Medicare Reimbursement for CPT 15787

CPT 15787 is a procedure code used in Medicare billing; the full descriptor is maintained by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjustable by locality, and separately for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$31.40	$14.36
ALASKA* (AK)	$37.74	$19.60
ALABAMA (AL)	$28.60	$13.70
ARKANSAS (AR)	$28.25	$13.61
ARIZONA (AZ)	$30.68	$14.17
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$40.24	$16.23
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$41.03	$16.46
OXNARD-THOUSAND OAKS-VENTURA (CA)	$35.09	$14.96
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$35.28	$15.13
NAPA (CA)	$38.11	$15.66
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$40.27	$16.25
VALLEJO (CA)	$38.08	$15.63
BAKERSFIELD (CA)	$33.26	$14.59
CHICO (CA)	$33.19	$14.52
FRESNO (CA)	$33.19	$14.52
HANFORD-CORCORAN (CA)	$33.19	$14.52
MADERA (CA)	$33.19	$14.52
MERCED (CA)	$33.19	$14.52
MODESTO (CA)	$33.19	$14.52
REDDING (CA)	$33.19	$14.52
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$33.41	$14.75
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$34.74	$14.93
SALINAS (CA)	$34.60	$14.86
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$41.12	$16.56
SANTA CRUZ-WATSONVILLE (CA)	$35.62	$14.92
SANTA ROSA-PETALUMA (CA)	$35.98	$15.06
STOCKTON (CA)	$33.19	$14.52
VISALIA (CA)	$33.19	$14.52
YUBA CITY (CA)	$33.19	$14.52
EL CENTRO (CA)	$33.20	$14.53
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$35.34	$14.97
SAN LUIS OBISPO-PASO ROBLES (CA)	$34.05	$14.65
SANTA MARIA-SANTA BARBARA (CA)	$34.71	$14.85
REST OF CALIFORNIA (CA)	$33.19	$14.52
COLORADO (CO)	$32.66	$14.54
CONNECTICUT (CT)	$33.29	$14.95
DC + MD/VA SUBURBS (DC)	$35.62	$15.55
DELAWARE (DE)	$31.14	$14.31
FORT LAUDERDALE (FL)	$32.20	$14.94
MIAMI (FL)	$33.24	$15.51
REST OF FLORIDA (FL)	$30.85	$14.57
ATLANTA (GA)	$31.88	$14.58
REST OF GEORGIA (GA)	$29.36	$14.17
HAWAII, GUAM (HI)	$33.86	$14.49
IOWA (IA)	$29.29	$13.70
IDAHO (ID)	$29.44	$13.77
EAST ST. LOUIS (IL)	$30.47	$14.80
SUBURBAN CHICAGO (IL)	$32.53	$15.03
CHICAGO (IL)	$32.44	$15.32
REST OF ILLINOIS (IL)	$30.03	$14.48
INDIANA (IN)	$29.59	$13.80
KANSAS (KS)	$29.14	$13.74
KENTUCKY (KY)	$29.12	$13.97
NEW ORLEANS (LA)	$30.31	$14.28
REST OF LOUISIANA (LA)	$29.06	$13.99
METROPOLITAN BOSTON (MA)	$35.65	$15.31
REST OF MASSACHUSETTS (MA)	$32.49	$14.56
BALTIMORE/SURR. CNTYS (MD)	$33.19	$14.91
REST OF MARYLAND (MD)	$31.69	$14.45
SOUTHERN MAINE (ME)	$30.97	$14.09
REST OF MAINE (ME)	$29.54	$13.87
DETROIT (MI)	$31.15	$14.72
REST OF MICHIGAN (MI)	$29.74	$14.19
MINNESOTA (MN)	$31.51	$13.98
METROPOLITAN ST. LOUIS (MO)	$30.44	$14.22
METROPOLITAN KANSAS CITY (MO)	$30.16	$14.16
REST OF MISSOURI (MO)	$28.61	$13.93
MISSISSIPPI (MS)	$28.44	$13.77
MONTANA** (MT)	$31.40	$14.36
NORTH CAROLINA (NC)	$29.81	$13.92
NORTH DAKOTA** (ND)	$31.00	$13.97
NEBRASKA (NE)	$29.44	$13.72
NEW HAMPSHIRE (NH)	$32.14	$14.40
NORTHERN NJ (NJ)	$35.32	$15.56
REST OF NEW JERSEY (NJ)	$33.73	$15.13
NEW MEXICO (NM)	$29.87	$14.25
NEVADA** (NV)	$31.31	$14.25
MANHATTAN (NY)	$35.72	$15.92
NYC SUBURBS/LONG ISLAND (NY)	$36.44	$16.19
POUGHKPSIE/N NYC SUBURBS (NY)	$33.92	$15.27
QUEENS (NY)	$36.02	$15.89
REST OF NEW YORK (NY)	$30.20	$14.01
OHIO (OH)	$29.66	$14.11
OKLAHOMA (OK)	$29.10	$13.89
PORTLAND (OR)	$33.62	$14.70
REST OF OREGON (OR)	$31.12	$14.15
METROPOLITAN PHILADELPHIA (PA)	$32.54	$14.81
REST OF PENNSYLVANIA (PA)	$29.72	$14.08
PUERTO RICO (PR)	$31.61	$14.39
RHODE ISLAND (RI)	$32.19	$14.59
SOUTH CAROLINA (SC)	$29.77	$14.03
SOUTH DAKOTA** (SD)	$30.95	$13.92
TENNESSEE (TN)	$29.26	$13.78
BRAZORIA (TX)	$31.16	$14.27
DALLAS (TX)	$31.32	$14.35
GALVESTON (TX)	$31.23	$14.31
HOUSTON (TX)	$31.59	$14.68
BEAUMONT (TX)	$29.55	$14.04
FORT WORTH (TX)	$31.13	$14.33
AUSTIN (TX)	$32.50	$14.48
REST OF TEXAS (TX)	$30.31	$14.14
UTAH (UT)	$30.13	$14.11
VIRGINIA (VA)	$30.86	$14.11
VIRGIN ISLANDS (VI)	$31.61	$14.39
VERMONT (VT)	$30.87	$14.00
SEATTLE (KING CNTY) (WA)	$36.36	$15.46
REST OF WASHINGTON (WA)	$32.44	$14.50
WISCONSIN (WI)	$30.09	$13.77
WEST VIRGINIA (WV)	$29.06	$14.26
WYOMING** (WY)	$31.22	$14.19

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 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's PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed. The geographically adjusted RVUs are summed and then multiplied by the annual Conversion Factor (CF), which converts relative value into a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs, which is why the allowed amount differs between the two; typically non-facility is higher because it reflects the practice's overhead for supplies and staff. The resulting national amount is a baseline; actual locality-specific payments can be higher or lower depending on each area's cost index.

RVUs — work 0.32, practice expense 0.6 (non-facility) / 0.09 (facility), malpractice 0.02 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on the published PFS formula — actual claim payment may differ.
Medicare typically pays 80% of the allowed amount after the patient's deductible is met; the patient or secondary payer is responsible for the remainder.
Modifiers, bilateral/multiple procedure rules, and other claim-specific adjustments can change the final paid amount.
Amounts are subject to annual budget-neutrality adjustments and sequestration reductions that are not reflected in the raw RVU calculation.
Always verify the exact allowed amount and any applicable adjustments with your Medicare Administrative Contractor (MAC).

Frequently asked

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

Facility rates use a lower practice-expense RVU because Medicare assumes less overhead is incurred by the billing provider when the procedure is performed in a hospital or other facility setting that bills separately for its own costs.

Does this amount reflect what my locality will actually pay?

No. The national amount uses a national average; your locality's GPCIs adjust the RVUs up or down based on local wage and cost differences, so the local allowed amount can vary from the national figure.

Will Medicare pay this full amount to the practice?

No. Medicare generally reimburses 80% of the allowed amount after the Part B deductible is met; the remaining 20% is typically billed to the patient or a secondary payer, subject to coverage and coinsurance rules.

Why might the amount change from year to year?

The RVUs, GPCIs, and the Conversion Factor are all updated annually by CMS, and budget-neutrality adjustments or legislative changes can shift the final calculated amount even if the code itself doesn't change.

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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.