Medicare Reimbursement for CPT Code 15758

This page covers a CPT procedure code (descriptor not shown due to AMA licensing restrictions) and displays its Medicare Physician Fee Schedule (PFS) allowed amount. Amounts are shown nationally and can vary by locality, with separate figures for non-facility and facility settings when the underlying practice-expense inputs differ.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1941.26	$1941.26
ALASKA* (AK)	$2491.84	$2491.84
ALABAMA (AL)	$1789.68	$1789.68
ARKANSAS (AR)	$1771.15	$1771.15
ARIZONA (AZ)	$1896.71	$1896.71
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2170.10	$2170.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2200.31	$2200.31
OXNARD-THOUSAND OAKS-VENTURA (CA)	$2002.51	$2002.51
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$2026.53	$2026.53
NAPA (CA)	$2097.11	$2097.11
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2176.61	$2176.61
VALLEJO (CA)	$2087.73	$2087.73
BAKERSFIELD (CA)	$1941.88	$1941.88
CHICO (CA)	$1925.51	$1925.51
FRESNO (CA)	$1925.51	$1925.51
HANFORD-CORCORAN (CA)	$1925.51	$1925.51
MADERA (CA)	$1925.51	$1925.51
MERCED (CA)	$1925.51	$1925.51
MODESTO (CA)	$1925.51	$1925.51
REDDING (CA)	$1925.51	$1925.51
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1987.38	$1987.38
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1985.06	$1985.06
SALINAS (CA)	$1976.86	$1976.86
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2226.91	$2226.91
SANTA CRUZ-WATSONVILLE (CA)	$1995.54	$1995.54
SANTA ROSA-PETALUMA (CA)	$2013.48	$2013.48
STOCKTON (CA)	$1925.51	$1925.51
VISALIA (CA)	$1925.51	$1925.51
YUBA CITY (CA)	$1925.51	$1925.51
EL CENTRO (CA)	$1926.46	$1926.46
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1997.09	$1997.09
SAN LUIS OBISPO-PASO ROBLES (CA)	$1949.07	$1949.07
SANTA MARIA-SANTA BARBARA (CA)	$1977.09	$1977.09
REST OF CALIFORNIA (CA)	$1925.51	$1925.51
COLORADO (CO)	$1948.85	$1948.85
CONNECTICUT (CT)	$2047.69	$2047.69
DC + MD/VA SUBURBS (DC)	$2125.35	$2125.35
DELAWARE (DE)	$1921.36	$1921.36
FORT LAUDERDALE (FL)	$2103.03	$2103.03
MIAMI (FL)	$2256.36	$2256.36
REST OF FLORIDA (FL)	$2013.41	$2013.41
ATLANTA (GA)	$1992.10	$1992.10
REST OF GEORGIA (GA)	$1918.81	$1918.81
HAWAII, GUAM (HI)	$1935.78	$1935.78
IOWA (IA)	$1779.26	$1779.26
IDAHO (ID)	$1796.55	$1796.55
EAST ST. LOUIS (IL)	$2091.48	$2091.48
SUBURBAN CHICAGO (IL)	$2112.22	$2112.22
CHICAGO (IL)	$2200.26	$2200.26
REST OF ILLINOIS (IL)	$2001.33	$2001.33
INDIANA (IN)	$1802.88	$1802.88
KANSAS (KS)	$1793.71	$1793.71
KENTUCKY (KY)	$1864.15	$1864.15
NEW ORLEANS (LA)	$1934.95	$1934.95
REST OF LOUISIANA (LA)	$1870.19	$1870.19
METROPOLITAN BOSTON (MA)	$2075.81	$2075.81
REST OF MASSACHUSETTS (MA)	$1950.69	$1950.69
BALTIMORE/SURR. CNTYS (MD)	$2045.86	$2045.86
REST OF MARYLAND (MD)	$1944.16	$1944.16
SOUTHERN MAINE (ME)	$1865.71	$1865.71
REST OF MAINE (ME)	$1825.07	$1825.07
DETROIT (MI)	$2053.37	$2053.37
REST OF MICHIGAN (MI)	$1918.26	$1918.26
MINNESOTA (MN)	$1822.42	$1822.42
METROPOLITAN ST. LOUIS (MO)	$1915.33	$1915.33
METROPOLITAN KANSAS CITY (MO)	$1903.42	$1903.42
REST OF MISSOURI (MO)	$1860.65	$1860.65
MISSISSIPPI (MS)	$1815.12	$1815.12
MONTANA** (MT)	$1940.88	$1940.88
NORTH CAROLINA (NC)	$1835.45	$1835.45
NORTH DAKOTA** (ND)	$1827.58	$1827.58
NEBRASKA (NE)	$1780.01	$1780.01
NEW HAMPSHIRE (NH)	$1939.81	$1939.81
NORTHERN NJ (NJ)	$2117.68	$2117.68
REST OF NEW JERSEY (NJ)	$2058.32	$2058.32
NEW MEXICO (NM)	$1934.24	$1934.24
NEVADA** (NV)	$1909.85	$1909.85
MANHATTAN (NY)	$2219.12	$2219.12
NYC SUBURBS/LONG ISLAND (NY)	$2285.78	$2285.78
POUGHKPSIE/N NYC SUBURBS (NY)	$2087.60	$2087.60
QUEENS (NY)	$2202.52	$2202.52
REST OF NEW YORK (NY)	$1857.01	$1857.01
OHIO (OH)	$1895.11	$1895.11
OKLAHOMA (OK)	$1839.93	$1839.93
PORTLAND (OR)	$1972.33	$1972.33
REST OF OREGON (OR)	$1882.23	$1882.23
METROPOLITAN PHILADELPHIA (PA)	$2022.30	$2022.30
REST OF PENNSYLVANIA (PA)	$1885.79	$1885.79
PUERTO RICO (PR)	$1944.42	$1944.42
RHODE ISLAND (RI)	$1961.51	$1961.51
SOUTH CAROLINA (SC)	$1870.90	$1870.90
SOUTH DAKOTA** (SD)	$1814.18	$1814.18
TENNESSEE (TN)	$1802.77	$1802.77
BRAZORIA (TX)	$1903.84	$1903.84
DALLAS (TX)	$1922.71	$1922.71
GALVESTON (TX)	$1914.12	$1914.12
HOUSTON (TX)	$2019.00	$2019.00
BEAUMONT (TX)	$1878.34	$1878.34
FORT WORTH (TX)	$1919.71	$1919.71
AUSTIN (TX)	$1953.64	$1953.64
REST OF TEXAS (TX)	$1894.74	$1894.74
UTAH (UT)	$1888.85	$1888.85
VIRGINIA (VA)	$1875.67	$1875.67
VIRGIN ISLANDS (VI)	$1944.42	$1944.42
VERMONT (VT)	$1841.23	$1841.23
SEATTLE (KING CNTY) (WA)	$2090.75	$2090.75
REST OF WASHINGTON (WA)	$1940.19	$1940.19
WISCONSIN (WI)	$1785.80	$1785.80
WEST VIRGINIA (WV)	$1951.95	$1951.95
WYOMING** (WY)	$1891.50	$1891.50

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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 payment is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The geographically adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Non-facility and facility rates can differ because practice-expense RVUs are often lower in facility settings, where the facility itself bears certain overhead costs.

RVUs — work 35.98, practice expense 16.41 (non-facility) / 16.41 (facility), malpractice 5.73 — × 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 beneficiary or secondary payer is responsible for the remainder.
Actual payment varies by locality GPCI values, applicable modifiers, place of service, and claim-specific adjustments.
Annual updates to RVUs, the conversion factor, and budget-neutrality adjustments can change this amount year to year.
Sequestration or other federal payment adjustments may reduce the final disbursed amount.
Always verify current rates with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why does the allowed amount change by locality?

Medicare adjusts the work, practice-expense, and malpractice RVUs using locality-specific GPCIs to account for regional differences in costs such as wages and rent, so the same code can have different allowed amounts in different areas.

Why are the non-facility and facility amounts the same here?

When the practice-expense RVU is identical for both settings, as shown in the inputs for this code, the calculated allowed amount comes out the same for non-facility and facility place of service.

Does this amount reflect what the provider will actually be paid?

No. It reflects the Medicare-allowed amount before the standard 20% coinsurance, deductible status, modifiers, and any sequestration or local contractor adjustments are applied.

Can I use this figure for a denial appeal?

This figure can help contextualize expected reimbursement, but appeals should rely on the MAC's actual remittance advice and current fee schedule data for the specific claim's date of service and locality.

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.