Medicare Reimbursement for CPT Code 15936

This page covers a CPT procedure code (descriptor not shown due to AMA licensing restrictions) and displays the Medicare Physician Fee Schedule (PFS) estimated allowed amount for 2026, both at the national level and adjusted by locality, with non-facility and facility rates shown separately.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$838.03	$838.03
ALASKA* (AK)	$1027.75	$1027.75
ALABAMA (AL)	$756.09	$756.09
ARKANSAS (AR)	$746.05	$746.05
ARIZONA (AZ)	$814.09	$814.09
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$948.59	$948.59
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$962.15	$962.15
OXNARD-THOUSAND OAKS-VENTURA (CA)	$868.92	$868.92
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$878.88	$878.88
NAPA (CA)	$914.62	$914.62
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$951.97	$951.97
VALLEJO (CA)	$909.75	$909.75
BAKERSFIELD (CA)	$837.01	$837.01
CHICO (CA)	$828.89	$828.89
FRESNO (CA)	$828.89	$828.89
HANFORD-CORCORAN (CA)	$828.89	$828.89
MADERA (CA)	$828.89	$828.89
MERCED (CA)	$828.89	$828.89
MODESTO (CA)	$828.89	$828.89
REDDING (CA)	$828.89	$828.89
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$860.87	$860.87
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$857.80	$857.80
SALINAS (CA)	$854.41	$854.41
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$975.99	$975.99
SANTA CRUZ-WATSONVILLE (CA)	$867.49	$867.49
SANTA ROSA-PETALUMA (CA)	$875.37	$875.37
STOCKTON (CA)	$828.89	$828.89
VISALIA (CA)	$828.89	$828.89
YUBA CITY (CA)	$828.89	$828.89
EL CENTRO (CA)	$829.38	$829.38
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$866.05	$866.05
SAN LUIS OBISPO-PASO ROBLES (CA)	$842.21	$842.21
SANTA MARIA-SANTA BARBARA (CA)	$855.30	$855.30
REST OF CALIFORNIA (CA)	$828.89	$828.89
COLORADO (CO)	$841.21	$841.21
CONNECTICUT (CT)	$891.37	$891.37
DC + MD/VA SUBURBS (DC)	$927.59	$927.59
DELAWARE (DE)	$826.40	$826.40
FORT LAUDERDALE (FL)	$922.48	$922.48
MIAMI (FL)	$1002.93	$1002.93
REST OF FLORIDA (FL)	$874.46	$874.46
ATLANTA (GA)	$864.28	$864.28
REST OF GEORGIA (GA)	$823.66	$823.66
HAWAII, GUAM (HI)	$838.59	$838.59
IOWA (IA)	$751.66	$751.66
IDAHO (ID)	$760.78	$760.78
EAST ST. LOUIS (IL)	$914.16	$914.16
SUBURBAN CHICAGO (IL)	$926.24	$926.24
CHICAGO (IL)	$971.48	$971.48
REST OF ILLINOIS (IL)	$867.10	$867.10
INDIANA (IN)	$764.24	$764.24
KANSAS (KS)	$758.90	$758.90
KENTUCKY (KY)	$795.16	$795.16
NEW ORLEANS (LA)	$833.28	$833.28
REST OF LOUISIANA (LA)	$798.20	$798.20
METROPOLITAN BOSTON (MA)	$904.78	$904.78
REST OF MASSACHUSETTS (MA)	$841.11	$841.11
BALTIMORE/SURR. CNTYS (MD)	$891.10	$891.10
REST OF MARYLAND (MD)	$837.87	$837.87
SOUTHERN MAINE (ME)	$798.51	$798.51
REST OF MAINE (ME)	$775.61	$775.61
DETROIT (MI)	$895.46	$895.46
REST OF MICHIGAN (MI)	$823.90	$823.90
MINNESOTA (MN)	$776.95	$776.95
METROPOLITAN ST. LOUIS (MO)	$823.35	$823.35
METROPOLITAN KANSAS CITY (MO)	$816.83	$816.83
REST OF MISSOURI (MO)	$792.67	$792.67
MISSISSIPPI (MS)	$768.97	$768.97
MONTANA** (MT)	$837.83	$837.83
NORTH CAROLINA (NC)	$781.33	$781.33
NORTH DAKOTA** (ND)	$778.90	$778.90
NEBRASKA (NE)	$752.25	$752.25
NEW HAMPSHIRE (NH)	$838.30	$838.30
NORTHERN NJ (NJ)	$921.39	$921.39
REST OF NEW JERSEY (NJ)	$893.34	$893.34
NEW MEXICO (NM)	$832.31	$832.31
NEVADA** (NV)	$821.72	$821.72
MANHATTAN (NY)	$974.00	$974.00
NYC SUBURBS/LONG ISLAND (NY)	$1009.34	$1009.34
POUGHKPSIE/N NYC SUBURBS (NY)	$907.66	$907.66
QUEENS (NY)	$965.86	$965.86
REST OF NEW YORK (NY)	$792.97	$792.97
OHIO (OH)	$811.86	$811.86
OKLAHOMA (OK)	$782.67	$782.67
PORTLAND (OR)	$853.81	$853.81
REST OF OREGON (OR)	$807.23	$807.23
METROPOLITAN PHILADELPHIA (PA)	$877.66	$877.66
REST OF PENNSYLVANIA (PA)	$807.14	$807.14
PUERTO RICO (PR)	$839.95	$839.95
RHODE ISLAND (RI)	$845.65	$845.65
SOUTH CAROLINA (SC)	$799.54	$799.54
SOUTH DAKOTA** (SD)	$771.94	$771.94
TENNESSEE (TN)	$763.74	$763.74
BRAZORIA (TX)	$816.77	$816.77
DALLAS (TX)	$826.51	$826.51
GALVESTON (TX)	$822.17	$822.17
HOUSTON (TX)	$876.71	$876.71
BEAUMONT (TX)	$803.07	$803.07
FORT WORTH (TX)	$824.71	$824.71
AUSTIN (TX)	$845.52	$845.52
REST OF TEXAS (TX)	$812.57	$812.57
UTAH (UT)	$809.28	$809.28
VIRGINIA (VA)	$803.50	$803.50
VIRGIN ISLANDS (VI)	$839.95	$839.95
VERMONT (VT)	$785.76	$785.76
SEATTLE (KING CNTY) (WA)	$911.60	$911.60
REST OF WASHINGTON (WA)	$836.24	$836.24
WISCONSIN (WI)	$756.13	$756.13
WEST VIRGINIA (WV)	$840.32	$840.32
WYOMING** (WY)	$812.15	$812.15

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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 fee for this code is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, and the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice-expense RVUs differ depending on whether the service is reported as non-facility (e.g., office) or facility (e.g., hospital), which is why non-facility and facility amounts can vary. The conversion factor is updated annually and applies nationwide, while GPCIs account for regional cost differences.

RVUs — work 12.83, practice expense 9.28 (non-facility) / 9.28 (facility), malpractice 2.98 — × 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 Part B deductible is met; the beneficiary or secondary payer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claim-specific circumstances, and sequestration or other federal adjustments.
Annual budget-neutrality adjustments and policy changes can alter RVUs and the conversion factor from year to year.
Always verify the exact allowed amount and coverage policy with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

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

The practice-expense RVU component is typically lower in the facility setting because the facility (not the physician's practice) bears many of the overhead costs. This can make the facility allowed amount different from the non-facility amount for the same code.

Why might my locality's payment differ from the national amount shown?

Medicare applies Geographic Practice Cost Indices (GPCIs) to adjust the work, practice-expense, and malpractice RVUs based on local labor and cost data, so the same code can have different allowed amounts in different areas.

Does this amount reflect what Medicare will actually pay?

No. It reflects the estimated Medicare-allowed amount before the standard 80/20 coinsurance split, deductible status, modifiers, and any sequestration or other adjustments are applied.

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

CPT code descriptors are copyrighted by the American Medical Association (AMA) and must be obtained through an AMA-licensed source such as the official CPT codebook or a licensed coding software product.

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.