Medicare Reimbursement for CPT 15734

CPT 15734 is a procedure code reported to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed payment amount, both at the national level and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1386.81	$1386.81
ALASKA* (AK)	$1717.35	$1717.35
ALABAMA (AL)	$1255.70	$1255.70
ARKANSAS (AR)	$1239.68	$1239.68
ARIZONA (AZ)	$1348.24	$1348.24
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1555.56	$1555.56
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1577.22	$1577.22
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1430.85	$1430.85
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1447.88	$1447.88
NAPA (CA)	$1502.04	$1502.04
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1561.22	$1561.22
VALLEJO (CA)	$1493.88	$1493.88
BAKERSFIELD (CA)	$1381.25	$1381.25
CHICO (CA)	$1367.60	$1367.60
FRESNO (CA)	$1367.60	$1367.60
HANFORD-CORCORAN (CA)	$1367.60	$1367.60
MADERA (CA)	$1367.60	$1367.60
MERCED (CA)	$1367.60	$1367.60
MODESTO (CA)	$1367.60	$1367.60
REDDING (CA)	$1367.60	$1367.60
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1421.08	$1421.08
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1413.42	$1413.42
SALINAS (CA)	$1407.78	$1407.78
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1600.34	$1600.34
SANTA CRUZ-WATSONVILLE (CA)	$1426.68	$1426.68
SANTA ROSA-PETALUMA (CA)	$1439.55	$1439.55
STOCKTON (CA)	$1367.60	$1367.60
VISALIA (CA)	$1367.60	$1367.60
YUBA CITY (CA)	$1367.60	$1367.60
EL CENTRO (CA)	$1368.44	$1368.44
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1425.47	$1425.47
SAN LUIS OBISPO-PASO ROBLES (CA)	$1387.87	$1387.87
SANTA MARIA-SANTA BARBARA (CA)	$1408.84	$1408.84
REST OF CALIFORNIA (CA)	$1367.60	$1367.60
COLORADO (CO)	$1389.53	$1389.53
CONNECTICUT (CT)	$1473.01	$1473.01
DC + MD/VA SUBURBS (DC)	$1529.95	$1529.95
DELAWARE (DE)	$1368.10	$1368.10
FORT LAUDERDALE (FL)	$1527.33	$1527.33
MIAMI (FL)	$1660.46	$1660.46
REST OF FLORIDA (FL)	$1449.74	$1449.74
ATLANTA (GA)	$1430.03	$1430.03
REST OF GEORGIA (GA)	$1367.84	$1367.84
HAWAII, GUAM (HI)	$1381.34	$1381.34
IOWA (IA)	$1246.45	$1246.45
IDAHO (ID)	$1261.44	$1261.44
EAST ST. LOUIS (IL)	$1517.77	$1517.77
SUBURBAN CHICAGO (IL)	$1533.19	$1533.19
CHICAGO (IL)	$1609.81	$1609.81
REST OF ILLINOIS (IL)	$1439.45	$1439.45
INDIANA (IN)	$1266.90	$1266.90
KANSAS (KS)	$1259.06	$1259.06
KENTUCKY (KY)	$1320.35	$1320.35
NEW ORLEANS (LA)	$1381.62	$1381.62
REST OF LOUISIANA (LA)	$1325.62	$1325.62
METROPOLITAN BOSTON (MA)	$1490.65	$1490.65
REST OF MASSACHUSETTS (MA)	$1390.00	$1390.00
BALTIMORE/SURR. CNTYS (MD)	$1472.62	$1472.62
REST OF MARYLAND (MD)	$1386.31	$1386.31
SOUTHERN MAINE (ME)	$1321.19	$1321.19
REST OF MAINE (ME)	$1286.23	$1286.23
DETROIT (MI)	$1484.42	$1484.42
REST OF MICHIGAN (MI)	$1367.26	$1367.26
MINNESOTA (MN)	$1283.37	$1283.37
METROPOLITAN ST. LOUIS (MO)	$1364.52	$1364.52
METROPOLITAN KANSAS CITY (MO)	$1354.23	$1354.23
REST OF MISSOURI (MO)	$1317.44	$1317.44
MISSISSIPPI (MS)	$1277.88	$1277.88
MONTANA** (MT)	$1386.47	$1386.47
NORTH CAROLINA (NC)	$1295.18	$1295.18
NORTH DAKOTA** (ND)	$1288.00	$1288.00
NEBRASKA (NE)	$1247.06	$1247.06
NEW HAMPSHIRE (NH)	$1385.34	$1385.34
NORTHERN NJ (NJ)	$1520.72	$1520.72
REST OF NEW JERSEY (NJ)	$1476.27	$1476.27
NEW MEXICO (NM)	$1381.12	$1381.12
NEVADA** (NV)	$1359.50	$1359.50
MANHATTAN (NY)	$1608.57	$1608.57
NYC SUBURBS/LONG ISLAND (NY)	$1666.38	$1666.38
POUGHKPSIE/N NYC SUBURBS (NY)	$1500.22	$1500.22
QUEENS (NY)	$1594.05	$1594.05
REST OF NEW YORK (NY)	$1313.84	$1313.84
OHIO (OH)	$1347.13	$1347.13
OKLAHOMA (OK)	$1299.28	$1299.28
PORTLAND (OR)	$1408.52	$1408.52
REST OF OREGON (OR)	$1335.52	$1335.52
METROPOLITAN PHILADELPHIA (PA)	$1451.72	$1451.72
REST OF PENNSYLVANIA (PA)	$1339.01	$1339.01
PUERTO RICO (PR)	$1389.49	$1389.49
RHODE ISLAND (RI)	$1398.63	$1398.63
SOUTH CAROLINA (SC)	$1326.04	$1326.04
SOUTH DAKOTA** (SD)	$1276.36	$1276.36
TENNESSEE (TN)	$1266.90	$1266.90
BRAZORIA (TX)	$1351.96	$1351.96
DALLAS (TX)	$1368.04	$1368.04
GALVESTON (TX)	$1360.89	$1360.89
HOUSTON (TX)	$1452.04	$1452.04
BEAUMONT (TX)	$1332.58	$1332.58
FORT WORTH (TX)	$1365.49	$1365.49
AUSTIN (TX)	$1396.68	$1396.68
REST OF TEXAS (TX)	$1346.64	$1346.64
UTAH (UT)	$1341.56	$1341.56
VIRGINIA (VA)	$1329.89	$1329.89
VIRGIN ISLANDS (VI)	$1389.49	$1389.49
VERMONT (VT)	$1299.92	$1299.92
SEATTLE (KING CNTY) (WA)	$1500.81	$1500.81
REST OF WASHINGTON (WA)	$1381.77	$1381.77
WISCONSIN (WI)	$1251.91	$1251.91
WEST VIRGINIA (WV)	$1396.76	$1396.76
WYOMING** (WY)	$1343.56	$1343.56

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 4 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 payment is based on three Relative Value Units (RVUs) assigned to the code: work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility amounts can differ because practice-expense RVUs are typically higher in non-facility (e.g., office) settings to reflect overhead costs; for this code, the practice-expense RVU is the same in both settings, so the national amounts shown are equal. Local amounts will vary depending on each locality's GPCI values.

RVUs — work 22.43, practice expense 14.11 (non-facility) / 14.11 (facility), malpractice 4.98 — × 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 Part B deductible is met; the patient or secondary payer is generally responsible for the remainder.
Actual payment can be affected by modifiers, place of service, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
Locality-specific amounts depend on the GPCIs in effect for that area and may change each year.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why is the facility amount the same as the non-facility amount for this code?

The practice-expense RVU used in the calculation is identical for both settings for this code, so the resulting national allowed amounts are the same. This is not true for all codes.

Why might my locality's payment differ from the national amount shown?

Local wage and cost indices (GPCIs) adjust the work, practice-expense, and malpractice RVUs for each geographic area, which can raise or lower the final allowed amount compared to the national average.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare Physician Fee Schedule allowed amount before the 80/20 coinsurance split, deductible status, modifiers, and other adjustments are applied.

Where can I find the official rate for my area?

Your Medicare Administrative Contractor (MAC) publishes the finalized locality-specific fee schedule, which should be used for billing and reconciliation purposes.

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.