Medicare Reimbursement for CPT 15776

CPT 15776 is a procedure code used in Medicare billing; the exact clinical description cannot be reproduced here due to AMA licensing. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$544.43	$303.61
ALASKA* (AK)	$640.62	$384.15
ALABAMA (AL)	$488.36	$277.64
ARKANSAS (AR)	$481.33	$274.47
ARIZONA (AZ)	$529.29	$295.93
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$677.39	$337.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$689.70	$342.44
OXNARD-THOUSAND OAKS-VENTURA (CA)	$596.75	$312.10
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$600.82	$315.93
NAPA (CA)	$644.06	$326.66
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$678.54	$338.99
VALLEJO (CA)	$642.39	$324.99
BAKERSFIELD (CA)	$566.25	$302.31
CHICO (CA)	$563.40	$299.46
FRESNO (CA)	$563.40	$299.46
HANFORD-CORCORAN (CA)	$563.40	$299.46
MADERA (CA)	$563.40	$299.46
MERCED (CA)	$563.40	$299.46
MODESTO (CA)	$563.40	$299.46
REDDING (CA)	$563.40	$299.46
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$574.38	$310.44
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$588.95	$308.88
SALINAS (CA)	$586.73	$307.62
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$694.44	$347.17
SANTA CRUZ-WATSONVILLE (CA)	$603.43	$310.83
SANTA ROSA-PETALUMA (CA)	$609.34	$313.62
STOCKTON (CA)	$563.40	$299.46
VISALIA (CA)	$563.40	$299.46
YUBA CITY (CA)	$563.40	$299.46
EL CENTRO (CA)	$563.57	$299.63
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$598.98	$310.96
SAN LUIS OBISPO-PASO ROBLES (CA)	$577.60	$303.31
SANTA MARIA-SANTA BARBARA (CA)	$588.50	$307.71
REST OF CALIFORNIA (CA)	$563.40	$299.46
COLORADO (CO)	$560.28	$304.04
CONNECTICUT (CT)	$580.63	$321.26
DC + MD/VA SUBURBS (DC)	$616.81	$333.12
DELAWARE (DE)	$537.93	$300.00
FORT LAUDERDALE (FL)	$576.26	$332.31
MIAMI (FL)	$610.07	$359.38
REST OF FLORIDA (FL)	$547.04	$316.81
ATLANTA (GA)	$557.11	$312.43
REST OF GEORGIA (GA)	$515.30	$300.49
HAWAII, GUAM (HI)	$575.35	$301.53
IOWA (IA)	$495.81	$275.46
IDAHO (ID)	$500.05	$278.50
EAST ST. LOUIS (IL)	$552.55	$331.00
SUBURBAN CHICAGO (IL)	$580.92	$333.59
CHICAGO (IL)	$591.47	$349.44
REST OF ILLINOIS (IL)	$534.88	$315.01
INDIANA (IN)	$502.81	$279.57
KANSAS (KS)	$495.82	$278.12
KENTUCKY (KY)	$504.87	$290.78
NEW ORLEANS (LA)	$529.58	$302.97
REST OF LOUISIANA (LA)	$505.02	$291.89
METROPOLITAN BOSTON (MA)	$612.15	$324.61
REST OF MASSACHUSETTS (MA)	$557.91	$304.32
BALTIMORE/SURR. CNTYS (MD)	$579.50	$321.10
REST OF MARYLAND (MD)	$547.41	$303.70
SOUTHERN MAINE (ME)	$528.89	$290.24
REST OF MAINE (ME)	$505.13	$283.57
DETROIT (MI)	$556.24	$323.85
REST OF MICHIGAN (MI)	$520.09	$300.22
MINNESOTA (MN)	$530.03	$282.23
METROPOLITAN ST. LOUIS (MO)	$528.65	$299.39
METROPOLITAN KANSAS CITY (MO)	$523.50	$297.37
REST OF MISSOURI (MO)	$497.96	$290.38
MISSISSIPPI (MS)	$489.63	$282.28
MONTANA** (MT)	$544.37	$303.55
NORTH CAROLINA (NC)	$510.00	$285.32
NORTH DAKOTA** (ND)	$524.20	$283.38
NEBRASKA (NE)	$497.81	$275.53
NEW HAMPSHIRE (NH)	$553.72	$303.03
NORTHERN NJ (NJ)	$610.95	$331.60
REST OF NEW JERSEY (NJ)	$585.33	$322.36
NEW MEXICO (NM)	$523.86	$303.03
NEVADA** (NV)	$539.08	$298.01
MANHATTAN (NY)	$629.44	$349.60
NYC SUBURBS/LONG ISLAND (NY)	$647.59	$361.25
POUGHKPSIE/N NYC SUBURBS (NY)	$591.07	$327.37
QUEENS (NY)	$631.14	$346.49
REST OF NEW YORK (NY)	$517.80	$289.02
OHIO (OH)	$515.97	$296.10
OKLAHOMA (OK)	$501.49	$286.44
PORTLAND (OR)	$575.26	$307.71
REST OF OREGON (OR)	$532.99	$293.14
METROPOLITAN PHILADELPHIA (PA)	$567.79	$317.10
REST OF PENNSYLVANIA (PA)	$515.47	$294.40
PUERTO RICO (PR)	$547.56	$304.09
RHODE ISLAND (RI)	$555.08	$306.31
SOUTH CAROLINA (SC)	$514.22	$291.70
SOUTH DAKOTA** (SD)	$521.81	$280.99
TENNESSEE (TN)	$498.60	$279.69
BRAZORIA (TX)	$535.41	$296.75
DALLAS (TX)	$539.90	$300.04
GALVESTON (TX)	$537.70	$298.57
HOUSTON (TX)	$556.37	$317.24
BEAUMONT (TX)	$512.29	$293.14
FORT WORTH (TX)	$537.04	$299.59
AUSTIN (TX)	$560.07	$305.28
REST OF TEXAS (TX)	$524.28	$295.74
UTAH (UT)	$521.14	$294.77
VIRGINIA (VA)	$528.80	$292.08
VIRGIN ISLANDS (VI)	$547.56	$304.09
VERMONT (VT)	$524.30	$285.89
SEATTLE (KING CNTY) (WA)	$622.19	$326.70
REST OF WASHINGTON (WA)	$556.14	$302.56
WISCONSIN (WI)	$506.98	$276.28
WEST VIRGINIA (WV)	$515.84	$306.57
WYOMING** (WY)	$535.58	$294.76

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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 PFS amounts are 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 regional 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 primarily because practice-expense RVUs are higher in non-facility settings (e.g., office) to account for overhead costs that a facility would otherwise absorb.

RVUs — work 5.39, practice expense 9.89 (non-facility) / 2.68 (facility), malpractice 1.02 — × 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 patient meets their deductible; the patient or secondary insurance is responsible for the remainder.
Actual payment can vary based on locality, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why is the facility rate lower than the non-facility rate for this code?

Facility rates use a lower practice-expense RVU because the facility (e.g., hospital) bears overhead costs like equipment and staff, which are otherwise built into the non-facility rate for office-based settings.

Does this amount reflect what Medicare will actually pay?

No. It reflects the PFS allowed amount before the standard 20% coinsurance, deductible, and any applicable adjustments like sequestration or modifiers are applied.

Why does the amount change by locality?

Geographic Practice Cost Indices (GPCIs) adjust the work, practice expense, and malpractice RVUs to reflect regional differences in wages and costs of practicing medicine.

Will this rate change next year?

Yes. The conversion factor and RVUs are updated annually by CMS and may change due to legislative action, budget-neutrality requirements, or coding revisions.

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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.