Medicare Reimbursement for CPT 15837

CPT 15837 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and adjusted by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$937.23	$658.33
ALASKA* (AK)	$1103.72	$806.69
ALABAMA (AL)	$841.09	$597.06
ARKANSAS (AR)	$829.05	$589.48
ARIZONA (AZ)	$911.29	$641.03
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1166.62	$773.38
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1187.86	$785.69
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1027.62	$697.96
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1034.60	$704.66
NAPA (CA)	$1109.17	$741.58
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1168.59	$775.34
VALLEJO (CA)	$1106.34	$738.75
BAKERSFIELD (CA)	$975.12	$669.45
CHICO (CA)	$970.28	$664.61
FRESNO (CA)	$970.28	$664.61
HANFORD-CORCORAN (CA)	$970.28	$664.61
MADERA (CA)	$970.28	$664.61
MERCED (CA)	$970.28	$664.61
MODESTO (CA)	$970.28	$664.61
REDDING (CA)	$970.28	$664.61
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$988.91	$683.24
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1014.28	$689.92
SALINAS (CA)	$1010.45	$687.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1195.89	$793.72
SANTA CRUZ-WATSONVILLE (CA)	$1039.17	$700.31
SANTA ROSA-PETALUMA (CA)	$1049.36	$706.87
STOCKTON (CA)	$970.28	$664.61
VISALIA (CA)	$970.28	$664.61
YUBA CITY (CA)	$970.28	$664.61
EL CENTRO (CA)	$970.57	$664.90
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1031.52	$697.95
SAN LUIS OBISPO-PASO ROBLES (CA)	$994.72	$677.06
SANTA MARIA-SANTA BARBARA (CA)	$1013.49	$688.30
REST OF CALIFORNIA (CA)	$970.28	$664.61
COLORADO (CO)	$964.69	$667.94
CONNECTICUT (CT)	$999.36	$698.98
DC + MD/VA SUBURBS (DC)	$1061.74	$733.20
DELAWARE (DE)	$926.13	$650.58
FORT LAUDERDALE (FL)	$991.31	$708.79
MIAMI (FL)	$1048.89	$758.56
REST OF FLORIDA (FL)	$941.28	$674.66
ATLANTA (GA)	$958.87	$675.51
REST OF GEORGIA (GA)	$886.93	$638.15
HAWAII, GUAM (HI)	$990.78	$673.68
IOWA (IA)	$854.06	$598.87
IDAHO (ID)	$861.30	$604.71
EAST ST. LOUIS (IL)	$950.34	$693.76
SUBURBAN CHICAGO (IL)	$999.36	$712.94
CHICAGO (IL)	$1017.08	$736.79
REST OF ILLINOIS (IL)	$920.30	$665.67
INDIANA (IN)	$866.03	$607.49
KANSAS (KS)	$853.99	$601.87
KENTUCKY (KY)	$869.22	$621.28
NEW ORLEANS (LA)	$911.55	$649.10
REST OF LOUISIANA (LA)	$869.43	$622.60
METROPOLITAN BOSTON (MA)	$1053.91	$720.90
REST OF MASSACHUSETTS (MA)	$960.60	$666.93
BALTIMORE/SURR. CNTYS (MD)	$997.40	$698.14
REST OF MARYLAND (MD)	$942.42	$660.18
SOUTHERN MAINE (ME)	$910.79	$634.40
REST OF MAINE (ME)	$869.91	$613.32
DETROIT (MI)	$956.97	$687.84
REST OF MICHIGAN (MI)	$895.23	$640.59
MINNESOTA (MN)	$913.04	$626.05
METROPOLITAN ST. LOUIS (MO)	$910.06	$644.55
METROPOLITAN KANSAS CITY (MO)	$901.22	$639.34
REST OF MISSOURI (MO)	$857.28	$616.87
MISSISSIPPI (MS)	$843.13	$603.00
MONTANA** (MT)	$937.11	$658.22
NORTH CAROLINA (NC)	$878.28	$618.07
NORTH DAKOTA** (ND)	$902.91	$624.01
NEBRASKA (NE)	$857.51	$600.09
NEW HAMPSHIRE (NH)	$953.31	$662.98
NORTHERN NJ (NJ)	$1051.71	$728.19
REST OF NEW JERSEY (NJ)	$1007.57	$703.02
NEW MEXICO (NM)	$901.66	$645.91
NEVADA** (NV)	$928.15	$648.97
MANHATTAN (NY)	$1083.09	$759.01
NYC SUBURBS/LONG ISLAND (NY)	$1114.09	$782.49
POUGHKPSIE/N NYC SUBURBS (NY)	$1017.36	$711.97
QUEENS (NY)	$1086.14	$756.48
REST OF NEW YORK (NY)	$891.64	$626.69
OHIO (OH)	$888.23	$633.60
OKLAHOMA (OK)	$863.52	$614.46
PORTLAND (OR)	$990.51	$680.66
REST OF OREGON (OR)	$917.79	$640.01
METROPOLITAN PHILADELPHIA (PA)	$977.29	$686.95
REST OF PENNSYLVANIA (PA)	$887.44	$631.41
PUERTO RICO (PR)	$942.62	$660.65
RHODE ISLAND (RI)	$955.66	$667.56
SOUTH CAROLINA (SC)	$885.36	$627.66
SOUTH DAKOTA** (SD)	$898.86	$619.96
TENNESSEE (TN)	$858.74	$605.23
BRAZORIA (TX)	$921.89	$645.50
DALLAS (TX)	$929.55	$651.77
GALVESTON (TX)	$925.80	$648.85
HOUSTON (TX)	$957.46	$680.52
BEAUMONT (TX)	$881.96	$628.17
FORT WORTH (TX)	$924.62	$649.62
AUSTIN (TX)	$964.24	$669.16
REST OF TEXAS (TX)	$902.63	$637.96
UTAH (UT)	$897.23	$635.06
VIRGINIA (VA)	$910.58	$636.42
VIRGIN ISLANDS (VI)	$942.62	$660.65
VERMONT (VT)	$903.00	$626.89
SEATTLE (KING CNTY) (WA)	$1071.25	$729.04
REST OF WASHINGTON (WA)	$957.59	$663.91
WISCONSIN (WI)	$873.37	$606.18
WEST VIRGINIA (WV)	$887.66	$645.30
WYOMING** (WY)	$922.21	$643.31

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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 Physician Fee Schedule amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice expense RVUs differ between non-facility and facility settings because overhead costs (equipment, staff, supplies) are typically higher when a service is performed in a physician's office versus a hospital or ambulatory surgical center.

RVUs — work 9.31, practice expense 17.02 (non-facility) / 8.67 (facility), malpractice 1.73 — × 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 deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Amounts vary by locality based on GPCI values, which are updated periodically.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the amount differ between non-facility and facility settings?

The practice expense RVU is lower in facility settings because the facility (e.g., hospital) absorbs some overhead costs like equipment and staff, whereas in non-facility settings the billing provider covers those costs directly.

Why does the Medicare amount vary by locality?

Each locality has its own Geographic Practice Cost Indices (GPCIs) for work, practice expense, and malpractice, which adjust the RVUs to reflect regional differences in cost of living and practice costs.

Does this amount include the patient's share?

No. The figure shown is the total Medicare-allowed amount. Medicare generally pays 80% of this after the deductible, with the patient or supplemental insurance responsible for the rest.

Can modifiers change this amount?

Yes. Modifiers such as those indicating bilateral procedures, reduced services, or multiple-procedure scenarios can increase or decrease the final reimbursement from the base PFS amount shown here.

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.