Medicare Reimbursement for CPT 15835

CPT 15835 is a procedure code used for billing purposes; the specific clinical descriptor is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code at the national level and, where available, adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$844.71	$844.71
ALASKA* (AK)	$1043.36	$1043.36
ALABAMA (AL)	$767.76	$767.76
ARKANSAS (AR)	$758.27	$758.27
ARIZONA (AZ)	$822.77	$822.77
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$980.42	$980.42
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$995.55	$995.55
OXNARD-THOUSAND OAKS-VENTURA (CA)	$889.40	$889.40
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$898.46	$898.46
NAPA (CA)	$941.83	$941.83
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$983.09	$983.09
VALLEJO (CA)	$937.99	$937.99
BAKERSFIELD (CA)	$854.99	$854.99
CHICO (CA)	$848.41	$848.41
FRESNO (CA)	$848.41	$848.41
HANFORD-CORCORAN (CA)	$848.41	$848.41
MADERA (CA)	$848.41	$848.41
MERCED (CA)	$848.41	$848.41
MODESTO (CA)	$848.41	$848.41
REDDING (CA)	$848.41	$848.41
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$873.72	$873.72
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$879.44	$879.44
SALINAS (CA)	$875.95	$875.95
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1006.46	$1006.46
SANTA CRUZ-WATSONVILLE (CA)	$890.93	$890.93
SANTA ROSA-PETALUMA (CA)	$899.19	$899.19
STOCKTON (CA)	$848.41	$848.41
VISALIA (CA)	$848.41	$848.41
YUBA CITY (CA)	$848.41	$848.41
EL CENTRO (CA)	$848.81	$848.81
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$888.69	$888.69
SAN LUIS OBISPO-PASO ROBLES (CA)	$863.16	$863.16
SANTA MARIA-SANTA BARBARA (CA)	$877.08	$877.08
REST OF CALIFORNIA (CA)	$848.41	$848.41
COLORADO (CO)	$854.55	$854.55
CONNECTICUT (CT)	$896.07	$896.07
DC + MD/VA SUBURBS (DC)	$937.49	$937.49
DELAWARE (DE)	$834.78	$834.78
FORT LAUDERDALE (FL)	$912.59	$912.59
MIAMI (FL)	$978.79	$978.79
REST OF FLORIDA (FL)	$869.10	$869.10
ATLANTA (GA)	$867.24	$867.24
REST OF GEORGIA (GA)	$822.73	$822.73
HAWAII, GUAM (HI)	$858.66	$858.66
IOWA (IA)	$768.22	$768.22
IDAHO (ID)	$775.90	$775.90
EAST ST. LOUIS (IL)	$896.86	$896.86
SUBURBAN CHICAGO (IL)	$917.53	$917.53
CHICAGO (IL)	$951.03	$951.03
REST OF ILLINOIS (IL)	$859.06	$859.06
INDIANA (IN)	$779.32	$779.32
KANSAS (KS)	$772.85	$772.85
KENTUCKY (KY)	$799.96	$799.96
NEW ORLEANS (LA)	$835.15	$835.15
REST OF LOUISIANA (LA)	$801.96	$801.96
METROPOLITAN BOSTON (MA)	$919.97	$919.97
REST OF MASSACHUSETTS (MA)	$853.73	$853.73
BALTIMORE/SURR. CNTYS (MD)	$895.12	$895.12
REST OF MARYLAND (MD)	$846.62	$846.62
SOUTHERN MAINE (ME)	$812.66	$812.66
REST OF MAINE (ME)	$787.60	$787.60
DETROIT (MI)	$886.55	$886.55
REST OF MICHIGAN (MI)	$824.99	$824.99
MINNESOTA (MN)	$799.40	$799.40
METROPOLITAN ST. LOUIS (MO)	$828.40	$828.40
METROPOLITAN KANSAS CITY (MO)	$821.98	$821.98
REST OF MISSOURI (MO)	$795.33	$795.33
MISSISSIPPI (MS)	$776.54	$776.54
MONTANA** (MT)	$844.55	$844.55
NORTH CAROLINA (NC)	$793.39	$793.39
NORTH DAKOTA** (ND)	$798.08	$798.08
NEBRASKA (NE)	$769.47	$769.47
NEW HAMPSHIRE (NH)	$848.96	$848.96
NORTHERN NJ (NJ)	$931.59	$931.59
REST OF NEW JERSEY (NJ)	$900.81	$900.81
NEW MEXICO (NM)	$832.01	$832.01
NEVADA** (NV)	$831.94	$831.94
MANHATTAN (NY)	$973.36	$973.36
NYC SUBURBS/LONG ISLAND (NY)	$1003.89	$1003.89
POUGHKPSIE/N NYC SUBURBS (NY)	$912.82	$912.82
QUEENS (NY)	$968.92	$968.92
REST OF NEW YORK (NY)	$804.25	$804.25
OHIO (OH)	$815.49	$815.49
OKLAHOMA (OK)	$790.50	$790.50
PORTLAND (OR)	$869.46	$869.46
REST OF OREGON (OR)	$820.02	$820.02
METROPOLITAN PHILADELPHIA (PA)	$881.54	$881.54
REST OF PENNSYLVANIA (PA)	$812.26	$812.26
PUERTO RICO (PR)	$847.30	$847.30
RHODE ISLAND (RI)	$855.59	$855.59
SOUTH CAROLINA (SC)	$806.86	$806.86
SOUTH DAKOTA** (SD)	$792.59	$792.59
TENNESSEE (TN)	$777.15	$777.15
BRAZORIA (TX)	$827.74	$827.74
DALLAS (TX)	$836.00	$836.00
GALVESTON (TX)	$832.19	$832.19
HOUSTON (TX)	$875.21	$875.21
BEAUMONT (TX)	$808.26	$808.26
FORT WORTH (TX)	$833.59	$833.59
AUSTIN (TX)	$856.50	$856.50
REST OF TEXAS (TX)	$819.60	$819.60
UTAH (UT)	$816.12	$816.12
VIRGINIA (VA)	$815.80	$815.80
VIRGIN ISLANDS (VI)	$847.30	$847.30
VERMONT (VT)	$802.50	$802.50
SEATTLE (KING CNTY) (WA)	$929.37	$929.37
REST OF WASHINGTON (WA)	$849.63	$849.63
WISCONSIN (WI)	$775.99	$775.99
WEST VIRGINIA (WV)	$833.60	$833.60
WYOMING** (WY)	$824.30	$824.30

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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: 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 — assigned to the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice expense RVUs often differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which can cause the total payment to vary by place of service, though for some codes these values are the same.

RVUs — work 12.67, practice expense 10.27 (non-facility) / 10.27 (facility), malpractice 2.35 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment can be affected by modifiers, sequestration, multiple-procedure reductions, and annual budget-neutrality adjustments.
Rates vary by locality based on GPCI adjustments; the figure shown may not reflect your specific Medicare Administrative Contractor (MAC) jurisdiction.
Always confirm final allowed amounts and coverage rules with your MAC or the current year's Medicare Physician Fee Schedule.

Frequently asked

Why does the non-facility and facility amount look the same for this code?

For some codes, the practice expense RVU is identical in both non-facility and facility settings, resulting in the same total allowed amount regardless of place of service.

Why might my actual payment differ from the national amount shown?

The national amount uses standardized GPCI values; your locality's actual GPCIs, along with modifiers and any sequestration reductions, will adjust the final paid amount.

Does this page tell me what CPT 15835 clinically involves?

No. CPT descriptors are copyrighted by the AMA and are not reproduced here; consult your CPT codebook or EHR system for the official description.

How much will Medicare actually pay for this code?

Medicare generally pays 80% of the allowed amount after the deductible is met; the remaining 20% is typically billed to the patient or secondary payer.

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.