Medicare Reimbursement for CPT 15772

CPT 15772 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$205.75	$126.26
ALASKA* (AK)	$246.85	$162.19
ALABAMA (AL)	$185.57	$116.02
ARKANSAS (AR)	$183.06	$114.77
ARIZONA (AZ)	$200.20	$123.17
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$249.63	$137.54
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$253.93	$139.30
OXNARD-THOUSAND OAKS-VENTURA (CA)	$222.24	$128.28
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$224.03	$129.99
NAPA (CA)	$238.22	$133.45
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$250.14	$138.05
VALLEJO (CA)	$237.48	$132.71
BAKERSFIELD (CA)	$211.91	$124.78
CHICO (CA)	$210.65	$123.52
FRESNO (CA)	$210.65	$123.52
HANFORD-CORCORAN (CA)	$210.65	$123.52
MADERA (CA)	$210.65	$123.52
MERCED (CA)	$210.65	$123.52
MODESTO (CA)	$210.65	$123.52
REDDING (CA)	$210.65	$123.52
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$215.49	$128.37
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$219.51	$127.06
SALINAS (CA)	$218.67	$126.53
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$256.02	$141.39
SANTA CRUZ-WATSONVILLE (CA)	$223.97	$127.38
SANTA ROSA-PETALUMA (CA)	$226.12	$128.50
STOCKTON (CA)	$210.65	$123.52
VISALIA (CA)	$210.65	$123.52
YUBA CITY (CA)	$210.65	$123.52
EL CENTRO (CA)	$210.72	$123.60
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$222.72	$127.64
SAN LUIS OBISPO-PASO ROBLES (CA)	$215.34	$124.80
SANTA MARIA-SANTA BARBARA (CA)	$219.19	$126.50
REST OF CALIFORNIA (CA)	$210.65	$123.52
COLORADO (CO)	$210.43	$125.84
CONNECTICUT (CT)	$218.95	$133.33
DC + MD/VA SUBURBS (DC)	$231.29	$137.65
DELAWARE (DE)	$203.33	$124.79
FORT LAUDERDALE (FL)	$219.31	$138.79
MIAMI (FL)	$233.21	$150.46
REST OF FLORIDA (FL)	$208.50	$132.51
ATLANTA (GA)	$210.76	$130.00
REST OF GEORGIA (GA)	$196.84	$125.93
HAWAII, GUAM (HI)	$214.39	$124.00
IOWA (IA)	$187.40	$114.67
IDAHO (ID)	$189.09	$115.96
EAST ST. LOUIS (IL)	$212.25	$139.12
SUBURBAN CHICAGO (IL)	$220.87	$139.23
CHICAGO (IL)	$226.33	$146.44
REST OF ILLINOIS (IL)	$204.71	$132.13
INDIANA (IN)	$190.05	$116.36
KANSAS (KS)	$187.81	$115.95
KENTUCKY (KY)	$192.35	$121.68
NEW ORLEANS (LA)	$201.35	$126.55
REST OF LOUISIANA (LA)	$192.56	$122.21
METROPOLITAN BOSTON (MA)	$228.63	$133.71
REST OF MASSACHUSETTS (MA)	$209.79	$126.08
BALTIMORE/SURR. CNTYS (MD)	$218.59	$133.29
REST OF MARYLAND (MD)	$206.64	$126.19
SOUTHERN MAINE (ME)	$199.22	$120.44
REST OF MAINE (ME)	$191.33	$118.20
DETROIT (MI)	$212.24	$135.53
REST OF MICHIGAN (MI)	$198.19	$125.61
MINNESOTA (MN)	$198.34	$116.54
METROPOLITAN ST. LOUIS (MO)	$200.54	$124.86
METROPOLITAN KANSAS CITY (MO)	$198.74	$124.10
REST OF MISSOURI (MO)	$190.29	$121.76
MISSISSIPPI (MS)	$186.64	$118.20
MONTANA** (MT)	$205.72	$126.23
NORTH CAROLINA (NC)	$193.01	$118.84
NORTH DAKOTA** (ND)	$196.82	$117.33
NEBRASKA (NE)	$187.99	$114.62
NEW HAMPSHIRE (NH)	$208.35	$125.60
NORTHERN NJ (NJ)	$229.38	$137.17
REST OF NEW JERSEY (NJ)	$220.52	$133.71
NEW MEXICO (NM)	$199.71	$126.81
NEVADA** (NV)	$203.35	$123.78
MANHATTAN (NY)	$237.47	$145.09
NYC SUBURBS/LONG ISLAND (NY)	$244.49	$149.97
POUGHKPSIE/N NYC SUBURBS (NY)	$222.95	$135.90
QUEENS (NY)	$237.49	$143.53
REST OF NEW YORK (NY)	$195.82	$120.31
OHIO (OH)	$196.37	$123.79
OKLAHOMA (OK)	$190.71	$119.72
PORTLAND (OR)	$215.33	$127.01
REST OF OREGON (OR)	$200.85	$121.67
METROPOLITAN PHILADELPHIA (PA)	$214.60	$131.84
REST OF PENNSYLVANIA (PA)	$195.97	$122.99
PUERTO RICO (PR)	$206.73	$126.36
RHODE ISLAND (RI)	$209.28	$127.16
SOUTH CAROLINA (SC)	$195.19	$121.74
SOUTH DAKOTA** (SD)	$195.77	$116.28
TENNESSEE (TN)	$188.85	$116.59
BRAZORIA (TX)	$202.11	$123.33
DALLAS (TX)	$203.91	$124.74
GALVESTON (TX)	$203.05	$124.11
HOUSTON (TX)	$211.29	$132.35
BEAUMONT (TX)	$194.85	$122.51
FORT WORTH (TX)	$203.02	$124.63
AUSTIN (TX)	$210.53	$126.43
REST OF TEXAS (TX)	$198.72	$123.28
UTAH (UT)	$197.66	$122.94
VIRGINIA (VA)	$199.47	$121.33
VIRGIN ISLANDS (VI)	$206.73	$126.36
VERMONT (VT)	$197.23	$118.53
SEATTLE (KING CNTY) (WA)	$231.87	$134.33
REST OF WASHINGTON (WA)	$209.01	$125.30
WISCONSIN (WI)	$190.76	$114.61
WEST VIRGINIA (WV)	$197.92	$128.84
WYOMING** (WY)	$201.84	$122.35

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 9 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 pricing starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility rates differ mainly because the practice-expense RVU is higher in non-facility settings, where the physician's office bears more of the overhead costs.

RVUs — work 2.44, practice expense 3.27 (non-facility) / 0.89 (facility), malpractice 0.45 — × 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 insurer is generally responsible for the rest.
Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Rates vary by locality due to GPCI differences and may be updated annually by CMS.
Always verify the current, locality-specific amount with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why does the amount differ between non-facility and facility settings?

The practice-expense RVU is higher in non-facility settings because the billing provider covers overhead costs like staff and supplies, whereas in a facility setting those costs are covered separately by the facility.

Why might my local Medicare payment differ from the national amount shown?

The national amount uses a GPCI value of 1.0 for comparison purposes, while actual payments are adjusted using the specific GPCI values for the provider's locality, which reflect regional cost-of-living and practice-cost differences.

Does this amount reflect what Medicare will actually pay?

No. This figure is the Medicare-allowed amount before the standard 20% coinsurance, annual deductible, sequestration, or any applicable modifiers are applied.

Can modifiers change this code's reimbursement?

Yes. Modifiers such as bilateral, multiple procedure, or assistant-at-surgery indicators can increase or decrease the final payment relative to the base allowed amount shown here.

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.