Medicare Reimbursement for CPT 15778
CPT 15778 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and, where available, by locality, for both non-facility and facility settings.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $353.38 | $353.38 |
| ALASKA* (AK) | $446.98 | $446.98 |
| ALABAMA (AL) | $320.35 | $320.35 |
| ARKANSAS (AR) | $316.38 | $316.38 |
| ARIZONA (AZ) | $343.12 | $343.12 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $370.06 | $370.06 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $374.06 | $374.06 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $350.62 | $350.62 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $356.00 | $356.00 |
| NAPA (CA) | $361.25 | $361.25 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $371.99 | $371.99 |
| VALLEJO (CA) | $358.47 | $358.47 |
| BAKERSFIELD (CA) | $341.98 | $341.98 |
| CHICO (CA) | $337.38 | $337.38 |
| FRESNO (CA) | $337.38 | $337.38 |
| HANFORD-CORCORAN (CA) | $337.38 | $337.38 |
| MADERA (CA) | $337.38 | $337.38 |
| MERCED (CA) | $337.38 | $337.38 |
| MODESTO (CA) | $337.38 | $337.38 |
| REDDING (CA) | $337.38 | $337.38 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $355.61 | $355.61 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $346.24 | $346.24 |
| SALINAS (CA) | $344.82 | $344.82 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $381.95 | $381.95 |
| SANTA CRUZ-WATSONVILLE (CA) | $346.29 | $346.29 |
| SANTA ROSA-PETALUMA (CA) | $349.23 | $349.23 |
| STOCKTON (CA) | $337.38 | $337.38 |
| VISALIA (CA) | $337.38 | $337.38 |
| YUBA CITY (CA) | $337.38 | $337.38 |
| EL CENTRO (CA) | $337.66 | $337.66 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $347.42 | $347.42 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $340.27 | $340.27 |
| SANTA MARIA-SANTA BARBARA (CA) | $344.60 | $344.60 |
| REST OF CALIFORNIA (CA) | $337.38 | $337.38 |
| COLORADO (CO) | $348.00 | $348.00 |
| CONNECTICUT (CT) | $375.06 | $375.06 |
| DC + MD/VA SUBURBS (DC) | $384.14 | $384.14 |
| DELAWARE (DE) | $347.99 | $347.99 |
| FORT LAUDERDALE (FL) | $400.13 | $400.13 |
| MIAMI (FL) | $442.95 | $442.95 |
| REST OF FLORIDA (FL) | $378.99 | $378.99 |
| ATLANTA (GA) | $366.56 | $366.56 |
| REST OF GEORGIA (GA) | $357.03 | $357.03 |
| HAWAII, GUAM (HI) | $338.67 | $338.67 |
| IOWA (IA) | $313.44 | $313.44 |
| IDAHO (ID) | $318.09 | $318.09 |
| EAST ST. LOUIS (IL) | $405.59 | $405.59 |
| SUBURBAN CHICAGO (IL) | $400.64 | $400.64 |
| CHICAGO (IL) | $428.86 | $428.86 |
| REST OF ILLINOIS (IL) | $379.51 | $379.51 |
| INDIANA (IN) | $319.29 | $319.29 |
| KANSAS (KS) | $318.77 | $318.77 |
| KENTUCKY (KY) | $341.10 | $341.10 |
| NEW ORLEANS (LA) | $357.14 | $357.14 |
| REST OF LOUISIANA (LA) | $343.28 | $343.28 |
| METROPOLITAN BOSTON (MA) | $369.57 | $369.57 |
| REST OF MASSACHUSETTS (MA) | $349.08 | $349.08 |
| BALTIMORE/SURR. CNTYS (MD) | $375.41 | $375.41 |
| REST OF MARYLAND (MD) | $351.83 | $351.83 |
| SOUTHERN MAINE (ME) | $331.82 | $331.82 |
| REST OF MAINE (ME) | $326.55 | $326.55 |
| DETROIT (MI) | $389.98 | $389.98 |
| REST OF MICHIGAN (MI) | $354.87 | $354.87 |
| MINNESOTA (MN) | $315.35 | $315.35 |
| METROPOLITAN ST. LOUIS (MO) | $350.27 | $350.27 |
| METROPOLITAN KANSAS CITY (MO) | $347.98 | $347.98 |
| REST OF MISSOURI (MO) | $342.64 | $342.64 |
| MISSISSIPPI (MS) | $329.23 | $329.23 |
| MONTANA** (MT) | $353.27 | $353.27 |
| NORTH CAROLINA (NC) | $328.39 | $328.39 |
| NORTH DAKOTA** (ND) | $319.65 | $319.65 |
| NEBRASKA (NE) | $312.89 | $312.89 |
| NEW HAMPSHIRE (NH) | $349.04 | $349.04 |
| NORTHERN NJ (NJ) | $382.44 | $382.44 |
| REST OF NEW JERSEY (NJ) | $374.24 | $374.24 |
| NEW MEXICO (NM) | $359.22 | $359.22 |
| NEVADA** (NV) | $343.97 | $343.97 |
| MANHATTAN (NY) | $412.22 | $412.22 |
| NYC SUBURBS/LONG ISLAND (NY) | $429.42 | $429.42 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $382.01 | $382.01 |
| QUEENS (NY) | $405.38 | $405.38 |
| REST OF NEW YORK (NY) | $333.16 | $333.16 |
| OHIO (OH) | $347.99 | $347.99 |
| OKLAHOMA (OK) | $333.54 | $333.54 |
| PORTLAND (OR) | $349.97 | $349.97 |
| REST OF OREGON (OR) | $336.25 | $336.25 |
| METROPOLITAN PHILADELPHIA (PA) | $371.22 | $371.22 |
| REST OF PENNSYLVANIA (PA) | $344.75 | $344.75 |
| PUERTO RICO (PR) | $353.27 | $353.27 |
| RHODE ISLAND (RI) | $353.82 | $353.82 |
| SOUTH CAROLINA (SC) | $339.76 | $339.76 |
| SOUTH DAKOTA** (SD) | $315.68 | $315.68 |
| TENNESSEE (TN) | $320.98 | $320.98 |
| BRAZORIA (TX) | $342.12 | $342.12 |
| DALLAS (TX) | $347.12 | $347.12 |
| GALVESTON (TX) | $344.98 | $344.98 |
| HOUSTON (TX) | $376.10 | $376.10 |
| BEAUMONT (TX) | $343.31 | $343.31 |
| FORT WORTH (TX) | $347.18 | $347.18 |
| AUSTIN (TX) | $351.26 | $351.26 |
| REST OF TEXAS (TX) | $344.45 | $344.45 |
| UTAH (UT) | $343.56 | $343.56 |
| VIRGINIA (VA) | $335.55 | $335.55 |
| VIRGIN ISLANDS (VI) | $353.27 | $353.27 |
| VERMONT (VT) | $324.66 | $324.66 |
| SEATTLE (KING CNTY) (WA) | $369.70 | $369.70 |
| REST OF WASHINGTON (WA) | $346.35 | $346.35 |
| WISCONSIN (WI) | $311.27 | $311.27 |
| WEST VIRGINIA (WV) | $369.06 | $369.06 |
| WYOMING** (WY) | $338.62 | $338.62 |
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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 national conversion factor to produce the dollar allowed amount. Non-facility and facility rates differ mainly in the practice-expense RVU, since facility settings assume the facility (not the physician's office) bears certain overhead costs.
RVUs — work 6.87, practice expense 2.01 (non-facility) / 2.01 (facility), malpractice 1.7 — × 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 payer is responsible for the remainder.
- Actual payment can vary by locality, applicable modifiers, place of service, 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 and non-facility amount the same for this code?
When the practice-expense RVU is identical in both settings, the calculated allowed amount comes out the same, since the work and malpractice RVU components don't change by setting.
Does this amount reflect what my practice will actually collect?
No. It's a PFS-based estimate before deductible, coinsurance, sequestration, and any locality-specific or contractual adjustments are applied.
Why do amounts differ by locality?
Each locality has its own GPCI values for work, practice expense, and malpractice, reflecting regional cost-of-living and cost-of-practice differences, which are applied before the conversion factor.
Will this rate change next year?
Yes — RVUs, GPCIs, and the conversion factor are updated annually (and sometimes mid-year), so the allowed amount can change from year to year.
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.
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