Medicare Reimbursement for CPT 15940

CPT code 15940 is a surgical procedure code; the exact service it describes is defined by the American Medical Association (AMA) and is not reproduced here. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and adjusted for your locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$664.34	$664.34
ALASKA* (AK)	$813.12	$813.12
ALABAMA (AL)	$599.41	$599.41
ARKANSAS (AR)	$591.45	$591.45
ARIZONA (AZ)	$645.48	$645.48
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$757.36	$757.36
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$768.42	$768.42
OXNARD-THOUSAND OAKS-VENTURA (CA)	$691.69	$691.69
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$699.38	$699.38
NAPA (CA)	$729.44	$729.44
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$759.93	$759.93
VALLEJO (CA)	$725.73	$725.73
BAKERSFIELD (CA)	$665.61	$665.61
CHICO (CA)	$659.41	$659.41
FRESNO (CA)	$659.41	$659.41
HANFORD-CORCORAN (CA)	$659.41	$659.41
MADERA (CA)	$659.41	$659.41
MERCED (CA)	$659.41	$659.41
MODESTO (CA)	$659.41	$659.41
REDDING (CA)	$659.41	$659.41
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$683.77	$683.77
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$682.89	$682.89
SALINAS (CA)	$680.20	$680.20
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$778.95	$778.95
SANTA CRUZ-WATSONVILLE (CA)	$691.22	$691.22
SANTA ROSA-PETALUMA (CA)	$697.54	$697.54
STOCKTON (CA)	$659.41	$659.41
VISALIA (CA)	$659.41	$659.41
YUBA CITY (CA)	$659.41	$659.41
EL CENTRO (CA)	$659.79	$659.79
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$689.80	$689.80
SAN LUIS OBISPO-PASO ROBLES (CA)	$670.42	$670.42
SANTA MARIA-SANTA BARBARA (CA)	$681.00	$681.00
REST OF CALIFORNIA (CA)	$659.41	$659.41
COLORADO (CO)	$668.12	$668.12
CONNECTICUT (CT)	$706.64	$706.64
DC + MD/VA SUBURBS (DC)	$736.46	$736.46
DELAWARE (DE)	$655.27	$655.27
FORT LAUDERDALE (FL)	$728.94	$728.94
MIAMI (FL)	$790.78	$790.78
REST OF FLORIDA (FL)	$691.21	$691.21
ATLANTA (GA)	$684.68	$684.68
REST OF GEORGIA (GA)	$651.23	$651.23
HAWAII, GUAM (HI)	$667.52	$667.52
IOWA (IA)	$596.85	$596.85
IDAHO (ID)	$603.89	$603.89
EAST ST. LOUIS (IL)	$720.73	$720.73
SUBURBAN CHICAGO (IL)	$732.12	$732.12
CHICAGO (IL)	$766.14	$766.14
REST OF ILLINOIS (IL)	$684.74	$684.74
INDIANA (IN)	$606.67	$606.67
KANSAS (KS)	$602.14	$602.14
KENTUCKY (KY)	$629.46	$629.46
NEW ORLEANS (LA)	$659.54	$659.54
REST OF LOUISIANA (LA)	$631.70	$631.70
METROPOLITAN BOSTON (MA)	$719.33	$719.33
REST OF MASSACHUSETTS (MA)	$667.85	$667.85
BALTIMORE/SURR. CNTYS (MD)	$706.33	$706.33
REST OF MARYLAND (MD)	$664.52	$664.52
SOUTHERN MAINE (ME)	$634.06	$634.06
REST OF MAINE (ME)	$615.19	$615.19
DETROIT (MI)	$707.39	$707.39
REST OF MICHIGAN (MI)	$651.84	$651.84
MINNESOTA (MN)	$618.40	$618.40
METROPOLITAN ST. LOUIS (MO)	$652.20	$652.20
METROPOLITAN KANSAS CITY (MO)	$646.97	$646.97
REST OF MISSOURI (MO)	$627.02	$627.02
MISSISSIPPI (MS)	$608.95	$608.95
MONTANA** (MT)	$664.19	$664.19
NORTH CAROLINA (NC)	$619.81	$619.81
NORTH DAKOTA** (ND)	$619.31	$619.31
NEBRASKA (NE)	$597.46	$597.46
NEW HAMPSHIRE (NH)	$665.37	$665.37
NORTHERN NJ (NJ)	$731.43	$731.43
REST OF NEW JERSEY (NJ)	$708.56	$708.56
NEW MEXICO (NM)	$658.32	$658.32
NEVADA** (NV)	$651.94	$651.94
MANHATTAN (NY)	$771.55	$771.55
NYC SUBURBS/LONG ISLAND (NY)	$799.01	$799.01
POUGHKPSIE/N NYC SUBURBS (NY)	$719.56	$719.56
QUEENS (NY)	$765.75	$765.75
REST OF NEW YORK (NY)	$629.02	$629.02
OHIO (OH)	$642.66	$642.66
OKLAHOMA (OK)	$620.02	$620.02
PORTLAND (OR)	$678.69	$678.69
REST OF OREGON (OR)	$640.80	$640.80
METROPOLITAN PHILADELPHIA (PA)	$695.46	$695.46
REST OF PENNSYLVANIA (PA)	$639.17	$639.17
PUERTO RICO (PR)	$666.02	$666.02
RHODE ISLAND (RI)	$670.92	$670.92
SOUTH CAROLINA (SC)	$633.50	$633.50
SOUTH DAKOTA** (SD)	$614.00	$614.00
TENNESSEE (TN)	$605.93	$605.93
BRAZORIA (TX)	$648.02	$648.02
DALLAS (TX)	$655.54	$655.54
GALVESTON (TX)	$652.17	$652.17
HOUSTON (TX)	$693.72	$693.72
BEAUMONT (TX)	$635.90	$635.90
FORT WORTH (TX)	$653.97	$653.97
AUSTIN (TX)	$671.22	$671.22
REST OF TEXAS (TX)	$643.92	$643.92
UTAH (UT)	$641.24	$641.24
VIRGINIA (VA)	$637.70	$637.70
VIRGIN ISLANDS (VI)	$666.02	$666.02
VERMONT (VT)	$624.33	$624.33
SEATTLE (KING CNTY) (WA)	$725.24	$725.24
REST OF WASHINGTON (WA)	$664.12	$664.12
WISCONSIN (WI)	$601.12	$601.12
WEST VIRGINIA (WV)	$663.46	$663.46
WYOMING** (WY)	$644.63	$644.63

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 units 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

The Medicare PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts can diverge; for this code they happen to be the same. These figures are recalculated each year as RVUs, GPCIs, and the conversion factor are updated by CMS.

RVUs — work 9.95, practice expense 7.67 (non-facility) / 7.67 (facility), malpractice 2.27 — × 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 annual Part B deductible is met; the patient or secondary payer is responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
CMS budget-neutrality adjustments and annual rule updates can shift RVUs and the conversion factor from year to year.
Always verify the current amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

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

When the practice expense RVUs are identical for both settings, the resulting allowed amounts come out the same, even though CMS still calculates them separately.

Does this amount reflect what my MAC will actually pay?

No — this is a national PFS estimate before local claims processing. Your MAC applies locality-specific GPCIs, any applicable modifiers, and other claim-specific adjustments to determine final payment.

Why can't you show the CPT code description?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page refers to the code generically rather than reproducing the official wording.

Will this amount change next year?

Yes. CMS updates RVUs, GPCIs, and the conversion factor annually, and budget-neutrality requirements can shift payment amounts even if the code's RVUs stay the same.

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.