Medicare Reimbursement for CPT 15945

CPT 15945 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$926.87	$926.87
ALASKA* (AK)	$1139.21	$1139.21
ALABAMA (AL)	$841.30	$841.30
ARKANSAS (AR)	$830.73	$830.73
ARIZONA (AZ)	$902.63	$902.63
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1083.88	$1083.88
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1100.94	$1100.94
OXNARD-THOUSAND OAKS-VENTURA (CA)	$980.10	$980.10
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$989.73	$989.73
NAPA (CA)	$1040.04	$1040.04
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1086.71	$1086.71
VALLEJO (CA)	$1035.96	$1035.96
BAKERSFIELD (CA)	$940.86	$940.86
CHICO (CA)	$933.90	$933.90
FRESNO (CA)	$933.90	$933.90
HANFORD-CORCORAN (CA)	$933.90	$933.90
MADERA (CA)	$933.90	$933.90
MERCED (CA)	$933.90	$933.90
MODESTO (CA)	$933.90	$933.90
REDDING (CA)	$933.90	$933.90
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$960.71	$960.71
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$968.93	$968.93
SALINAS (CA)	$965.10	$965.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1112.50	$1112.50
SANTA CRUZ-WATSONVILLE (CA)	$982.79	$982.79
SANTA ROSA-PETALUMA (CA)	$991.96	$991.96
STOCKTON (CA)	$933.90	$933.90
VISALIA (CA)	$933.90	$933.90
YUBA CITY (CA)	$933.90	$933.90
EL CENTRO (CA)	$934.31	$934.31
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$979.80	$979.80
SAN LUIS OBISPO-PASO ROBLES (CA)	$950.92	$950.92
SANTA MARIA-SANTA BARBARA (CA)	$966.53	$966.53
REST OF CALIFORNIA (CA)	$933.90	$933.90
COLORADO (CO)	$939.37	$939.37
CONNECTICUT (CT)	$983.78	$983.78
DC + MD/VA SUBURBS (DC)	$1030.91	$1030.91
DELAWARE (DE)	$915.96	$915.96
FORT LAUDERDALE (FL)	$999.22	$999.22
MIAMI (FL)	$1070.27	$1070.27
REST OF FLORIDA (FL)	$951.29	$951.29
ATLANTA (GA)	$951.27	$951.27
REST OF GEORGIA (GA)	$900.10	$900.10
HAWAII, GUAM (HI)	$946.09	$946.09
IOWA (IA)	$843.08	$843.08
IDAHO (ID)	$851.38	$851.38
EAST ST. LOUIS (IL)	$979.54	$979.54
SUBURBAN CHICAGO (IL)	$1004.90	$1004.90
CHICAGO (IL)	$1039.69	$1039.69
REST OF ILLINOIS (IL)	$939.26	$939.26
INDIANA (IN)	$855.23	$855.23
KANSAS (KS)	$847.63	$847.63
KENTUCKY (KY)	$875.87	$875.87
NEW ORLEANS (LA)	$914.83	$914.83
REST OF LOUISIANA (LA)	$877.86	$877.86
METROPOLITAN BOSTON (MA)	$1012.88	$1012.88
REST OF MASSACHUSETTS (MA)	$938.14	$938.14
BALTIMORE/SURR. CNTYS (MD)	$982.65	$982.65
REST OF MARYLAND (MD)	$929.28	$929.28
SOUTHERN MAINE (ME)	$892.62	$892.62
REST OF MAINE (ME)	$863.77	$863.77
DETROIT (MI)	$970.08	$970.08
REST OF MICHIGAN (MI)	$903.17	$903.17
MINNESOTA (MN)	$879.80	$879.80
METROPOLITAN ST. LOUIS (MO)	$908.04	$908.04
METROPOLITAN KANSAS CITY (MO)	$900.82	$900.82
REST OF MISSOURI (MO)	$870.09	$870.09
MISSISSIPPI (MS)	$850.15	$850.15
MONTANA** (MT)	$926.71	$926.71
NORTH CAROLINA (NC)	$870.33	$870.33
NORTH DAKOTA** (ND)	$877.47	$877.47
NEBRASKA (NE)	$844.67	$844.67
NEW HAMPSHIRE (NH)	$932.71	$932.71
NORTHERN NJ (NJ)	$1024.08	$1024.08
REST OF NEW JERSEY (NJ)	$989.27	$989.27
NEW MEXICO (NM)	$910.74	$910.74
NEVADA** (NV)	$913.38	$913.38
MANHATTAN (NY)	$1068.40	$1068.40
NYC SUBURBS/LONG ISLAND (NY)	$1101.62	$1101.62
POUGHKPSIE/N NYC SUBURBS (NY)	$1002.10	$1002.10
QUEENS (NY)	$1064.34	$1064.34
REST OF NEW YORK (NY)	$882.38	$882.38
OHIO (OH)	$893.11	$893.11
OKLAHOMA (OK)	$865.98	$865.98
PORTLAND (OR)	$956.68	$956.68
REST OF OREGON (OR)	$900.59	$900.59
METROPOLITAN PHILADELPHIA (PA)	$967.22	$967.22
REST OF PENNSYLVANIA (PA)	$889.85	$889.85
PUERTO RICO (PR)	$929.98	$929.98
RHODE ISLAND (RI)	$939.46	$939.46
SOUTH CAROLINA (SC)	$884.32	$884.32
SOUTH DAKOTA** (SD)	$871.65	$871.65
TENNESSEE (TN)	$852.35	$852.35
BRAZORIA (TX)	$908.60	$908.60
DALLAS (TX)	$917.51	$917.51
GALVESTON (TX)	$913.38	$913.38
HOUSTON (TX)	$958.96	$958.96
BEAUMONT (TX)	$885.35	$885.35
FORT WORTH (TX)	$914.64	$914.64
AUSTIN (TX)	$941.25	$941.25
REST OF TEXAS (TX)	$898.62	$898.62
UTAH (UT)	$894.64	$894.64
VIRGINIA (VA)	$895.69	$895.69
VIRGIN ISLANDS (VI)	$929.98	$929.98
VERMONT (VT)	$881.83	$881.83
SEATTLE (KING CNTY) (WA)	$1023.90	$1023.90
REST OF WASHINGTON (WA)	$933.80	$933.80
WISCONSIN (WI)	$852.70	$852.70
WEST VIRGINIA (WV)	$910.87	$910.87
WYOMING** (WY)	$905.25	$905.25

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

Medicare's allowed amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, which is why the two amounts may differ; for this code they happen to be the same. Because GPCIs vary by region, the same code can price differently across localities even though the RVUs and conversion factor stay constant nationwide.

RVUs — work 13.41, practice expense 11.85 (non-facility) / 11.85 (facility), malpractice 2.49 — × 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 rules, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why do non-facility and facility amounts sometimes differ?

Medicare uses different practice-expense RVUs depending on where the service is performed, since office-based practices typically bear more overhead costs than hospitals or facilities. For this code, the practice-expense RVU is the same in both settings, so the amounts match.

Why does the allowed amount change by locality?

Each locality has its own GPCI values for work, practice expense, and malpractice costs, reflecting regional differences in wages and expenses. These GPCIs adjust the RVUs before they're converted to a dollar amount.

Is this the amount Medicare will actually pay?

No. This is the Medicare-allowed amount before cost-sharing. Medicare generally pays 80% of this figure after the deductible, and other factors like modifiers or sequestration can further adjust the final payment.

Where can I find the official rate for my area?

Your Medicare Administrative Contractor (MAC) publishes the finalized, locality-specific fee schedule, which should be used for authoritative billing decisions.

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.