Medicare Reimbursement for CPT Code 15934

This page covers a procedure identified by CPT code 15934, a surgical/medical service defined by the American Medical Association (CPT descriptors are not reproduced here due to licensing). It shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level, with context on how non-facility and facility settings are calculated.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$888.46	$888.46
ALASKA* (AK)	$1097.46	$1097.46
ALABAMA (AL)	$807.51	$807.51
ARKANSAS (AR)	$797.52	$797.52
ARIZONA (AZ)	$865.37	$865.37
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1030.79	$1030.79
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1046.67	$1046.67
OXNARD-THOUSAND OAKS-VENTURA (CA)	$935.24	$935.24
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$944.79	$944.79
NAPA (CA)	$990.28	$990.28
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1033.60	$1033.60
VALLEJO (CA)	$986.22	$986.22
BAKERSFIELD (CA)	$899.11	$899.11
CHICO (CA)	$892.17	$892.17
FRESNO (CA)	$892.17	$892.17
HANFORD-CORCORAN (CA)	$892.17	$892.17
MADERA (CA)	$892.17	$892.17
MERCED (CA)	$892.17	$892.17
MODESTO (CA)	$892.17	$892.17
REDDING (CA)	$892.17	$892.17
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$918.87	$918.87
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$924.76	$924.76
SALINAS (CA)	$921.09	$921.09
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1058.19	$1058.19
SANTA CRUZ-WATSONVILLE (CA)	$936.80	$936.80
SANTA ROSA-PETALUMA (CA)	$945.49	$945.49
STOCKTON (CA)	$892.17	$892.17
VISALIA (CA)	$892.17	$892.17
YUBA CITY (CA)	$892.17	$892.17
EL CENTRO (CA)	$892.58	$892.58
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$934.46	$934.46
SAN LUIS OBISPO-PASO ROBLES (CA)	$907.65	$907.65
SANTA MARIA-SANTA BARBARA (CA)	$922.28	$922.28
REST OF CALIFORNIA (CA)	$892.17	$892.17
COLORADO (CO)	$898.71	$898.71
CONNECTICUT (CT)	$942.50	$942.50
DC + MD/VA SUBURBS (DC)	$985.98	$985.98
DELAWARE (DE)	$878.00	$878.00
FORT LAUDERDALE (FL)	$960.07	$960.07
MIAMI (FL)	$1029.88	$1029.88
REST OF FLORIDA (FL)	$914.29	$914.29
ATLANTA (GA)	$912.21	$912.21
REST OF GEORGIA (GA)	$865.48	$865.48
HAWAII, GUAM (HI)	$902.92	$902.92
IOWA (IA)	$807.91	$807.91
IDAHO (ID)	$816.01	$816.01
EAST ST. LOUIS (IL)	$943.65	$943.65
SUBURBAN CHICAGO (IL)	$965.25	$965.25
CHICAGO (IL)	$1000.65	$1000.65
REST OF ILLINOIS (IL)	$903.77	$903.77
INDIANA (IN)	$819.60	$819.60
KANSAS (KS)	$812.81	$812.81
KENTUCKY (KY)	$841.46	$841.46
NEW ORLEANS (LA)	$878.49	$878.49
REST OF LOUISIANA (LA)	$843.58	$843.58
METROPOLITAN BOSTON (MA)	$967.47	$967.47
REST OF MASSACHUSETTS (MA)	$897.86	$897.86
BALTIMORE/SURR. CNTYS (MD)	$941.51	$941.51
REST OF MARYLAND (MD)	$890.45	$890.45
SOUTHERN MAINE (ME)	$854.66	$854.66
REST OF MAINE (ME)	$828.35	$828.35
DETROIT (MI)	$932.69	$932.69
REST OF MICHIGAN (MI)	$867.82	$867.82
MINNESOTA (MN)	$840.59	$840.59
METROPOLITAN ST. LOUIS (MO)	$871.35	$871.35
METROPOLITAN KANSAS CITY (MO)	$864.59	$864.59
REST OF MISSOURI (MO)	$836.62	$836.62
MISSISSIPPI (MS)	$816.80	$816.80
MONTANA** (MT)	$888.30	$888.30
NORTH CAROLINA (NC)	$834.44	$834.44
NORTH DAKOTA** (ND)	$839.26	$839.26
NEBRASKA (NE)	$809.22	$809.22
NEW HAMPSHIRE (NH)	$892.87	$892.87
NORTHERN NJ (NJ)	$979.78	$979.78
REST OF NEW JERSEY (NJ)	$947.45	$947.45
NEW MEXICO (NM)	$875.23	$875.23
NEVADA** (NV)	$874.99	$874.99
MANHATTAN (NY)	$1023.85	$1023.85
NYC SUBURBS/LONG ISLAND (NY)	$1056.02	$1056.02
POUGHKPSIE/N NYC SUBURBS (NY)	$960.12	$960.12
QUEENS (NY)	$1019.12	$1019.12
REST OF NEW YORK (NY)	$845.86	$845.86
OHIO (OH)	$857.80	$857.80
OKLAHOMA (OK)	$831.47	$831.47
PORTLAND (OR)	$914.35	$914.35
REST OF OREGON (OR)	$862.42	$862.42
METROPOLITAN PHILADELPHIA (PA)	$927.23	$927.23
REST OF PENNSYLVANIA (PA)	$854.38	$854.38
PUERTO RICO (PR)	$891.18	$891.18
RHODE ISLAND (RI)	$899.87	$899.87
SOUTH CAROLINA (SC)	$848.67	$848.67
SOUTH DAKOTA** (SD)	$833.46	$833.46
TENNESSEE (TN)	$817.35	$817.35
BRAZORIA (TX)	$870.56	$870.56
DALLAS (TX)	$879.27	$879.27
GALVESTON (TX)	$875.26	$875.26
HOUSTON (TX)	$920.65	$920.65
BEAUMONT (TX)	$850.18	$850.18
FORT WORTH (TX)	$876.75	$876.75
AUSTIN (TX)	$900.80	$900.80
REST OF TEXAS (TX)	$862.07	$862.07
UTAH (UT)	$858.41	$858.41
VIRGINIA (VA)	$857.99	$857.99
VIRGIN ISLANDS (VI)	$891.18	$891.18
VERMONT (VT)	$843.94	$843.94
SEATTLE (KING CNTY) (WA)	$977.32	$977.32
REST OF WASHINGTON (WA)	$893.54	$893.54
WISCONSIN (WI)	$816.02	$816.02
WEST VIRGINIA (WV)	$877.00	$877.00
WYOMING** (WY)	$866.93	$866.93

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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 (PE), and malpractice (MP). 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 national conversion factor (a dollar figure set by CMS) to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different PE RVUs because overhead costs are allocated differently; for some codes, including this one, those PE RVU values are the same, so the non-facility and facility allowed amounts may not differ.

RVUs — work 13.34, practice expense 10.78 (non-facility) / 10.78 (facility), malpractice 2.48 — × 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 Part B deductible; the patient or secondary insurer is responsible for the remainder.
Actual payment varies by locality GPCIs, applicable modifiers, claim-specific circumstances, and mandatory sequestration reductions.
Annual updates to RVUs and the conversion factor, along with budget-neutrality adjustments, can change this amount from year to year.
Always verify the exact allowed amount and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

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 cannot reproduce the official language. Refer to your CPT codebook or practice management system for the full descriptor.

Why are the facility and non-facility amounts sometimes the same?

The facility and non-facility rates differ only when the practice expense (PE) RVU differs between the two settings. If CMS has assigned the same PE RVU value for both, the resulting allowed amounts will match.

How is the conversion factor determined?

CMS sets a single national conversion factor each year through rulemaking, reflecting statutory updates and annual budget-neutrality adjustments across the fee schedule.

Does this amount reflect what my practice will actually collect?

No — it reflects the Medicare-allowed amount before adjustments for sequestration, secondary payers, patient cost-sharing, or claim-specific modifiers, so actual reimbursement may differ.

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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.