Medicare Reimbursement for CPT 15852

CPT 15852 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code at the national level and, where applicable, in facility versus non-facility settings. Actual payment depends on locality and claim-specific factors.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$38.75	$38.75
ALASKA* (AK)	$51.41	$51.41
ALABAMA (AL)	$36.17	$36.17
ARKANSAS (AR)	$35.86	$35.86
ARIZONA (AZ)	$37.96	$37.96
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$41.84	$41.84
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$42.37	$42.37
OXNARD-THOUSAND OAKS-VENTURA (CA)	$39.24	$39.24
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$39.77	$39.77
NAPA (CA)	$40.66	$40.66
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$41.98	$41.98
VALLEJO (CA)	$40.47	$40.47
BAKERSFIELD (CA)	$38.35	$38.35
CHICO (CA)	$38.00	$38.00
FRESNO (CA)	$38.00	$38.00
HANFORD-CORCORAN (CA)	$38.00	$38.00
MADERA (CA)	$38.00	$38.00
MERCED (CA)	$38.00	$38.00
MODESTO (CA)	$38.00	$38.00
REDDING (CA)	$38.00	$38.00
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$39.30	$39.30
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$38.98	$38.98
SALINAS (CA)	$38.82	$38.82
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$42.92	$42.92
SANTA CRUZ-WATSONVILLE (CA)	$38.91	$38.91
SANTA ROSA-PETALUMA (CA)	$39.25	$39.25
STOCKTON (CA)	$38.00	$38.00
VISALIA (CA)	$38.00	$38.00
YUBA CITY (CA)	$38.00	$38.00
EL CENTRO (CA)	$38.02	$38.02
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$39.06	$39.06
SAN LUIS OBISPO-PASO ROBLES (CA)	$38.29	$38.29
SANTA MARIA-SANTA BARBARA (CA)	$38.78	$38.78
REST OF CALIFORNIA (CA)	$38.00	$38.00
COLORADO (CO)	$38.63	$38.63
CONNECTICUT (CT)	$40.66	$40.66
DC + MD/VA SUBURBS (DC)	$41.90	$41.90
DELAWARE (DE)	$38.40	$38.40
FORT LAUDERDALE (FL)	$42.07	$42.07
MIAMI (FL)	$45.15	$45.15
REST OF FLORIDA (FL)	$40.47	$40.47
ATLANTA (GA)	$39.74	$39.74
REST OF GEORGIA (GA)	$38.79	$38.79
HAWAII, GUAM (HI)	$37.97	$37.97
IOWA (IA)	$35.76	$35.76
IDAHO (ID)	$36.10	$36.10
EAST ST. LOUIS (IL)	$42.27	$42.27
SUBURBAN CHICAGO (IL)	$42.22	$42.22
CHICAGO (IL)	$44.17	$44.17
REST OF ILLINOIS (IL)	$40.42	$40.42
INDIANA (IN)	$36.20	$36.20
KANSAS (KS)	$36.12	$36.12
KENTUCKY (KY)	$37.66	$37.66
NEW ORLEANS (LA)	$38.90	$38.90
REST OF LOUISIANA (LA)	$37.81	$37.81
METROPOLITAN BOSTON (MA)	$40.75	$40.75
REST OF MASSACHUSETTS (MA)	$38.73	$38.73
BALTIMORE/SURR. CNTYS (MD)	$40.63	$40.63
REST OF MARYLAND (MD)	$38.78	$38.78
SOUTHERN MAINE (ME)	$37.21	$37.21
REST OF MAINE (ME)	$36.70	$36.70
DETROIT (MI)	$41.26	$41.26
REST OF MICHIGAN (MI)	$38.68	$38.68
MINNESOTA (MN)	$36.12	$36.12
METROPOLITAN ST. LOUIS (MO)	$38.43	$38.43
METROPOLITAN KANSAS CITY (MO)	$38.25	$38.25
REST OF MISSOURI (MO)	$37.72	$37.72
MISSISSIPPI (MS)	$36.77	$36.77
MONTANA** (MT)	$38.74	$38.74
NORTH CAROLINA (NC)	$36.85	$36.85
NORTH DAKOTA** (ND)	$36.36	$36.36
NEBRASKA (NE)	$35.74	$35.74
NEW HAMPSHIRE (NH)	$38.52	$38.52
NORTHERN NJ (NJ)	$41.85	$41.85
REST OF NEW JERSEY (NJ)	$40.87	$40.87
NEW MEXICO (NM)	$39.00	$39.00
NEVADA** (NV)	$38.08	$38.08
MANHATTAN (NY)	$43.97	$43.97
NYC SUBURBS/LONG ISLAND (NY)	$45.24	$45.24
POUGHKPSIE/N NYC SUBURBS (NY)	$41.48	$41.48
QUEENS (NY)	$43.53	$43.53
REST OF NEW YORK (NY)	$37.22	$37.22
OHIO (OH)	$38.20	$38.20
OKLAHOMA (OK)	$37.14	$37.14
PORTLAND (OR)	$38.91	$38.91
REST OF OREGON (OR)	$37.53	$37.53
METROPOLITAN PHILADELPHIA (PA)	$40.30	$40.30
REST OF PENNSYLVANIA (PA)	$37.98	$37.98
PUERTO RICO (PR)	$38.76	$38.76
RHODE ISLAND (RI)	$39.07	$39.07
SOUTH CAROLINA (SC)	$37.64	$37.64
SOUTH DAKOTA** (SD)	$36.08	$36.08
TENNESSEE (TN)	$36.28	$36.28
BRAZORIA (TX)	$38.03	$38.03
DALLAS (TX)	$38.40	$38.40
GALVESTON (TX)	$38.23	$38.23
HOUSTON (TX)	$40.43	$40.43
BEAUMONT (TX)	$37.86	$37.86
FORT WORTH (TX)	$38.39	$38.39
AUSTIN (TX)	$38.73	$38.73
REST OF TEXAS (TX)	$38.02	$38.02
UTAH (UT)	$37.94	$37.94
VIRGINIA (VA)	$37.45	$37.45
VIRGIN ISLANDS (VI)	$38.76	$38.76
VERMONT (VT)	$36.70	$36.70
SEATTLE (KING CNTY) (WA)	$40.93	$40.93
REST OF WASHINGTON (WA)	$38.51	$38.51
WISCONSIN (WI)	$35.69	$35.69
WEST VIRGINIA (WV)	$39.60	$39.60
WYOMING** (WY)	$37.70	$37.70

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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 Physician Fee Schedule amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) that reflect local cost differences. These locality-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which can make the allowed amount vary by place of service. The conversion factor and RVU values are updated annually by CMS and can shift due to policy or budget-neutrality adjustments.

RVUs — work 0.84, practice expense 0.2 (non-facility) / 0.2 (facility), malpractice 0.12 — × 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 patient or secondary payer is responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
Amounts are subject to annual budget-neutrality adjustments and mid-year CMS corrections.
Always confirm current rates and locality-specific amounts with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

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

The practice-expense component of the RVU is calculated differently depending on where the service is performed, since overhead costs (staff, equipment, supplies) differ between office and facility settings.

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

No. It's a national or locality-adjusted estimate based on standard RVUs and the conversion factor. Your actual payment can vary due to your specific MAC, modifiers used, and other claim details.

Why might this amount change next year?

CMS updates RVUs and the conversion factor annually, and may apply budget-neutrality adjustments, so the allowed amount for the same code can rise or fall from year to year.

Where can I find the exact amount for my locality?

Use the locality-specific GPCI-adjusted figures on this page as a reference, but confirm final amounts with your MAC's fee schedule lookup tool.

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.