Medicare Reimbursement for CPT 15736

CPT 15736 is a surgical procedure code; this page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both nationally and adjusted for locality, and compares non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1111.25	$1111.25
ALASKA* (AK)	$1367.99	$1367.99
ALABAMA (AL)	$1007.53	$1007.53
ARKANSAS (AR)	$994.76	$994.76
ARIZONA (AZ)	$1081.50	$1081.50
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1283.20	$1283.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1302.70	$1302.70
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1166.26	$1166.26
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1178.45	$1178.45
NAPA (CA)	$1233.60	$1233.60
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1286.96	$1286.96
VALLEJO (CA)	$1228.19	$1228.19
BAKERSFIELD (CA)	$1121.37	$1121.37
CHICO (CA)	$1112.19	$1112.19
FRESNO (CA)	$1112.19	$1112.19
HANFORD-CORCORAN (CA)	$1112.19	$1112.19
MADERA (CA)	$1112.19	$1112.19
MERCED (CA)	$1112.19	$1112.19
MODESTO (CA)	$1112.19	$1112.19
REDDING (CA)	$1112.19	$1112.19
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1147.79	$1147.79
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1152.60	$1152.60
SALINAS (CA)	$1148.05	$1148.05
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1318.06	$1318.06
SANTA CRUZ-WATSONVILLE (CA)	$1167.47	$1167.47
SANTA ROSA-PETALUMA (CA)	$1178.26	$1178.26
STOCKTON (CA)	$1112.19	$1112.19
VISALIA (CA)	$1112.19	$1112.19
YUBA CITY (CA)	$1112.19	$1112.19
EL CENTRO (CA)	$1112.74	$1112.74
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1164.65	$1164.65
SAN LUIS OBISPO-PASO ROBLES (CA)	$1131.36	$1131.36
SANTA MARIA-SANTA BARBARA (CA)	$1149.50	$1149.50
REST OF CALIFORNIA (CA)	$1112.19	$1112.19
COLORADO (CO)	$1122.23	$1122.23
CONNECTICUT (CT)	$1179.90	$1179.90
DC + MD/VA SUBURBS (DC)	$1233.07	$1233.07
DELAWARE (DE)	$1097.50	$1097.50
FORT LAUDERDALE (FL)	$1206.37	$1206.37
MIAMI (FL)	$1298.57	$1298.57
REST OF FLORIDA (FL)	$1147.24	$1147.24
ATLANTA (GA)	$1142.27	$1142.27
REST OF GEORGIA (GA)	$1084.32	$1084.32
HAWAII, GUAM (HI)	$1125.79	$1125.79
IOWA (IA)	$1006.68	$1006.68
IDAHO (ID)	$1017.31	$1017.31
EAST ST. LOUIS (IL)	$1187.68	$1187.68
SUBURBAN CHICAGO (IL)	$1212.52	$1212.52
CHICAGO (IL)	$1260.53	$1260.53
REST OF ILLINOIS (IL)	$1134.70	$1134.70
INDIANA (IN)	$1021.87	$1021.87
KANSAS (KS)	$1013.61	$1013.61
KENTUCKY (KY)	$1052.36	$1052.36
NEW ORLEANS (LA)	$1099.98	$1099.98
REST OF LOUISIANA (LA)	$1055.33	$1055.33
METROPOLITAN BOSTON (MA)	$1208.34	$1208.34
REST OF MASSACHUSETTS (MA)	$1121.31	$1121.31
BALTIMORE/SURR. CNTYS (MD)	$1178.88	$1178.88
REST OF MARYLAND (MD)	$1113.08	$1113.08
SOUTHERN MAINE (ME)	$1066.44	$1066.44
REST OF MAINE (ME)	$1033.79	$1033.79
DETROIT (MI)	$1171.48	$1171.48
REST OF MICHIGAN (MI)	$1086.72	$1086.72
MINNESOTA (MN)	$1046.35	$1046.35
METROPOLITAN ST. LOUIS (MO)	$1090.07	$1090.07
METROPOLITAN KANSAS CITY (MO)	$1081.51	$1081.51
REST OF MISSOURI (MO)	$1046.84	$1046.84
MISSISSIPPI (MS)	$1020.41	$1020.41
MONTANA** (MT)	$1111.03	$1111.03
NORTH CAROLINA (NC)	$1041.46	$1041.46
NORTH DAKOTA** (ND)	$1045.58	$1045.58
NEBRASKA (NE)	$1008.15	$1008.15
NEW HAMPSHIRE (NH)	$1115.71	$1115.71
NORTHERN NJ (NJ)	$1225.06	$1225.06
REST OF NEW JERSEY (NJ)	$1185.19	$1185.19
NEW MEXICO (NM)	$1096.46	$1096.46
NEVADA** (NV)	$1093.23	$1093.23
MANHATTAN (NY)	$1283.78	$1283.78
NYC SUBURBS/LONG ISLAND (NY)	$1325.78	$1325.78
POUGHKPSIE/N NYC SUBURBS (NY)	$1201.79	$1201.79
QUEENS (NY)	$1276.77	$1276.77
REST OF NEW YORK (NY)	$1056.12	$1056.12
OHIO (OH)	$1073.34	$1073.34
OKLAHOMA (OK)	$1038.88	$1038.88
PORTLAND (OR)	$1141.32	$1141.32
REST OF OREGON (OR)	$1076.63	$1076.63
METROPOLITAN PHILADELPHIA (PA)	$1160.85	$1160.85
REST OF PENNSYLVANIA (PA)	$1068.60	$1068.60
PUERTO RICO (PR)	$1114.49	$1114.49
RHODE ISLAND (RI)	$1124.56	$1124.56
SOUTH CAROLINA (SC)	$1060.78	$1060.78
SOUTH DAKOTA** (SD)	$1037.84	$1037.84
TENNESSEE (TN)	$1019.48	$1019.48
BRAZORIA (TX)	$1087.35	$1087.35
DALLAS (TX)	$1098.76	$1098.76
GALVESTON (TX)	$1093.55	$1093.55
HOUSTON (TX)	$1154.13	$1154.13
BEAUMONT (TX)	$1063.27	$1063.27
FORT WORTH (TX)	$1095.74	$1095.74
AUSTIN (TX)	$1125.62	$1125.62
REST OF TEXAS (TX)	$1077.78	$1077.78
UTAH (UT)	$1073.22	$1073.22
VIRGINIA (VA)	$1071.16	$1071.16
VIRGIN ISLANDS (VI)	$1114.49	$1114.49
VERMONT (VT)	$1052.17	$1052.17
SEATTLE (KING CNTY) (WA)	$1219.98	$1219.98
REST OF WASHINGTON (WA)	$1115.67	$1115.67
WISCONSIN (WI)	$1016.01	$1016.01
WEST VIRGINIA (WV)	$1100.48	$1100.48
WYOMING** (WY)	$1082.50	$1082.50

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) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality. The adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Practice expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, though for this code the practice expense RVU is the same in both settings, so the resulting amounts are equal. These figures are recalculated each year as RVUs, GPCIs, and the conversion factor are updated.

RVUs — work 16.61, practice expense 13.35 (non-facility) / 13.35 (facility), malpractice 3.31 — × 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 Part B deductible is met; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Always verify current rates and local adjustments with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why do non-facility and facility amounts sometimes differ?

Facility settings generally have lower practice expense RVUs because overhead costs like equipment and supplies are covered by the facility rather than the billing physician. For CPT 15736, however, the practice expense RVU is the same in both settings, so the allowed amounts match.

Why does the amount change by locality?

Each Medicare locality has its own Geographic Practice Cost Indices (GPCIs) for work, practice expense, and malpractice, which adjust the national RVUs to reflect local cost differences before applying the conversion factor.

Does this amount reflect what the patient will owe?

No. The PFS amount is the total allowed amount; after the deductible, Medicare pays 80% and the patient or secondary insurance is typically responsible for the remaining 20%.

Will this rate stay the same all year?

Rates can be affected by mid-year regulatory changes, sequestration, or budget-neutrality adjustments, so it's good practice to confirm current figures with your 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.