Medicare Reimbursement for CPT 15834

CPT 15834 is a surgical procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated national Medicare allowed amount for this code, along with how it may vary by locality and by site of service (non-facility vs. facility).

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$811.64	$811.64
ALASKA* (AK)	$999.26	$999.26
ALABAMA (AL)	$737.14	$737.14
ARKANSAS (AR)	$727.94	$727.94
ARIZONA (AZ)	$790.51	$790.51
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$947.48	$947.48
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$962.32	$962.32
OXNARD-THOUSAND OAKS-VENTURA (CA)	$857.41	$857.41
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$865.91	$865.91
NAPA (CA)	$909.39	$909.39
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$949.96	$949.96
VALLEJO (CA)	$905.81	$905.81
BAKERSFIELD (CA)	$823.41	$823.41
CHICO (CA)	$817.28	$817.28
FRESNO (CA)	$817.28	$817.28
HANFORD-CORCORAN (CA)	$817.28	$817.28
MADERA (CA)	$817.28	$817.28
MERCED (CA)	$817.28	$817.28
MODESTO (CA)	$817.28	$817.28
REDDING (CA)	$817.28	$817.28
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$840.86	$840.86
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$847.72	$847.72
SALINAS (CA)	$844.37	$844.37
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$972.49	$972.49
SANTA CRUZ-WATSONVILLE (CA)	$859.56	$859.56
SANTA ROSA-PETALUMA (CA)	$867.58	$867.58
STOCKTON (CA)	$817.28	$817.28
VISALIA (CA)	$817.28	$817.28
YUBA CITY (CA)	$817.28	$817.28
EL CENTRO (CA)	$817.64	$817.64
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$857.07	$857.07
SAN LUIS OBISPO-PASO ROBLES (CA)	$831.98	$831.98
SANTA MARIA-SANTA BARBARA (CA)	$845.58	$845.58
REST OF CALIFORNIA (CA)	$817.28	$817.28
COLORADO (CO)	$822.27	$822.27
CONNECTICUT (CT)	$861.27	$861.27
DC + MD/VA SUBURBS (DC)	$902.20	$902.20
DELAWARE (DE)	$802.13	$802.13
FORT LAUDERDALE (FL)	$875.19	$875.19
MIAMI (FL)	$937.51	$937.51
REST OF FLORIDA (FL)	$833.39	$833.39
ATLANTA (GA)	$833.01	$833.01
REST OF GEORGIA (GA)	$788.75	$788.75
HAWAII, GUAM (HI)	$827.70	$827.70
IOWA (IA)	$738.46	$738.46
IDAHO (ID)	$745.73	$745.73
EAST ST. LOUIS (IL)	$858.45	$858.45
SUBURBAN CHICAGO (IL)	$880.12	$880.12
CHICAGO (IL)	$910.85	$910.85
REST OF ILLINOIS (IL)	$823.07	$823.07
INDIANA (IN)	$749.08	$749.08
KANSAS (KS)	$742.53	$742.53
KENTUCKY (KY)	$767.46	$767.46
NEW ORLEANS (LA)	$801.41	$801.41
REST OF LOUISIANA (LA)	$769.24	$769.24
METROPOLITAN BOSTON (MA)	$886.20	$886.20
REST OF MASSACHUSETTS (MA)	$821.26	$821.26
BALTIMORE/SURR. CNTYS (MD)	$860.29	$860.29
REST OF MARYLAND (MD)	$813.71	$813.71
SOUTHERN MAINE (ME)	$781.57	$781.57
REST OF MAINE (ME)	$756.63	$756.63
DETROIT (MI)	$849.85	$849.85
REST OF MICHIGAN (MI)	$791.32	$791.32
MINNESOTA (MN)	$770.06	$770.06
METROPOLITAN ST. LOUIS (MO)	$795.37	$795.37
METROPOLITAN KANSAS CITY (MO)	$789.10	$789.10
REST OF MISSOURI (MO)	$762.54	$762.54
MISSISSIPPI (MS)	$745.01	$745.01
MONTANA** (MT)	$811.50	$811.50
NORTH CAROLINA (NC)	$762.32	$762.32
NORTH DAKOTA** (ND)	$768.19	$768.19
NEBRASKA (NE)	$739.81	$739.81
NEW HAMPSHIRE (NH)	$816.52	$816.52
NORTHERN NJ (NJ)	$896.32	$896.32
REST OF NEW JERSEY (NJ)	$866.06	$866.06
NEW MEXICO (NM)	$797.96	$797.96
NEVADA** (NV)	$799.77	$799.77
MANHATTAN (NY)	$935.29	$935.29
NYC SUBURBS/LONG ISLAND (NY)	$964.35	$964.35
POUGHKPSIE/N NYC SUBURBS (NY)	$877.34	$877.34
QUEENS (NY)	$931.60	$931.60
REST OF NEW YORK (NY)	$772.82	$772.82
OHIO (OH)	$782.47	$782.47
OKLAHOMA (OK)	$758.73	$758.73
PORTLAND (OR)	$837.22	$837.22
REST OF OREGON (OR)	$788.55	$788.55
METROPOLITAN PHILADELPHIA (PA)	$846.92	$846.92
REST OF PENNSYLVANIA (PA)	$779.57	$779.57
PUERTO RICO (PR)	$814.31	$814.31
RHODE ISLAND (RI)	$822.56	$822.56
SOUTH CAROLINA (SC)	$774.68	$774.68
SOUTH DAKOTA** (SD)	$763.07	$763.07
TENNESSEE (TN)	$746.65	$746.65
BRAZORIA (TX)	$795.64	$795.64
DALLAS (TX)	$803.45	$803.45
GALVESTON (TX)	$799.84	$799.84
HOUSTON (TX)	$839.92	$839.92
BEAUMONT (TX)	$775.67	$775.67
FORT WORTH (TX)	$800.99	$800.99
AUSTIN (TX)	$823.93	$823.93
REST OF TEXAS (TX)	$787.10	$787.10
UTAH (UT)	$783.66	$783.66
VIRGINIA (VA)	$784.32	$784.32
VIRGIN ISLANDS (VI)	$814.31	$814.31
VERMONT (VT)	$772.09	$772.09
SEATTLE (KING CNTY) (WA)	$895.72	$895.72
REST OF WASHINGTON (WA)	$817.44	$817.44
WISCONSIN (WI)	$746.66	$746.66
WEST VIRGINIA (WV)	$798.36	$798.36
WYOMING** (WY)	$792.62	$792.62

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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 allowed amount is built from three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted using the Geographic Practice Cost Indices (GPCIs) for the 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 the allowed amount. Practice-expense RVUs — and therefore the final rate — can differ between non-facility settings (e.g., physician office) and facility settings (e.g., hospital outpatient), since overhead costs differ. These figures update annually and can shift due to policy changes.

RVUs — work 11.87, practice expense 10.24 (non-facility) / 10.24 (facility), malpractice 2.19 — × 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 beneficiary or secondary insurance is responsible for the remainder.
Actual payment varies by locality, provider type, applicable modifiers, and claim-specific circumstances.
Sequestration and annual budget-neutrality adjustments can change the effective payment.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the Medicare rate for CPT 15834 differ by location?

Locality-specific GPCIs adjust the work, practice expense, and malpractice RVUs to reflect regional cost-of-living and practice cost differences, so the same code can have different allowed amounts in different areas.

Why might the facility and non-facility rates be the same or different for this code?

The difference depends on whether the practice-expense RVU assigned to the code varies by site of service; some codes have identical non-facility and facility practice-expense RVUs, resulting in the same allowed amount in both settings.

Does this amount include what the patient owes?

No. The figure shown is the total Medicare-allowed amount; Medicare generally pays 80% after the deductible, with the patient or secondary payer responsible for the remaining 20%.

Will this rate change next year?

Yes. CMS updates RVUs, GPCIs, and the conversion factor annually, and budget-neutrality adjustments or policy changes can alter the final allowed amount 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.