Medicare Reimbursement for CPT 15830

This page covers a procedure code reported under the Medicare Physician Fee Schedule (PFS). It shows the national Medicare allowed amount for 2026, along with the work, practice expense, and malpractice RVU components used to calculate it, for both non-facility and facility settings. Actual payment in a specific locality will be adjusted using that area's geographic practice cost indices (GPCIs).

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1067.16	$1067.16
ALASKA* (AK)	$1321.36	$1321.36
ALABAMA (AL)	$968.83	$968.83
ARKANSAS (AR)	$956.75	$956.75
ARIZONA (AZ)	$1038.70	$1038.70
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1218.98	$1218.98
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1236.95	$1236.95
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1113.04	$1113.04
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1125.26	$1125.26
NAPA (CA)	$1173.81	$1173.81
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1222.79	$1222.79
VALLEJO (CA)	$1168.33	$1168.33
BAKERSFIELD (CA)	$1072.22	$1072.22
CHICO (CA)	$1062.93	$1062.93
FRESNO (CA)	$1062.93	$1062.93
HANFORD-CORCORAN (CA)	$1062.93	$1062.93
MADERA (CA)	$1062.93	$1062.93
MERCED (CA)	$1062.93	$1062.93
MODESTO (CA)	$1062.93	$1062.93
REDDING (CA)	$1062.93	$1062.93
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1098.96	$1098.96
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1100.19	$1100.19
SALINAS (CA)	$1095.82	$1095.82
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1252.50	$1252.50
SANTA CRUZ-WATSONVILLE (CA)	$1112.54	$1112.54
SANTA ROSA-PETALUMA (CA)	$1122.73	$1122.73
STOCKTON (CA)	$1062.93	$1062.93
VISALIA (CA)	$1062.93	$1062.93
YUBA CITY (CA)	$1062.93	$1062.93
EL CENTRO (CA)	$1063.49	$1063.49
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1110.66	$1110.66
SAN LUIS OBISPO-PASO ROBLES (CA)	$1080.05	$1080.05
SANTA MARIA-SANTA BARBARA (CA)	$1096.93	$1096.93
REST OF CALIFORNIA (CA)	$1062.93	$1062.93
COLORADO (CO)	$1074.82	$1074.82
CONNECTICUT (CT)	$1132.46	$1132.46
DC + MD/VA SUBURBS (DC)	$1180.76	$1180.76
DELAWARE (DE)	$1053.87	$1053.87
FORT LAUDERDALE (FL)	$1162.74	$1162.74
MIAMI (FL)	$1254.57	$1254.57
REST OF FLORIDA (FL)	$1105.92	$1105.92
ATLANTA (GA)	$1097.69	$1097.69
REST OF GEORGIA (GA)	$1045.64	$1045.64
HAWAII, GUAM (HI)	$1074.60	$1074.60
IOWA (IA)	$965.85	$965.85
IDAHO (ID)	$976.34	$976.34
EAST ST. LOUIS (IL)	$1148.77	$1148.77
SUBURBAN CHICAGO (IL)	$1168.19	$1168.19
CHICAGO (IL)	$1217.95	$1217.95
REST OF ILLINOIS (IL)	$1095.52	$1095.52
INDIANA (IN)	$980.58	$980.58
KANSAS (KS)	$973.44	$973.44
KENTUCKY (KY)	$1013.45	$1013.45
NEW ORLEANS (LA)	$1058.89	$1058.89
REST OF LOUISIANA (LA)	$1016.67	$1016.67
METROPOLITAN BOSTON (MA)	$1154.93	$1154.93
REST OF MASSACHUSETTS (MA)	$1074.46	$1074.46
BALTIMORE/SURR. CNTYS (MD)	$1131.66	$1131.66
REST OF MARYLAND (MD)	$1068.33	$1068.33
SOUTHERN MAINE (ME)	$1022.29	$1022.29
REST OF MAINE (ME)	$993.01	$993.01
DETROIT (MI)	$1129.98	$1129.98
REST OF MICHIGAN (MI)	$1046.95	$1046.95
MINNESOTA (MN)	$999.93	$999.93
METROPOLITAN ST. LOUIS (MO)	$1048.27	$1048.27
METROPOLITAN KANSAS CITY (MO)	$1040.30	$1040.30
REST OF MISSOURI (MO)	$1009.31	$1009.31
MISSISSIPPI (MS)	$982.61	$982.61
MONTANA** (MT)	$1066.93	$1066.93
NORTH CAROLINA (NC)	$1000.09	$1000.09
NORTH DAKOTA** (ND)	$1000.69	$1000.69
NEBRASKA (NE)	$966.90	$966.90
NEW HAMPSHIRE (NH)	$1069.50	$1069.50
NORTHERN NJ (NJ)	$1173.57	$1173.57
REST OF NEW JERSEY (NJ)	$1136.93	$1136.93
NEW MEXICO (NM)	$1056.60	$1056.60
NEVADA** (NV)	$1048.87	$1048.87
MANHATTAN (NY)	$1232.88	$1232.88
NYC SUBURBS/LONG ISLAND (NY)	$1273.96	$1273.96
POUGHKPSIE/N NYC SUBURBS (NY)	$1153.55	$1153.55
QUEENS (NY)	$1224.73	$1224.73
REST OF NEW YORK (NY)	$1014.02	$1014.02
OHIO (OH)	$1033.42	$1033.42
OKLAHOMA (OK)	$999.61	$999.61
PORTLAND (OR)	$1091.62	$1091.62
REST OF OREGON (OR)	$1032.33	$1032.33
METROPOLITAN PHILADELPHIA (PA)	$1115.11	$1115.11
REST OF PENNSYLVANIA (PA)	$1028.36	$1028.36
PUERTO RICO (PR)	$1069.86	$1069.86
RHODE ISLAND (RI)	$1078.80	$1078.80
SOUTH CAROLINA (SC)	$1020.12	$1020.12
SOUTH DAKOTA** (SD)	$992.86	$992.86
TENNESSEE (TN)	$979.12	$979.12
BRAZORIA (TX)	$1043.42	$1043.42
DALLAS (TX)	$1054.69	$1054.69
GALVESTON (TX)	$1049.58	$1049.58
HOUSTON (TX)	$1110.90	$1110.90
BEAUMONT (TX)	$1023.38	$1023.38
FORT WORTH (TX)	$1052.16	$1052.16
AUSTIN (TX)	$1078.61	$1078.61
REST OF TEXAS (TX)	$1036.00	$1036.00
UTAH (UT)	$1031.86	$1031.86
VIRGINIA (VA)	$1027.49	$1027.49
VIRGIN ISLANDS (VI)	$1069.86	$1069.86
VERMONT (VT)	$1007.90	$1007.90
SEATTLE (KING CNTY) (WA)	$1164.92	$1164.92
REST OF WASHINGTON (WA)	$1068.76	$1068.76
WISCONSIN (WI)	$973.01	$973.01
WEST VIRGINIA (WV)	$1063.23	$1063.23
WYOMING** (WY)	$1038.07	$1038.07

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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 allowed amount is built from three Relative Value Units (RVUs): physician work, practice expense (PE), and malpractice (MP). Each RVU component is multiplied by a corresponding Geographic Practice Cost Index (GPCI) to reflect local cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor (a dollar-per-RVU rate set by CMS) to produce the allowed amount. Non-facility and facility PE RVUs can differ because facility settings assume some overhead is borne by the facility rather than the billing provider; for this code, the non-facility and facility PE RVUs are the same, so the two allowed amounts shown are identical. Because GPCIs vary by locality, the same RVUs can yield different dollar amounts depending on where the service is performed.

RVUs — work 16.68, practice expense 11.92 (non-facility) / 11.92 (facility), malpractice 3.35 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate based on national RVUs and the standard conversion factor — actual payment varies by Medicare Administrative Contractor (MAC) locality.
Medicare typically pays 80% of the allowed amount after the patient meets their Part B deductible; the patient or secondary insurance is responsible for the remainder.
Modifiers (e.g., bilateral, multiple procedure, assistant-at-surgery), place-of-service, and other claim-specific factors can increase or decrease the final payment.
Annual budget-neutrality adjustments, sequestration, and mid-year CMS rule changes can alter the conversion factor or RVUs from what's shown here.
Always confirm the final allowed amount with your MAC's fee schedule lookup tool or Medicare remittance advice before billing or appealing a denial.

Frequently asked

Why are the non-facility and facility amounts the same for this code?

The practice expense RVU is identical in both settings for this code, so there is no site-of-service payment differential — the calculated allowed amount comes out the same whether billed in a non-facility or facility place of service.

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

Not necessarily. The national amount uses a standardized GPCI baseline; your actual locality-specific payment depends on that area's wage, rent, and malpractice cost indices, which can raise or lower the final allowed amount.

Why isn't the CPT code description shown here?

CPT code descriptors are copyrighted by the American Medical Association and cannot be republished without a license, so this page refers to the code generically rather than quoting its official descriptor.

Does this amount reflect what Medicare will actually pay on my claim?

No — it is a calculated estimate based on standard RVUs and the conversion factor. The actual payment on a remittance advice can differ due to modifiers, deductible status, secondary payer coordination, and other claim-level adjustments.

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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.