Medicare Reimbursement for CPT 15777

CPT 15777 is a procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount nationally and by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings. Actual payment depends on where the service is performed and the patient's specific locality.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$224.12	$182.37
ALASKA* (AK)	$278.91	$234.44
ALABAMA (AL)	$204.05	$167.52
ARKANSAS (AR)	$201.59	$165.72
ARIZONA (AZ)	$218.33	$177.87
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$256.51	$197.64
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$260.32	$200.11
OXNARD-THOUSAND OAKS-VENTURA (CA)	$234.09	$184.74
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$236.63	$187.24
NAPA (CA)	$246.94	$191.91
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$257.27	$198.40
VALLEJO (CA)	$245.85	$190.82
BAKERSFIELD (CA)	$225.58	$179.82
CHICO (CA)	$223.71	$177.95
FRESNO (CA)	$223.71	$177.95
HANFORD-CORCORAN (CA)	$223.71	$177.95
MADERA (CA)	$223.71	$177.95
MERCED (CA)	$223.71	$177.95
MODESTO (CA)	$223.71	$177.95
REDDING (CA)	$223.71	$177.95
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$230.92	$185.16
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$231.52	$182.96
SALINAS (CA)	$230.59	$182.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$263.43	$203.22
SANTA CRUZ-WATSONVILLE (CA)	$234.04	$183.32
SANTA ROSA-PETALUMA (CA)	$236.19	$184.92
STOCKTON (CA)	$223.71	$177.95
VISALIA (CA)	$223.71	$177.95
YUBA CITY (CA)	$223.71	$177.95
EL CENTRO (CA)	$223.82	$178.06
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$233.67	$183.74
SAN LUIS OBISPO-PASO ROBLES (CA)	$227.27	$179.72
SANTA MARIA-SANTA BARBARA (CA)	$230.82	$182.13
REST OF CALIFORNIA (CA)	$223.71	$177.95
COLORADO (CO)	$225.95	$181.52
CONNECTICUT (CT)	$237.58	$192.61
DC + MD/VA SUBURBS (DC)	$247.81	$198.63
DELAWARE (DE)	$221.46	$180.21
FORT LAUDERDALE (FL)	$243.28	$200.98
MIAMI (FL)	$261.73	$218.27
REST OF FLORIDA (FL)	$231.73	$191.82
ATLANTA (GA)	$230.30	$187.88
REST OF GEORGIA (GA)	$219.47	$182.23
HAWAII, GUAM (HI)	$226.05	$178.58
IOWA (IA)	$203.58	$165.38
IDAHO (ID)	$205.70	$167.29
EAST ST. LOUIS (IL)	$240.19	$201.77
SUBURBAN CHICAGO (IL)	$244.47	$201.59
CHICAGO (IL)	$254.35	$212.39
REST OF ILLINOIS (IL)	$229.51	$191.39
INDIANA (IN)	$206.57	$167.87
KANSAS (KS)	$205.07	$167.33
KENTUCKY (KY)	$213.02	$175.91
NEW ORLEANS (LA)	$222.28	$182.99
REST OF LOUISIANA (LA)	$213.65	$176.70
METROPOLITAN BOSTON (MA)	$242.60	$192.75
REST OF MASSACHUSETTS (MA)	$225.87	$181.91
BALTIMORE/SURR. CNTYS (MD)	$237.37	$192.57
REST OF MARYLAND (MD)	$224.47	$182.22
SOUTHERN MAINE (ME)	$215.12	$173.74
REST OF MAINE (ME)	$209.03	$170.62
DETROIT (MI)	$236.57	$196.28
REST OF MICHIGAN (MI)	$219.80	$181.68
MINNESOTA (MN)	$210.77	$167.81
METROPOLITAN ST. LOUIS (MO)	$220.19	$180.44
METROPOLITAN KANSAS CITY (MO)	$218.55	$179.35
REST OF MISSOURI (MO)	$212.11	$176.12
MISSISSIPPI (MS)	$206.77	$170.82
MONTANA** (MT)	$224.08	$182.32
NORTH CAROLINA (NC)	$210.49	$171.54
NORTH DAKOTA** (ND)	$210.83	$169.08
NEBRASKA (NE)	$203.82	$165.29
NEW HAMPSHIRE (NH)	$224.72	$181.26
NORTHERN NJ (NJ)	$246.39	$197.96
REST OF NEW JERSEY (NJ)	$238.67	$193.08
NEW MEXICO (NM)	$221.74	$183.46
NEVADA** (NV)	$220.47	$178.67
MANHATTAN (NY)	$258.26	$209.75
NYC SUBURBS/LONG ISLAND (NY)	$266.56	$216.92
POUGHKPSIE/N NYC SUBURBS (NY)	$242.04	$196.32
QUEENS (NY)	$256.70	$207.35
REST OF NEW YORK (NY)	$213.33	$173.67
OHIO (OH)	$217.09	$178.97
OKLAHOMA (OK)	$210.27	$172.98
PORTLAND (OR)	$229.49	$183.10
REST OF OREGON (OR)	$217.14	$175.56
METROPOLITAN PHILADELPHIA (PA)	$233.98	$190.51
REST OF PENNSYLVANIA (PA)	$216.10	$177.77
PUERTO RICO (PR)	$224.70	$182.49
RHODE ISLAND (RI)	$226.70	$183.57
SOUTH CAROLINA (SC)	$214.47	$175.89
SOUTH DAKOTA** (SD)	$209.26	$167.51
TENNESSEE (TN)	$206.22	$168.27
BRAZORIA (TX)	$219.40	$178.03
DALLAS (TX)	$221.68	$180.10
GALVESTON (TX)	$220.64	$179.18
HOUSTON (TX)	$232.91	$191.45
BEAUMONT (TX)	$215.08	$177.08
FORT WORTH (TX)	$221.14	$179.98
AUSTIN (TX)	$226.61	$182.44
REST OF TEXAS (TX)	$217.72	$178.10
UTAH (UT)	$216.87	$177.62
VIRGINIA (VA)	$216.13	$175.09
VIRGIN ISLANDS (VI)	$224.70	$182.49
VERMONT (VT)	$212.24	$170.90
SEATTLE (KING CNTY) (WA)	$244.77	$193.54
REST OF WASHINGTON (WA)	$224.71	$180.74
WISCONSIN (WI)	$205.16	$165.16
WEST VIRGINIA (WV)	$222.91	$186.63
WYOMING** (WY)	$218.30	$176.55

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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: 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 PFS amounts are built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the service locality, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Non-facility and facility settings use different practice-expense RVUs, since facility settings typically have lower overhead cost built into the physician payment because the facility is paid separately. This is why the same code often has two different national or locality-based allowed amounts.

RVUs — work 3.56, practice expense 2.48 (non-facility) / 1.23 (facility), malpractice 0.67 — × 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.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual conversion factor updates and budget-neutrality adjustments can shift amounts year to year.
Always verify final pricing and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does this code show two different national amounts?

One reflects the non-facility (e.g., office) setting and the other reflects the facility (e.g., hospital outpatient) setting, which use different practice-expense RVUs.

Will my locality's payment match the national amount shown?

Not necessarily. Locality-specific GPCIs adjust the RVUs for local cost differences, so the final allowed amount can be higher or lower than the national figure.

Does this amount include what the patient owes?

No. The allowed amount is the total Medicare-approved payment; Medicare generally pays 80% of it after the deductible, with the patient or secondary payer responsible for the rest.

Can modifiers change this amount?

Yes. Modifiers indicating bilateral procedures, reduced services, multiple procedures, or other circumstances can increase or decrease the final payment relative to the base PFS 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.