Medicare Reimbursement for CPT 15937

CPT 15937 is a surgical procedure code; the full code description cannot be displayed here because CPT descriptors are licensed by the AMA. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for 2026, both at the national level and adjusted for local cost differences, and distinguishes non-facility (e.g., office) from facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$919.53	$919.53
ALASKA* (AK)	$1147.05	$1147.05
ALABAMA (AL)	$838.14	$838.14
ARKANSAS (AR)	$828.13	$828.13
ARIZONA (AZ)	$896.04	$896.04
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1051.75	$1051.75
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1067.34	$1067.34
OXNARD-THOUSAND OAKS-VENTURA (CA)	$960.17	$960.17
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$970.64	$970.64
NAPA (CA)	$1012.63	$1012.63
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1054.84	$1054.84
VALLEJO (CA)	$1008.18	$1008.18
BAKERSFIELD (CA)	$925.60	$925.60
CHICO (CA)	$917.98	$917.98
FRESNO (CA)	$917.98	$917.98
HANFORD-CORCORAN (CA)	$917.98	$917.98
MADERA (CA)	$917.98	$917.98
MERCED (CA)	$917.98	$917.98
MODESTO (CA)	$917.98	$917.98
REDDING (CA)	$917.98	$917.98
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$947.27	$947.27
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$949.84	$949.84
SALINAS (CA)	$946.03	$946.03
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1079.97	$1079.97
SANTA CRUZ-WATSONVILLE (CA)	$959.90	$959.90
SANTA ROSA-PETALUMA (CA)	$968.70	$968.70
STOCKTON (CA)	$917.98	$917.98
VISALIA (CA)	$917.98	$917.98
YUBA CITY (CA)	$917.98	$917.98
EL CENTRO (CA)	$918.43	$918.43
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$958.50	$958.50
SAN LUIS OBISPO-PASO ROBLES (CA)	$932.41	$932.41
SANTA MARIA-SANTA BARBARA (CA)	$946.90	$946.90
REST OF CALIFORNIA (CA)	$917.98	$917.98
COLORADO (CO)	$927.03	$927.03
CONNECTICUT (CT)	$974.31	$974.31
DC + MD/VA SUBURBS (DC)	$1016.17	$1016.17
DELAWARE (DE)	$908.79	$908.79
FORT LAUDERDALE (FL)	$997.30	$997.30
MIAMI (FL)	$1072.20	$1072.20
REST OF FLORIDA (FL)	$950.45	$950.45
ATLANTA (GA)	$944.64	$944.64
REST OF GEORGIA (GA)	$900.72	$900.72
HAWAII, GUAM (HI)	$927.27	$927.27
IOWA (IA)	$836.21	$836.21
IDAHO (ID)	$844.79	$844.79
EAST ST. LOUIS (IL)	$984.79	$984.79
SUBURBAN CHICAGO (IL)	$1002.18	$1002.18
CHICAGO (IL)	$1042.31	$1042.31
REST OF ILLINOIS (IL)	$941.47	$941.47
INDIANA (IN)	$848.33	$848.33
KANSAS (KS)	$842.24	$842.24
KENTUCKY (KY)	$874.54	$874.54
NEW ORLEANS (LA)	$912.08	$912.08
REST OF LOUISIANA (LA)	$877.11	$877.11
METROPOLITAN BOSTON (MA)	$994.87	$994.87
REST OF MASSACHUSETTS (MA)	$926.76	$926.76
BALTIMORE/SURR. CNTYS (MD)	$973.45	$973.45
REST OF MARYLAND (MD)	$921.04	$921.04
SOUTHERN MAINE (ME)	$882.98	$882.98
REST OF MAINE (ME)	$858.33	$858.33
DETROIT (MI)	$970.10	$970.10
REST OF MICHIGAN (MI)	$902.04	$902.04
MINNESOTA (MN)	$865.30	$865.30
METROPOLITAN ST. LOUIS (MO)	$903.60	$903.60
METROPOLITAN KANSAS CITY (MO)	$896.96	$896.96
REST OF MISSOURI (MO)	$870.84	$870.84
MISSISSIPPI (MS)	$849.16	$849.16
MONTANA** (MT)	$919.35	$919.35
NORTH CAROLINA (NC)	$864.24	$864.24
NORTH DAKOTA** (ND)	$865.56	$865.56
NEBRASKA (NE)	$837.17	$837.17
NEW HAMPSHIRE (NH)	$921.93	$921.93
NORTHERN NJ (NJ)	$1010.47	$1010.47
REST OF NEW JERSEY (NJ)	$978.94	$978.94
NEW MEXICO (NM)	$909.93	$909.93
NEVADA** (NV)	$904.69	$904.69
MANHATTAN (NY)	$1058.70	$1058.70
NYC SUBURBS/LONG ISLAND (NY)	$1092.38	$1092.38
POUGHKPSIE/N NYC SUBURBS (NY)	$992.68	$992.68
QUEENS (NY)	$1052.33	$1052.33
REST OF NEW YORK (NY)	$875.76	$875.76
OHIO (OH)	$891.05	$891.05
OKLAHOMA (OK)	$863.35	$863.35
PORTLAND (OR)	$941.42	$941.42
REST OF OREGON (OR)	$891.20	$891.20
METROPOLITAN PHILADELPHIA (PA)	$959.70	$959.70
REST OF PENNSYLVANIA (PA)	$887.00	$887.00
PUERTO RICO (PR)	$921.86	$921.86
RHODE ISLAND (RI)	$930.16	$930.16
SOUTH CAROLINA (SC)	$880.39	$880.39
SOUTH DAKOTA** (SD)	$859.20	$859.20
TENNESSEE (TN)	$846.92	$846.92
BRAZORIA (TX)	$900.46	$900.46
DALLAS (TX)	$909.72	$909.72
GALVESTON (TX)	$905.49	$905.49
HOUSTON (TX)	$955.28	$955.28
BEAUMONT (TX)	$882.87	$882.87
FORT WORTH (TX)	$907.54	$907.54
AUSTIN (TX)	$929.63	$929.63
REST OF TEXAS (TX)	$893.59	$893.59
UTAH (UT)	$890.12	$890.12
VIRGINIA (VA)	$887.11	$887.11
VIRGIN ISLANDS (VI)	$921.86	$921.86
VERMONT (VT)	$871.29	$871.29
SEATTLE (KING CNTY) (WA)	$1003.75	$1003.75
REST OF WASHINGTON (WA)	$922.01	$922.01
WISCONSIN (WI)	$842.56	$842.56
WEST VIRGINIA (WV)	$914.71	$914.71
WYOMING** (WY)	$895.91	$895.91

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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 amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the provider's locality to reflect regional cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice expense RVUs typically differ between non-facility and facility settings because overhead costs differ, which is why the two amounts can diverge; in this case they are equal, meaning the practice-expense component is priced the same regardless of setting. The conversion factor itself is set annually by CMS and applies uniformly across all codes.

RVUs — work 14.76, practice expense 10.05 (non-facility) / 10.05 (facility), malpractice 2.72 — × 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 deductible; the beneficiary or secondary payer is responsible for the remainder.
Actual payment can vary by locality, applicable modifiers, claim-specific adjustments, sequestration, and annual budget-neutrality changes CMS applies to the conversion factor.
Always confirm final pricing and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

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

The practice expense RVU, which usually differs between settings to reflect overhead costs, is identical for both settings in this case, so the total calculated payment comes out the same.

Why can't the CPT code description be shown?

CPT codes and their descriptors are copyrighted by the American Medical Association (AMA) and require a license to reproduce, so this page refers to the code generically.

Will my locality's payment match the national amount shown?

Not necessarily. The national amount uses a GPCI value of 1.0 for all components; actual payment in your locality is adjusted up or down based on local GPCIs for work, practice expense, and malpractice costs.

Does this amount include any add-on codes or modifiers?

No. This figure reflects only the base RVUs for this code at standard values; modifiers, bundling edits, and add-on codes can change the final reimbursement.

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.