Medicare Reimbursement for CPT 15922

CPT 15922 is a procedure code used in Medicare billing; the specific clinical description is maintained by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$731.15	$731.15
ALASKA* (AK)	$893.43	$893.43
ALABAMA (AL)	$662.60	$662.60
ARKANSAS (AR)	$654.11	$654.11
ARIZONA (AZ)	$711.86	$711.86
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$862.59	$862.59
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$876.47	$876.47
OXNARD-THOUSAND OAKS-VENTURA (CA)	$777.06	$777.06
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$784.36	$784.36
NAPA (CA)	$826.59	$826.59
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$864.72	$864.72
VALLEJO (CA)	$823.52	$823.52
BAKERSFIELD (CA)	$744.73	$744.73
CHICO (CA)	$739.47	$739.47
FRESNO (CA)	$739.47	$739.47
HANFORD-CORCORAN (CA)	$739.47	$739.47
MADERA (CA)	$739.47	$739.47
MERCED (CA)	$739.47	$739.47
MODESTO (CA)	$739.47	$739.47
REDDING (CA)	$739.47	$739.47
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$759.71	$759.71
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$768.02	$768.02
SALINAS (CA)	$765.01	$765.01
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$885.20	$885.20
SANTA CRUZ-WATSONVILLE (CA)	$780.13	$780.13
SANTA ROSA-PETALUMA (CA)	$787.47	$787.47
STOCKTON (CA)	$739.47	$739.47
VISALIA (CA)	$739.47	$739.47
YUBA CITY (CA)	$739.47	$739.47
EL CENTRO (CA)	$739.78	$739.78
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$777.27	$777.27
SAN LUIS OBISPO-PASO ROBLES (CA)	$753.67	$753.67
SANTA MARIA-SANTA BARBARA (CA)	$766.31	$766.31
REST OF CALIFORNIA (CA)	$739.47	$739.47
COLORADO (CO)	$742.59	$742.59
CONNECTICUT (CT)	$776.53	$776.53
DC + MD/VA SUBURBS (DC)	$815.29	$815.29
DELAWARE (DE)	$722.53	$722.53
FORT LAUDERDALE (FL)	$786.18	$786.18
MIAMI (FL)	$840.70	$840.70
REST OF FLORIDA (FL)	$748.20	$748.20
ATLANTA (GA)	$750.07	$750.07
REST OF GEORGIA (GA)	$707.53	$707.53
HAWAII, GUAM (HI)	$749.97	$749.97
IOWA (IA)	$665.20	$665.20
IDAHO (ID)	$671.63	$671.63
EAST ST. LOUIS (IL)	$768.39	$768.39
SUBURBAN CHICAGO (IL)	$790.91	$790.91
CHICAGO (IL)	$816.48	$816.48
REST OF ILLINOIS (IL)	$737.76	$737.76
INDIANA (IN)	$674.76	$674.76
KANSAS (KS)	$668.29	$668.29
KENTUCKY (KY)	$689.14	$689.14
NEW ORLEANS (LA)	$720.20	$720.20
REST OF LOUISIANA (LA)	$690.52	$690.52
METROPOLITAN BOSTON (MA)	$802.18	$802.18
REST OF MASSACHUSETTS (MA)	$741.31	$741.31
BALTIMORE/SURR. CNTYS (MD)	$775.55	$775.55
REST OF MARYLAND (MD)	$733.34	$733.34
SOUTHERN MAINE (ME)	$705.00	$705.00
REST OF MAINE (ME)	$680.98	$680.98
DETROIT (MI)	$762.66	$762.66
REST OF MICHIGAN (MI)	$710.51	$710.51
MINNESOTA (MN)	$696.52	$696.52
METROPOLITAN ST. LOUIS (MO)	$715.42	$715.42
METROPOLITAN KANSAS CITY (MO)	$709.55	$709.55
REST OF MISSOURI (MO)	$683.93	$683.93
MISSISSIPPI (MS)	$668.84	$668.84
MONTANA** (MT)	$731.02	$731.02
NORTH CAROLINA (NC)	$686.34	$686.34
NORTH DAKOTA** (ND)	$693.85	$693.85
NEBRASKA (NE)	$666.65	$666.65
NEW HAMPSHIRE (NH)	$736.84	$736.84
NORTHERN NJ (NJ)	$809.56	$809.56
REST OF NEW JERSEY (NJ)	$781.15	$781.15
NEW MEXICO (NM)	$716.35	$716.35
NEVADA** (NV)	$720.99	$720.99
MANHATTAN (NY)	$843.09	$843.09
NYC SUBURBS/LONG ISLAND (NY)	$869.03	$869.03
POUGHKPSIE/N NYC SUBURBS (NY)	$790.92	$790.92
QUEENS (NY)	$840.65	$840.65
REST OF NEW YORK (NY)	$695.98	$695.98
OHIO (OH)	$702.91	$702.91
OKLAHOMA (OK)	$681.80	$681.80
PORTLAND (OR)	$757.15	$757.15
REST OF OREGON (OR)	$711.17	$711.17
METROPOLITAN PHILADELPHIA (PA)	$762.89	$762.89
REST OF PENNSYLVANIA (PA)	$700.60	$700.60
PUERTO RICO (PR)	$733.84	$733.84
RHODE ISLAND (RI)	$741.69	$741.69
SOUTH CAROLINA (SC)	$696.62	$696.62
SOUTH DAKOTA** (SD)	$689.45	$689.45
TENNESSEE (TN)	$672.01	$672.01
BRAZORIA (TX)	$717.06	$717.06
DALLAS (TX)	$723.95	$723.95
GALVESTON (TX)	$720.74	$720.74
HOUSTON (TX)	$755.15	$755.15
BEAUMONT (TX)	$696.96	$696.96
FORT WORTH (TX)	$721.46	$721.46
AUSTIN (TX)	$743.82	$743.82
REST OF TEXAS (TX)	$708.21	$708.21
UTAH (UT)	$704.92	$704.92
VIRGINIA (VA)	$707.07	$707.07
VIRGIN ISLANDS (VI)	$733.84	$733.84
VERMONT (VT)	$696.82	$696.82
SEATTLE (KING CNTY) (WA)	$811.54	$811.54
REST OF WASHINGTON (WA)	$738.04	$738.04
WISCONSIN (WI)	$673.82	$673.82
WEST VIRGINIA (WV)	$714.94	$714.94
WYOMING** (WY)	$714.82	$714.82

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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 allowed amount is built from three components: physician work, practice expense, and malpractice relative value units (RVUs) 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 a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings often have different practice-expense RVUs, which is why the allowed amount can differ between the two.

RVUs — work 10.12, practice expense 9.89 (non-facility) / 9.89 (facility), malpractice 1.88 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment or coverage.
Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary insurer is generally responsible for the remainder.
Actual payment may vary by locality, applicable modifiers, site of service, sequestration reductions, and annual budget-neutrality adjustments.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

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

Practice-expense RVUs are typically lower in the facility setting because the facility, not the physician's office, incurs certain overhead costs. This can result in a lower facility allowed amount compared to non-facility.

Will my locality's reimbursement match the national amount shown here?

Not necessarily. The national amount uses national averages, while actual payment is adjusted using locality-specific GPCIs, which can raise or lower the amount depending on where the service is performed.

Does this amount reflect what Medicare will actually pay?

No. This is the PFS allowed amount before the 20% beneficiary coinsurance, deductible status, modifiers, and any sequestration or other adjustments are applied.

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

The CPT code set is copyrighted by the American Medical Association. Refer to your licensed CPT codebook or the AMA's resources for the official descriptor.

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.