Medicare Reimbursement for CPT 15860

This page covers Medicare Physician Fee Schedule (PFS) pricing for CPT code 15860, a procedure code maintained by the AMA. It shows the national Medicare allowed amount for 2026, along with how that amount can vary by locality and by place of service (non-facility vs. facility).

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$93.19	$93.19
ALASKA* (AK)	$120.50	$120.50
ALABAMA (AL)	$85.65	$85.65
ARKANSAS (AR)	$84.75	$84.75
ARIZONA (AZ)	$90.87	$90.87
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$99.23	$99.23
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$100.39	$100.39
OXNARD-THOUSAND OAKS-VENTURA (CA)	$93.47	$93.47
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$94.82	$94.82
NAPA (CA)	$96.63	$96.63
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$99.65	$99.65
VALLEJO (CA)	$96.02	$96.02
BAKERSFIELD (CA)	$91.23	$91.23
CHICO (CA)	$90.20	$90.20
FRESNO (CA)	$90.20	$90.20
HANFORD-CORCORAN (CA)	$90.20	$90.20
MADERA (CA)	$90.20	$90.20
MERCED (CA)	$90.20	$90.20
MODESTO (CA)	$90.20	$90.20
REDDING (CA)	$90.20	$90.20
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$94.18	$94.18
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$92.57	$92.57
SALINAS (CA)	$92.18	$92.18
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$102.11	$102.11
SANTA CRUZ-WATSONVILLE (CA)	$92.52	$92.52
SANTA ROSA-PETALUMA (CA)	$93.32	$93.32
STOCKTON (CA)	$90.20	$90.20
VISALIA (CA)	$90.20	$90.20
YUBA CITY (CA)	$90.20	$90.20
EL CENTRO (CA)	$90.26	$90.26
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$92.84	$92.84
SAN LUIS OBISPO-PASO ROBLES (CA)	$90.95	$90.95
SANTA MARIA-SANTA BARBARA (CA)	$92.11	$92.11
REST OF CALIFORNIA (CA)	$90.20	$90.20
COLORADO (CO)	$92.36	$92.36
CONNECTICUT (CT)	$98.39	$98.39
DC + MD/VA SUBURBS (DC)	$101.10	$101.10
DELAWARE (DE)	$92.05	$92.05
FORT LAUDERDALE (FL)	$103.40	$103.40
MIAMI (FL)	$112.80	$112.80
REST OF FLORIDA (FL)	$98.64	$98.64
ATLANTA (GA)	$96.14	$96.14
REST OF GEORGIA (GA)	$93.69	$93.69
HAWAII, GUAM (HI)	$90.37	$90.37
IOWA (IA)	$84.26	$84.26
IDAHO (ID)	$85.29	$85.29
EAST ST. LOUIS (IL)	$104.33	$104.33
SUBURBAN CHICAGO (IL)	$103.64	$103.64
CHICAGO (IL)	$109.72	$109.72
REST OF ILLINOIS (IL)	$98.64	$98.64
INDIANA (IN)	$85.57	$85.57
KANSAS (KS)	$85.39	$85.39
KENTUCKY (KY)	$90.21	$90.21
NEW ORLEANS (LA)	$93.84	$93.84
REST OF LOUISIANA (LA)	$90.67	$90.67
METROPOLITAN BOSTON (MA)	$97.80	$97.80
REST OF MASSACHUSETTS (MA)	$92.62	$92.62
BALTIMORE/SURR. CNTYS (MD)	$98.40	$98.40
REST OF MARYLAND (MD)	$93.02	$93.02
SOUTHERN MAINE (ME)	$88.47	$88.47
REST OF MAINE (ME)	$87.13	$87.13
DETROIT (MI)	$101.06	$101.06
REST OF MICHIGAN (MI)	$93.27	$93.27
MINNESOTA (MN)	$84.99	$84.99
METROPOLITAN ST. LOUIS (MO)	$92.38	$92.38
METROPOLITAN KANSAS CITY (MO)	$91.84	$91.84
REST OF MISSOURI (MO)	$90.47	$90.47
MISSISSIPPI (MS)	$87.55	$87.55
MONTANA** (MT)	$93.16	$93.16
NORTH CAROLINA (NC)	$87.56	$87.56
NORTH DAKOTA** (ND)	$85.85	$85.85
NEBRASKA (NE)	$84.16	$84.16
NEW HAMPSHIRE (NH)	$92.36	$92.36
NORTHERN NJ (NJ)	$100.81	$100.81
REST OF NEW JERSEY (NJ)	$98.52	$98.52
NEW MEXICO (NM)	$94.23	$94.23
NEVADA** (NV)	$91.14	$91.14
MANHATTAN (NY)	$107.31	$107.31
NYC SUBURBS/LONG ISLAND (NY)	$111.12	$111.12
POUGHKPSIE/N NYC SUBURBS (NY)	$100.29	$100.29
QUEENS (NY)	$105.87	$105.87
REST OF NEW YORK (NY)	$88.65	$88.65
OHIO (OH)	$91.78	$91.78
OKLAHOMA (OK)	$88.57	$88.57
PORTLAND (OR)	$92.97	$92.97
REST OF OREGON (OR)	$89.45	$89.45
METROPOLITAN PHILADELPHIA (PA)	$97.43	$97.43
REST OF PENNSYLVANIA (PA)	$91.08	$91.08
PUERTO RICO (PR)	$93.19	$93.19
RHODE ISLAND (RI)	$93.63	$93.63
SOUTH CAROLINA (SC)	$90.01	$90.01
SOUTH DAKOTA** (SD)	$84.98	$84.98
TENNESSEE (TN)	$85.89	$85.89
BRAZORIA (TX)	$90.82	$90.82
DALLAS (TX)	$91.94	$91.94
GALVESTON (TX)	$91.45	$91.45
HOUSTON (TX)	$98.22	$98.22
BEAUMONT (TX)	$90.75	$90.75
FORT WORTH (TX)	$91.92	$91.92
AUSTIN (TX)	$92.91	$92.91
REST OF TEXAS (TX)	$91.10	$91.10
UTAH (UT)	$90.89	$90.89
VIRGINIA (VA)	$89.26	$89.26
VIRGIN ISLANDS (VI)	$93.19	$93.19
VERMONT (VT)	$86.91	$86.91
SEATTLE (KING CNTY) (WA)	$98.04	$98.04
REST OF WASHINGTON (WA)	$91.98	$91.98
WISCONSIN (WI)	$83.91	$83.91
WEST VIRGINIA (WV)	$96.24	$96.24
WYOMING** (WY)	$89.98	$89.98

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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 allowed 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, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Practice-expense RVUs often differ between non-facility settings (like a physician office) and facility settings (like a hospital), which is why the two amounts can diverge; malpractice and work RVUs generally stay the same across settings. For this code, the non-facility and facility practice-expense RVUs are identical, so the resulting allowed amounts are the same in both settings.

RVUs — work 1.9, practice expense 0.52 (non-facility) / 0.52 (facility), malpractice 0.37 — × 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 the annual deductible; the patient or secondary payer is responsible for the rest.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Locality-specific GPCIs mean the real allowed amount can differ from the national figure shown here.
Always confirm final payment policy and amounts with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does the fee amount change by location?

Medicare adjusts the practice expense, work, and malpractice RVUs using locality-specific GPCIs to reflect regional cost differences before applying the conversion factor.

Why are the non-facility and facility amounts the same for this code?

Because the practice-expense RVU is identical in both settings for this code, the calculated allowed amount does not differ between non-facility and facility places of service.

Is this the amount I'll actually be paid?

No. This is the Medicare PFS allowed amount estimate; actual payment depends on patient deductible status, coinsurance, modifiers, claim-specific adjustments, and MAC processing.

Where can I find the official CPT descriptor for this code?

CPT code descriptors are copyrighted by the AMA; consult your CPT codebook or AMA-licensed coding software for the official language.

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.