Medicare Reimbursement for CPT 15792
CPT 15792 is a physician procedure code billed under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount for this code 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) | $329.67 | $192.06 |
| ALASKA* (AK) | $373.79 | $227.23 |
| ALABAMA (AL) | $293.85 | $173.44 |
| ARKANSAS (AR) | $289.30 | $171.09 |
| ARIZONA (AZ) | $320.53 | $187.18 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $438.88 | $244.85 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $447.98 | $249.54 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $376.44 | $213.78 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $377.77 | $214.98 |
| NAPA (CA) | $413.40 | $232.03 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $439.12 | $245.08 |
| VALLEJO (CA) | $413.06 | $231.69 |
| BAKERSFIELD (CA) | $353.24 | $202.42 |
| CHICO (CA) | $352.61 | $201.79 |
| FRESNO (CA) | $352.61 | $201.79 |
| HANFORD-CORCORAN (CA) | $352.61 | $201.79 |
| MADERA (CA) | $352.61 | $201.79 |
| MERCED (CA) | $352.61 | $201.79 |
| MODESTO (CA) | $352.61 | $201.79 |
| REDDING (CA) | $352.61 | $201.79 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $354.89 | $204.07 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $371.33 | $211.28 |
| SALINAS (CA) | $369.98 | $210.48 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $448.95 | $250.52 |
| SANTA CRUZ-WATSONVILLE (CA) | $384.05 | $216.86 |
| SANTA ROSA-PETALUMA (CA) | $388.01 | $219.02 |
| STOCKTON (CA) | $352.61 | $201.79 |
| VISALIA (CA) | $352.61 | $201.79 |
| YUBA CITY (CA) | $352.61 | $201.79 |
| EL CENTRO (CA) | $352.65 | $201.82 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $379.66 | $215.08 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $363.89 | $207.15 |
| SANTA MARIA-SANTA BARBARA (CA) | $371.63 | $211.17 |
| REST OF CALIFORNIA (CA) | $352.61 | $201.79 |
| COLORADO (CO) | $345.64 | $199.22 |
| CONNECTICUT (CT) | $352.54 | $204.33 |
| DC + MD/VA SUBURBS (DC) | $380.40 | $218.29 |
| DELAWARE (DE) | $326.11 | $190.15 |
| FORT LAUDERDALE (FL) | $338.74 | $199.34 |
| MIAMI (FL) | $351.14 | $207.89 |
| REST OF FLORIDA (FL) | $321.66 | $190.10 |
| ATLANTA (GA) | $335.45 | $195.64 |
| REST OF GEORGIA (GA) | $302.70 | $179.95 |
| HAWAII, GUAM (HI) | $362.63 | $206.17 |
| IOWA (IA) | $303.15 | $177.24 |
| IDAHO (ID) | $304.99 | $178.39 |
| EAST ST. LOUIS (IL) | $315.80 | $189.20 |
| SUBURBAN CHICAGO (IL) | $342.58 | $201.26 |
| CHICAGO (IL) | $340.48 | $202.18 |
| REST OF ILLINOIS (IL) | $310.80 | $185.17 |
| INDIANA (IN) | $306.92 | $179.36 |
| KANSAS (KS) | $301.02 | $176.62 |
| KENTUCKY (KY) | $299.97 | $177.63 |
| NEW ORLEANS (LA) | $315.15 | $185.66 |
| REST OF LOUISIANA (LA) | $299.22 | $177.43 |
| METROPOLITAN BOSTON (MA) | $382.24 | $217.93 |
| REST OF MASSACHUSETTS (MA) | $343.11 | $198.20 |
| BALTIMORE/SURR. CNTYS (MD) | $351.44 | $203.78 |
| REST OF MARYLAND (MD) | $332.84 | $193.58 |
| SOUTHERN MAINE (ME) | $324.72 | $188.35 |
| REST OF MAINE (ME) | $306.04 | $179.44 |
| DETROIT (MI) | $325.30 | $192.51 |
| REST OF MICHIGAN (MI) | $307.76 | $182.12 |
| MINNESOTA (MN) | $332.33 | $190.73 |
| METROPOLITAN ST. LOUIS (MO) | $317.10 | $186.09 |
| METROPOLITAN KANSAS CITY (MO) | $313.51 | $184.29 |
| REST OF MISSOURI (MO) | $293.30 | $174.68 |
| MISSISSIPPI (MS) | $291.39 | $172.91 |
| MONTANA** (MT) | $329.65 | $192.04 |
| NORTH CAROLINA (NC) | $309.57 | $181.18 |
| NORTH DAKOTA** (ND) | $325.50 | $187.89 |
| NEBRASKA (NE) | $305.11 | $178.10 |
| NEW HAMPSHIRE (NH) | $339.54 | $196.29 |
| NORTHERN NJ (NJ) | $375.90 | $216.27 |
| REST OF NEW JERSEY (NJ) | $356.89 | $206.62 |
| NEW MEXICO (NM) | $309.31 | $183.12 |
| NEVADA** (NV) | $328.76 | $191.01 |
| MANHATTAN (NY) | $380.12 | $220.22 |
| NYC SUBURBS/LONG ISLAND (NY) | $389.10 | $225.48 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $358.77 | $208.08 |
| QUEENS (NY) | $384.36 | $221.70 |
| REST OF NEW YORK (NY) | $314.47 | $183.74 |
| OHIO (OH) | $306.91 | $181.27 |
| OKLAHOMA (OK) | $300.05 | $177.16 |
| PORTLAND (OR) | $357.94 | $205.06 |
| REST OF OREGON (OR) | $326.53 | $189.47 |
| METROPOLITAN PHILADELPHIA (PA) | $342.86 | $199.61 |
| REST OF PENNSYLVANIA (PA) | $307.78 | $181.45 |
| PUERTO RICO (PR) | $332.45 | $193.32 |
| RHODE ISLAND (RI) | $338.71 | $196.56 |
| SOUTH CAROLINA (SC) | $308.69 | $181.53 |
| SOUTH DAKOTA** (SD) | $325.01 | $187.40 |
| TENNESSEE (TN) | $302.56 | $177.47 |
| BRAZORIA (TX) | $326.25 | $189.87 |
| DALLAS (TX) | $328.17 | $191.10 |
| GALVESTON (TX) | $327.11 | $190.46 |
| HOUSTON (TX) | $330.95 | $194.30 |
| BEAUMONT (TX) | $305.57 | $180.34 |
| FORT WORTH (TX) | $325.64 | $189.95 |
| AUSTIN (TX) | $344.20 | $198.60 |
| REST OF TEXAS (TX) | $315.61 | $185.02 |
| UTAH (UT) | $313.22 | $183.86 |
| VIRGINIA (VA) | $323.15 | $187.88 |
| VIRGIN ISLANDS (VI) | $332.45 | $193.32 |
| VERMONT (VT) | $323.58 | $187.34 |
| SEATTLE (KING CNTY) (WA) | $390.92 | $222.08 |
| REST OF WASHINGTON (WA) | $342.67 | $197.77 |
| WISCONSIN (WI) | $313.80 | $181.97 |
| WEST VIRGINIA (WV) | $298.34 | $178.76 |
| WYOMING** (WY) | $327.84 | $190.23 |
Look up another code or locality →
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's allowed amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to the code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific Medicare 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 a dollar amount. Non-facility and facility rates differ mainly because the practice-expense RVU is lower when the service is performed in a facility, since the facility (not the physician's office) bears certain overhead costs.
RVUs — work 1.81, practice expense 7.85 (non-facility) / 3.73 (facility), malpractice 0.21 — × 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 Part B deductible; the patient or secondary insurer is generally responsible for the remainder.
- Actual payment can vary by locality, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments to RVUs or the conversion factor.
- Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.
Frequently asked
Why does the facility amount differ from the non-facility amount?
The facility rate uses a lower practice-expense RVU because overhead costs like equipment and supplies are typically borne by the facility rather than the billing physician.
Does this amount reflect what my specific locality will pay?
The national amount is a baseline; actual payment is adjusted by the GPCI values for your specific Medicare locality, which can raise or lower the final rate.
Will modifiers change this amount?
Yes. Modifiers such as those for bilateral procedures, multiple procedures, or professional/technical component splits can increase or decrease the final paid amount relative to the base PFS rate shown here.
Does the conversion factor change every year?
Yes. CMS updates the conversion factor annually, and RVUs can also be revised, so amounts shown for one year may not apply in another.
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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