Medicare Reimbursement for CPT 15952

CPT 15952 is a surgical procedure code; the specific descriptor is not shown here because CPT descriptors are licensed by the AMA and cannot be reproduced. This page presents the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, nationally and by locality, showing both non-facility and facility rates.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$833.02	$833.02
ALASKA* (AK)	$1023.40	$1023.40
ALABAMA (AL)	$756.08	$756.08
ARKANSAS (AR)	$746.57	$746.57
ARIZONA (AZ)	$811.24	$811.24
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$975.26	$975.26
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$990.66	$990.66
OXNARD-THOUSAND OAKS-VENTURA (CA)	$881.45	$881.45
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$890.06	$890.06
NAPA (CA)	$935.65	$935.65
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$977.78	$977.78
VALLEJO (CA)	$932.02	$932.02
BAKERSFIELD (CA)	$846.01	$846.01
CHICO (CA)	$839.80	$839.80
FRESNO (CA)	$839.80	$839.80
HANFORD-CORCORAN (CA)	$839.80	$839.80
MADERA (CA)	$839.80	$839.80
MERCED (CA)	$839.80	$839.80
MODESTO (CA)	$839.80	$839.80
REDDING (CA)	$839.80	$839.80
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$863.71	$863.71
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$871.41	$871.41
SALINAS (CA)	$867.97	$867.97
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1000.96	$1000.96
SANTA CRUZ-WATSONVILLE (CA)	$884.01	$884.01
SANTA ROSA-PETALUMA (CA)	$892.27	$892.27
STOCKTON (CA)	$839.80	$839.80
VISALIA (CA)	$839.80	$839.80
YUBA CITY (CA)	$839.80	$839.80
EL CENTRO (CA)	$840.17	$840.17
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$881.26	$881.26
SAN LUIS OBISPO-PASO ROBLES (CA)	$855.20	$855.20
SANTA MARIA-SANTA BARBARA (CA)	$869.27	$869.27
REST OF CALIFORNIA (CA)	$839.80	$839.80
COLORADO (CO)	$844.51	$844.51
CONNECTICUT (CT)	$884.18	$884.18
DC + MD/VA SUBURBS (DC)	$926.78	$926.78
DELAWARE (DE)	$823.24	$823.24
FORT LAUDERDALE (FL)	$897.59	$897.59
MIAMI (FL)	$961.07	$961.07
REST OF FLORIDA (FL)	$854.56	$854.56
ATLANTA (GA)	$854.85	$854.85
REST OF GEORGIA (GA)	$808.59	$808.59
HAWAII, GUAM (HI)	$850.86	$850.86
IOWA (IA)	$757.87	$757.87
IDAHO (ID)	$765.30	$765.30
EAST ST. LOUIS (IL)	$879.56	$879.56
SUBURBAN CHICAGO (IL)	$902.74	$902.74
CHICAGO (IL)	$933.64	$933.64
REST OF ILLINOIS (IL)	$843.61	$843.61
INDIANA (IN)	$768.77	$768.77
KANSAS (KS)	$761.87	$761.87
KENTUCKY (KY)	$786.97	$786.97
NEW ORLEANS (LA)	$821.98	$821.98
REST OF LOUISIANA (LA)	$788.73	$788.73
METROPOLITAN BOSTON (MA)	$910.76	$910.76
REST OF MASSACHUSETTS (MA)	$843.36	$843.36
BALTIMORE/SURR. CNTYS (MD)	$883.14	$883.14
REST OF MARYLAND (MD)	$835.24	$835.24
SOUTHERN MAINE (ME)	$802.43	$802.43
REST OF MAINE (ME)	$776.35	$776.35
DETROIT (MI)	$871.35	$871.35
REST OF MICHIGAN (MI)	$811.43	$811.43
MINNESOTA (MN)	$791.20	$791.20
METROPOLITAN ST. LOUIS (MO)	$815.98	$815.98
METROPOLITAN KANSAS CITY (MO)	$809.47	$809.47
REST OF MISSOURI (MO)	$781.68	$781.68
MISSISSIPPI (MS)	$763.90	$763.90
MONTANA** (MT)	$832.87	$832.87
NORTH CAROLINA (NC)	$782.26	$782.26
NORTH DAKOTA** (ND)	$788.97	$788.97
NEBRASKA (NE)	$759.33	$759.33
NEW HAMPSHIRE (NH)	$838.43	$838.43
NORTHERN NJ (NJ)	$920.60	$920.60
REST OF NEW JERSEY (NJ)	$889.18	$889.18
NEW MEXICO (NM)	$818.20	$818.20
NEVADA** (NV)	$820.99	$820.99
MANHATTAN (NY)	$960.13	$960.13
NYC SUBURBS/LONG ISLAND (NY)	$989.89	$989.89
POUGHKPSIE/N NYC SUBURBS (NY)	$900.64	$900.64
QUEENS (NY)	$956.61	$956.61
REST OF NEW YORK (NY)	$793.09	$793.09
OHIO (OH)	$802.46	$802.46
OKLAHOMA (OK)	$778.17	$778.17
PORTLAND (OR)	$860.19	$860.19
REST OF OREGON (OR)	$809.56	$809.56
METROPOLITAN PHILADELPHIA (PA)	$869.22	$869.22
REST OF PENNSYLVANIA (PA)	$799.58	$799.58
PUERTO RICO (PR)	$835.84	$835.84
RHODE ISLAND (RI)	$844.44	$844.44
SOUTH CAROLINA (SC)	$794.68	$794.68
SOUTH DAKOTA** (SD)	$783.78	$783.78
TENNESSEE (TN)	$766.10	$766.10
BRAZORIA (TX)	$816.69	$816.69
DALLAS (TX)	$824.66	$824.66
GALVESTON (TX)	$820.96	$820.96
HOUSTON (TX)	$861.60	$861.60
BEAUMONT (TX)	$795.53	$795.53
FORT WORTH (TX)	$822.05	$822.05
AUSTIN (TX)	$846.13	$846.13
REST OF TEXAS (TX)	$807.56	$807.56
UTAH (UT)	$803.97	$803.97
VIRGINIA (VA)	$805.13	$805.13
VIRGIN ISLANDS (VI)	$835.84	$835.84
VERMONT (VT)	$792.81	$792.81
SEATTLE (KING CNTY) (WA)	$920.77	$920.77
REST OF WASHINGTON (WA)	$839.48	$839.48
WISCONSIN (WI)	$766.67	$766.67
WEST VIRGINIA (WV)	$818.07	$818.07
WYOMING** (WY)	$813.74	$813.74

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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 the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed. These locality-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 (e.g., office) and facility (e.g., hospital) settings, which is why the two amounts can diverge. Because GPCIs vary by locality, the same code can be worth different amounts depending on where the service is billed.

RVUs — work 12, practice expense 10.72 (non-facility) / 10.72 (facility), malpractice 2.22 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on the national conversion factor and standard RVUs — actual payment depends on your specific locality's GPCIs.
Medicare typically pays 80% of the allowed amount after the patient's Part B deductible is met; the beneficiary or secondary insurer is responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the final paid amount.
Always verify the current, locality-specific rate with your Medicare Administrative Contractor (MAC) or the official CMS PFS lookup tool before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The two settings use different practice-expense RVUs, reflecting the fact that overhead costs (equipment, staff, supplies) are generally lower when a procedure is performed in a facility such as a hospital, since the facility itself bills separately for some of those costs.

Is this the amount Medicare will actually pay me?

No. This is a national or locality-estimated allowed amount before adjustments. Final payment depends on your specific GPCI locality, applicable modifiers, sequestration, and any other claim-specific adjustments applied by your MAC.

Why can't you show the CPT code description?

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

How often do these rates change?

The conversion factor and RVUs are updated annually by CMS, and can also be revised mid-year due to legislative or regulatory changes, so figures should be checked each year.

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.