.62
NAPA (CA)	$483.63	$278.04
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$512.73	$292.80
VALLEJO (CA)	$482.94	$277.36
BAKERSFIELD (CA)	$415.88	$244.92
CHICO (CA)	$414.69	$243.74
FRESNO (CA)	$414.69	$243.74
HANFORD-CORCORAN (CA)	$414.69	$243.74
MADERA (CA)	$414.69	$243.74
MERCED (CA)	$414.69	$243.74
MODESTO (CA)	$414.69	$243.74
REDDING (CA)	$414.69	$243.74
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$419.22	$248.26
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$436.04	$254.63
SALINAS (CA)	$434.44	$253.66
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$524.49	$299.57
SANTA CRUZ-WATSONVILLE (CA)	$450.16	$260.64
SANTA ROSA-PETALUMA (CA)	$454.73	$263.19
STOCKTON (CA)	$414.69	$243.74
VISALIA (CA)	$414.69	$243.74
YUBA CITY (CA)	$414.69	$243.74
EL CENTRO (CA)	$414.76	$243.81
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$445.37	$258.82
SAN LUIS OBISPO-PASO ROBLES (CA)	$427.39	$249.72
SANTA MARIA-SANTA BARBARA (CA)	$436.26	$254.39
REST OF CALIFORNIA (CA)	$414.69	$243.74
COLORADO (CO)	$408.27	$242.30
CONNECTICUT (CT)	$418.78	$250.79
DC + MD/VA SUBURBS (DC)	$450.04	$266.29
DELAWARE (DE)	$386.91	$232.80
FORT LAUDERDALE (FL)	$406.63	$248.62
MIAMI (FL)	$425.01	$262.64
REST OF FLORIDA (FL)	$385.52	$236.40
ATLANTA (GA)	$399.25	$240.77
REST OF GEORGIA (GA)	$362.26	$223.13
HAWAII, GUAM (HI)	$426.00	$248.65
IOWA (IA)	$357.90	$215.18
IDAHO (ID)	$360.44	$216.94
EAST ST. LOUIS (IL)	$382.06	$238.56
SUBURBAN CHICAGO (IL)	$410.84	$250.64
CHICAGO (IL)	$411.68	$254.91
REST OF ILLINOIS (IL)	$373.67	$231.26
INDIANA (IN)	$362.69	$218.10
KANSAS (KS)	$356.16	$215.15
KENTUCKY (KY)	$357.49	$218.82
NEW ORLEANS (LA)	$375.95	$229.17
REST OF LOUISIANA (LA)	$356.91	$218.87
METROPOLITAN BOSTON (MA)	$450.57	$264.32
REST OF MASSACHUSETTS (MA)	$405.57	$241.33
BALTIMORE/SURR. CNTYS (MD)	$417.65	$250.28
REST OF MARYLAND (MD)	$394.67	$236.82
SOUTHERN MAINE (ME)	$383.62	$229.05
REST OF MAINE (ME)	$362.53	$219.03
DETROIT (MI)	$390.75	$240.22
REST OF MICHIGAN (MI)	$367.58	$225.17
MINNESOTA (MN)	$390.15	$229.64
METROPOLITAN ST. LOUIS (MO)	$377.31	$228.82
METROPOLITAN KANSAS CITY (MO)	$373.12	$226.66
REST OF MISSOURI (MO)	$350.35	$215.89
MISSISSIPPI (MS)	$346.76	$212.45
MONTANA** (MT)	$391.43	$235.45
NORTH CAROLINA (NC)	$366.61	$221.08
NORTH DAKOTA** (ND)	$383.13	$227.14
NEBRASKA (NE)	$360.00	$216.03
NEW HAMPSHIRE (NH)	$401.81	$239.43
NORTHERN NJ (NJ)	$444.83	$263.89
REST OF NEW JERSEY (NJ)	$423.27	$252.94
NEW MEXICO (NM)	$369.77	$226.74
NEVADA** (NV)	$389.41	$233.27
MANHATTAN (NY)	$452.77	$271.52
NYC SUBURBS/LONG ISLAND (NY)	$464.54	$279.08
POUGHKPSIE/N NYC SUBURBS (NY)	$426.15	$255.35
QUEENS (NY)	$456.66	$272.28
REST OF NEW YORK (NY)	$372.53	$224.35
OHIO (OH)	$365.88	$223.47
OKLAHOMA (OK)	$356.74	$217.44
PORTLAND (OR)	$421.96	$248.66
REST OF OREGON (OR)	$386.11	$230.75
METROPOLITAN PHILADELPHIA (PA)	$407.75	$245.37
REST OF PENNSYLVANIA (PA)	$366.48	$223.28
PUERTO RICO (PR)	$394.50	$236.80
RHODE ISLAND (RI)	$401.25	$240.12
SOUTH CAROLINA (SC)	$366.91	$222.79
SOUTH DAKOTA** (SD)	$382.14	$226.16
TENNESSEE (TN)	$358.09	$216.31
BRAZORIA (TX)	$386.37	$231.79
DALLAS (TX)	$389.02	$233.67
GALVESTON (TX)	$387.64	$232.75
HOUSTON (TX)	$395.32	$240.43
BEAUMONT (TX)	$363.89	$221.94
FORT WORTH (TX)	$386.25	$232.46
AUSTIN (TX)	$407.15	$242.12
REST OF TEXAS (TX)	$375.04	$227.01
UTAH (UT)	$372.31	$225.69
VIRGINIA (VA)	$382.31	$228.98
VIRGIN ISLANDS (VI)	$394.50	$236.80
VERMONT (VT)	$381.58	$227.15
SEATTLE (KING CNTY) (WA)	$460.02	$268.63
REST OF WASHINGTON (WA)	$404.82	$240.57
WISCONSIN (WI)	$369.35	$219.92
WEST VIRGINIA (WV)	$358.83	$223.28
WYOMING** (WY)	$387.81	$231.83

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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 the code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility and facility settings because overhead costs (equipment, supplies, staff) are assumed to be lower when the procedure is performed in a hospital or ASC versus a physician's office.

RVUs — work 2.46, practice expense 8.84 (non-facility) / 4.17 (facility), malpractice 0.42 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimated allowed amount only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the remaining 20% is patient or secondary-payer responsibility.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Rates vary by Medicare Administrative Contractor (MAC) locality; always confirm current figures with your MAC or the official CMS PFS lookup tool.

Frequently asked

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

The facility rate uses a lower practice-expense RVU because Medicare assumes the hospital or ASC — not the physician's office — is absorbing most of the overhead costs, such as equipment and supplies, for the procedure.

Does this fee schedule amount reflect what Medicare will actually pay?

No. It reflects the estimated allowed amount before cost-sharing, modifiers, sequestration, or locality-specific adjustments are applied. Actual payment may differ.

Why do GPCIs matter for this code?

GPCIs adjust the work, practice-expense, and malpractice RVUs to reflect the relative cost of delivering care in a specific locality, so the same code can have different allowed amounts across the country.

Can I use this page to bill or appeal a claim?

This page is for reference only. For billing decisions, claim disputes, or appeals, verify current rates and policies directly with your Medicare Administrative Contractor (MAC).

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.