Medicare Reimbursement for CPT Code 15842

This page covers a Current Procedural Terminology (CPT) code used to report a specific physician service; the exact procedure description is not shown here because CPT descriptors are licensed by the AMA. Below you'll find the Medicare Physician Fee Schedule (PFS) allowed amount for this code, shown nationally and adjustable by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$2363.78	$2363.78
ALASKA* (AK)	$2970.75	$2970.75
ALABAMA (AL)	$2158.55	$2158.55
ARKANSAS (AR)	$2133.41	$2133.41
ARIZONA (AZ)	$2303.86	$2303.86
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$2667.85	$2667.85
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$2705.89	$2705.89
OXNARD-THOUSAND OAKS-VENTURA (CA)	$2449.62	$2449.62
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$2477.93	$2477.93
NAPA (CA)	$2573.93	$2573.93
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$2676.28	$2676.28
VALLEJO (CA)	$2561.77	$2561.77
BAKERSFIELD (CA)	$2367.02	$2367.02
CHICO (CA)	$2346.24	$2346.24
FRESNO (CA)	$2346.24	$2346.24
HANFORD-CORCORAN (CA)	$2346.24	$2346.24
MADERA (CA)	$2346.24	$2346.24
MERCED (CA)	$2346.24	$2346.24
MODESTO (CA)	$2346.24	$2346.24
REDDING (CA)	$2346.24	$2346.24
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$2426.24	$2426.24
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$2423.88	$2423.88
SALINAS (CA)	$2414.09	$2414.09
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2740.39	$2740.39
SANTA CRUZ-WATSONVILLE (CA)	$2444.43	$2444.43
SANTA ROSA-PETALUMA (CA)	$2466.59	$2466.59
STOCKTON (CA)	$2346.24	$2346.24
VISALIA (CA)	$2346.24	$2346.24
YUBA CITY (CA)	$2346.24	$2346.24
EL CENTRO (CA)	$2347.48	$2347.48
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$2443.11	$2443.11
SAN LUIS OBISPO-PASO ROBLES (CA)	$2379.79	$2379.79
SANTA MARIA-SANTA BARBARA (CA)	$2415.54	$2415.54
REST OF CALIFORNIA (CA)	$2346.24	$2346.24
COLORADO (CO)	$2375.39	$2375.39
CONNECTICUT (CT)	$2502.68	$2502.68
DC + MD/VA SUBURBS (DC)	$2602.82	$2602.82
DELAWARE (DE)	$2336.03	$2336.03
FORT LAUDERDALE (FL)	$2574.45	$2574.45
MIAMI (FL)	$2775.22	$2775.22
REST OF FLORIDA (FL)	$2454.28	$2454.28
ATLANTA (GA)	$2430.15	$2430.15
REST OF GEORGIA (GA)	$2327.16	$2327.16
HAWAII, GUAM (HI)	$2366.20	$2366.20
IOWA (IA)	$2147.82	$2147.82
IDAHO (ID)	$2170.58	$2170.58
EAST ST. LOUIS (IL)	$2553.01	$2553.01
SUBURBAN CHICAGO (IL)	$2585.78	$2585.78
CHICAGO (IL)	$2698.41	$2698.41
REST OF ILLINOIS (IL)	$2435.62	$2435.62
INDIANA (IN)	$2179.27	$2179.27
KANSAS (KS)	$2165.79	$2165.79
KENTUCKY (KY)	$2256.08	$2256.08
NEW ORLEANS (LA)	$2351.50	$2351.50
REST OF LOUISIANA (LA)	$2263.63	$2263.63
METROPOLITAN BOSTON (MA)	$2542.60	$2542.60
REST OF MASSACHUSETTS (MA)	$2376.12	$2376.12
BALTIMORE/SURR. CNTYS (MD)	$2500.92	$2500.92
REST OF MARYLAND (MD)	$2366.15	$2366.15
SOUTHERN MAINE (ME)	$2265.19	$2265.19
REST OF MAINE (ME)	$2207.55	$2207.55
DETROIT (MI)	$2506.72	$2506.72
REST OF MICHIGAN (MI)	$2327.91	$2327.91
MINNESOTA (MN)	$2211.70	$2211.70
METROPOLITAN ST. LOUIS (MO)	$2326.83	$2326.83
METROPOLITAN KANSAS CITY (MO)	$2310.48	$2310.48
REST OF MISSOURI (MO)	$2249.66	$2249.66
MISSISSIPPI (MS)	$2190.56	$2190.56
MONTANA** (MT)	$2363.29	$2363.29
NORTH CAROLINA (NC)	$2221.92	$2221.92
NORTH DAKOTA** (ND)	$2216.37	$2216.37
NEBRASKA (NE)	$2149.34	$2149.34
NEW HAMPSHIRE (NH)	$2364.75	$2364.75
NORTHERN NJ (NJ)	$2589.62	$2589.62
REST OF NEW JERSEY (NJ)	$2513.05	$2513.05
NEW MEXICO (NM)	$2348.90	$2348.90
NEVADA** (NV)	$2323.12	$2323.12
MANHATTAN (NY)	$2721.07	$2721.07
NYC SUBURBS/LONG ISLAND (NY)	$2809.39	$2809.39
POUGHKPSIE/N NYC SUBURBS (NY)	$2550.11	$2550.11
QUEENS (NY)	$2700.94	$2700.94
REST OF NEW YORK (NY)	$2251.06	$2251.06
OHIO (OH)	$2297.89	$2297.89
OKLAHOMA (OK)	$2224.95	$2224.95
PORTLAND (OR)	$2408.22	$2408.22
REST OF OREGON (OR)	$2286.95	$2286.95
METROPOLITAN PHILADELPHIA (PA)	$2467.70	$2467.70
REST OF PENNSYLVANIA (PA)	$2286.15	$2286.15
PUERTO RICO (PR)	$2368.64	$2368.64
RHODE ISLAND (RI)	$2388.10	$2388.10
SOUTH CAROLINA (SC)	$2267.26	$2267.26
SOUTH DAKOTA** (SD)	$2199.00	$2199.00
TENNESSEE (TN)	$2177.88	$2177.88
BRAZORIA (TX)	$2312.85	$2312.85
DALLAS (TX)	$2337.44	$2337.44
GALVESTON (TX)	$2326.32	$2326.32
HOUSTON (TX)	$2462.31	$2462.31
BEAUMONT (TX)	$2275.94	$2275.94
FORT WORTH (TX)	$2332.86	$2332.86
AUSTIN (TX)	$2383.42	$2383.42
REST OF TEXAS (TX)	$2299.92	$2299.92
UTAH (UT)	$2291.65	$2291.65
VIRGINIA (VA)	$2277.56	$2277.56
VIRGIN ISLANDS (VI)	$2368.64	$2368.64
VERMONT (VT)	$2233.38	$2233.38
SEATTLE (KING CNTY) (WA)	$2562.25	$2562.25
REST OF WASHINGTON (WA)	$2363.18	$2363.18
WISCONSIN (WI)	$2159.28	$2159.28
WEST VIRGINIA (WV)	$2368.53	$2368.53
WYOMING** (WY)	$2299.26	$2299.26

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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) assigned to the code: work (clinician effort/skill), practice expense (overhead, staff, supplies), and malpractice (liability insurance cost). 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 Conversion Factor (a dollar figure set by CMS each year) to produce the allowed amount. Practice-expense RVUs — and therefore the total payment — often differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings because overhead costs differ by site of service.

RVUs — work 39.98, practice expense 23.36 (non-facility) / 23.36 (facility), malpractice 7.43 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This figure is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets the annual Part B deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment varies by locality GPCI values, which are not uniform nationwide.
Modifiers (e.g., bilateral, multiple procedure, assistant surgeon) can increase or reduce the allowed amount.
Sequestration and annual budget-neutrality adjustments can change the effective payment year to year.
Always confirm the current allowed amount and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why don't you show the CPT code's description?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page references the code generically rather than reproducing the official language.

Why is the non-facility amount different from the facility amount?

The practice-expense RVU component is typically higher in non-facility settings because the billing provider absorbs overhead costs (space, staff, supplies) that a facility would otherwise bear when the service is performed in a hospital or other facility.

Does this amount reflect what my locality will actually be paid?

No — the figure shown applies the Geographic Practice Cost Indices (GPCIs) for a selected locality to the national RVUs. Payment in your specific locality may differ based on the applicable GPCI values and any modifiers appended to the claim.

Will this amount change during the year?

It can. CMS updates the conversion factor annually, and in-year adjustments such as sequestration or budget-neutrality corrections can also affect the final paid amount.

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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.