Medicare Reimbursement for CPT 15775

CPT 15775 is a procedure code reported to Medicare and other payers; the specific service it describes is defined by the AMA's CPT codebook. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted by locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$402.15	$223.12
ALASKA* (AK)	$472.04	$281.37
ALABAMA (AL)	$360.62	$203.97
ARKANSAS (AR)	$355.42	$201.63
ARIZONA (AZ)	$390.99	$217.51
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$503.16	$250.73
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$512.42	$254.26
OXNARD-THOUSAND OAKS-VENTURA (CA)	$442.28	$230.67
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$445.17	$233.38
NAPA (CA)	$478.03	$242.07
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$503.97	$251.54
VALLEJO (CA)	$476.87	$240.91
BAKERSFIELD (CA)	$419.30	$223.09
CHICO (CA)	$417.31	$221.10
FRESNO (CA)	$417.31	$221.10
HANFORD-CORCORAN (CA)	$417.31	$221.10
MADERA (CA)	$417.31	$221.10
MERCED (CA)	$417.31	$221.10
MODESTO (CA)	$417.31	$221.10
REDDING (CA)	$417.31	$221.10
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$424.96	$228.74
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$436.50	$228.29
SALINAS (CA)	$434.85	$227.36
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$515.72	$257.56
SANTA CRUZ-WATSONVILLE (CA)	$447.56	$230.04
SANTA ROSA-PETALUMA (CA)	$451.96	$232.12
STOCKTON (CA)	$417.31	$221.10
VISALIA (CA)	$417.31	$221.10
YUBA CITY (CA)	$417.31	$221.10
EL CENTRO (CA)	$417.43	$221.22
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$444.11	$229.99
SAN LUIS OBISPO-PASO ROBLES (CA)	$428.06	$224.14
SANTA MARIA-SANTA BARBARA (CA)	$436.22	$227.47
REST OF CALIFORNIA (CA)	$417.31	$221.10
COLORADO (CO)	$414.49	$224.00
CONNECTICUT (CT)	$428.94	$236.12
DC + MD/VA SUBURBS (DC)	$456.24	$245.35
DELAWARE (DE)	$397.40	$220.52
FORT LAUDERDALE (FL)	$424.56	$243.20
MIAMI (FL)	$448.65	$262.28
REST OF FLORIDA (FL)	$403.08	$231.93
ATLANTA (GA)	$411.30	$229.40
REST OF GEORGIA (GA)	$379.72	$220.02
HAWAII, GUAM (HI)	$426.39	$222.84
IOWA (IA)	$366.61	$202.80
IDAHO (ID)	$369.66	$204.96
EAST ST. LOUIS (IL)	$406.21	$241.50
SUBURBAN CHICAGO (IL)	$428.10	$244.24
CHICAGO (IL)	$435.01	$255.08
REST OF ILLINOIS (IL)	$393.76	$230.31
INDIANA (IN)	$371.72	$205.76
KANSAS (KS)	$366.40	$204.56
KENTUCKY (KY)	$372.40	$213.24
NEW ORLEANS (LA)	$390.63	$222.17
REST OF LOUISIANA (LA)	$372.42	$213.98
METROPOLITAN BOSTON (MA)	$453.28	$239.52
REST OF MASSACHUSETTS (MA)	$412.63	$224.11
BALTIMORE/SURR. CNTYS (MD)	$428.06	$235.97
REST OF MARYLAND (MD)	$404.49	$223.31
SOUTHERN MAINE (ME)	$391.15	$213.73
REST OF MAINE (ME)	$373.20	$208.49
DETROIT (MI)	$409.67	$236.91
REST OF MICHIGAN (MI)	$383.47	$220.02
MINNESOTA (MN)	$392.70	$208.48
METROPOLITAN ST. LOUIS (MO)	$390.20	$219.77
METROPOLITAN KANSAS CITY (MO)	$386.36	$218.25
REST OF MISSOURI (MO)	$367.05	$212.73
MISSISSIPPI (MS)	$361.23	$207.09
MONTANA** (MT)	$402.10	$223.07
NORTH CAROLINA (NC)	$376.85	$209.81
NORTH DAKOTA** (ND)	$388.06	$209.03
NEBRASKA (NE)	$368.16	$202.92
NEW HAMPSHIRE (NH)	$409.43	$223.06
NORTHERN NJ (NJ)	$451.84	$244.16
REST OF NEW JERSEY (NJ)	$432.58	$237.08
NEW MEXICO (NM)	$386.18	$222.01
NEVADA** (NV)	$398.44	$219.23
MANHATTAN (NY)	$464.75	$256.72
NYC SUBURBS/LONG ISLAND (NY)	$477.92	$265.05
POUGHKPSIE/N NYC SUBURBS (NY)	$436.65	$240.61
QUEENS (NY)	$466.33	$254.72
REST OF NEW YORK (NY)	$382.61	$212.53
OHIO (OH)	$380.60	$217.15
OKLAHOMA (OK)	$370.13	$210.25
PORTLAND (OR)	$425.87	$226.96
REST OF OREGON (OR)	$394.10	$215.79
METROPOLITAN PHILADELPHIA (PA)	$419.28	$232.91
REST OF PENNSYLVANIA (PA)	$380.36	$216.01
PUERTO RICO (PR)	$404.54	$223.54
RHODE ISLAND (RI)	$410.27	$225.34
SOUTH CAROLINA (SC)	$379.60	$214.18
SOUTH DAKOTA** (SD)	$386.40	$207.37
TENNESSEE (TN)	$368.43	$205.69
BRAZORIA (TX)	$395.71	$218.29
DALLAS (TX)	$398.94	$220.62
GALVESTON (TX)	$397.35	$219.57
HOUSTON (TX)	$410.34	$232.57
BEAUMONT (TX)	$377.98	$215.06
FORT WORTH (TX)	$396.75	$220.22
AUSTIN (TX)	$414.19	$224.78
REST OF TEXAS (TX)	$387.10	$217.21
UTAH (UT)	$384.74	$216.45
VIRGINIA (VA)	$390.93	$214.94
VIRGIN ISLANDS (VI)	$404.54	$223.54
VERMONT (VT)	$387.93	$210.69
SEATTLE (KING CNTY) (WA)	$460.95	$241.28
REST OF WASHINGTON (WA)	$411.39	$222.87
WISCONSIN (WI)	$375.24	$203.73
WEST VIRGINIA (WV)	$379.64	$224.06
WYOMING** (WY)	$395.98	$216.95

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. 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 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 adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice expense RVUs differ between non-facility and facility settings because facilities absorb certain overhead costs, which typically results in a lower facility rate.

RVUs — work 3.85, practice expense 7.48 (non-facility) / 2.12 (facility), malpractice 0.71 — × 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 responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Local Medicare Administrative Contractor (MAC) policies and coverage determinations may affect payment eligibility.
Always verify current-year rates and coverage rules directly with your MAC before billing.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The facility rate uses lower practice expense RVUs because the facility (e.g., hospital) is assumed to bear overhead costs like equipment and staff, which are instead built into the non-facility rate when performed in a private office.

Does this amount reflect what my practice will actually be paid?

No. This is a national or locality-adjusted estimate based on standard PFS inputs. Actual payment can vary due to modifiers, secondary payers, sequestration, and contractual arrangements.

Why do GPCIs matter for this code?

GPCIs adjust the work, practice expense, and malpractice RVUs to reflect cost-of-living and practice cost differences across localities, so the same code can have different allowed amounts in different parts of the country.

Where can I find the official CPT descriptor for this code?

CPT descriptors are copyrighted by the American Medical Association. Refer to your licensed CPT codebook or AMA resources for the official description of this code.

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.