Medicare Reimbursement for CPT 17315

CPT 17315 is a procedure code billed under Medicare Part B; this page shows the Medicare Physician Fee Schedule (PFS) allowed amount for the code at the national level and by locality. Amounts are shown separately for non-facility (e.g., office) and facility (e.g., hospital) settings, since practice expense differs by site of service.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$79.16	$40.08
ALASKA* (AK)	$95.45	$53.83
ALABAMA (AL)	$72.09	$37.90
ARKANSAS (AR)	$71.20	$37.63
ARIZONA (AZ)	$77.32	$39.45
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$100.37	$45.27
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$102.28	$45.93
OXNARD-THOUSAND OAKS-VENTURA (CA)	$87.89	$41.70
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$88.40	$42.17
NAPA (CA)	$95.20	$43.69
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$100.45	$45.35
VALLEJO (CA)	$95.09	$43.58
BAKERSFIELD (CA)	$83.43	$40.60
CHICO (CA)	$83.21	$40.38
FRESNO (CA)	$83.21	$40.38
HANFORD-CORCORAN (CA)	$83.21	$40.38
MADERA (CA)	$83.21	$40.38
MERCED (CA)	$83.21	$40.38
MODESTO (CA)	$83.21	$40.38
REDDING (CA)	$83.21	$40.38
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$83.98	$41.15
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$86.99	$41.54
SALINAS (CA)	$86.66	$41.36
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$102.60	$46.25
SANTA CRUZ-WATSONVILLE (CA)	$89.08	$41.60
SANTA ROSA-PETALUMA (CA)	$89.97	$41.98
STOCKTON (CA)	$83.21	$40.38
VISALIA (CA)	$83.21	$40.38
YUBA CITY (CA)	$83.21	$40.38
EL CENTRO (CA)	$83.22	$40.39
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$88.43	$41.70
SAN LUIS OBISPO-PASO ROBLES (CA)	$85.29	$40.78
SANTA MARIA-SANTA BARBARA (CA)	$86.91	$41.34
REST OF CALIFORNIA (CA)	$83.21	$40.38
COLORADO (CO)	$82.09	$40.51
CONNECTICUT (CT)	$83.95	$41.86
DC + MD/VA SUBURBS (DC)	$89.58	$43.54
DELAWARE (DE)	$78.48	$39.87
FORT LAUDERDALE (FL)	$81.68	$42.09
MIAMI (FL)	$84.72	$44.04
REST OF FLORIDA (FL)	$78.21	$40.85
ATLANTA (GA)	$80.49	$40.79
REST OF GEORGIA (GA)	$74.38	$39.52
HAWAII, GUAM (HI)	$84.81	$40.38
IOWA (IA)	$73.63	$37.88
IDAHO (ID)	$74.05	$38.10
EAST ST. LOUIS (IL)	$77.66	$41.70
SUBURBAN CHICAGO (IL)	$82.47	$42.34
CHICAGO (IL)	$82.63	$43.35
REST OF ILLINOIS (IL)	$76.26	$40.58
INDIANA (IN)	$74.42	$38.20
KANSAS (KS)	$73.35	$38.02
KENTUCKY (KY)	$73.59	$38.84
NEW ORLEANS (LA)	$76.62	$39.85
REST OF LOUISIANA (LA)	$73.49	$38.91
METROPOLITAN BOSTON (MA)	$89.46	$42.80
REST OF MASSACHUSETTS (MA)	$81.71	$40.56
BALTIMORE/SURR. CNTYS (MD)	$83.70	$41.77
REST OF MARYLAND (MD)	$79.83	$40.29
SOUTHERN MAINE (ME)	$77.86	$39.13
REST OF MAINE (ME)	$74.40	$38.45
DETROIT (MI)	$79.07	$41.36
REST OF MICHIGAN (MI)	$75.25	$39.57
MINNESOTA (MN)	$78.92	$38.71
METROPOLITAN ST. LOUIS (MO)	$76.84	$39.64
METROPOLITAN KANSAS CITY (MO)	$76.15	$39.46
REST OF MISSOURI (MO)	$72.42	$38.73
MISSISSIPPI (MS)	$71.82	$38.17
MONTANA** (MT)	$79.16	$40.08
NORTH CAROLINA (NC)	$75.07	$38.61
NORTH DAKOTA** (ND)	$77.77	$38.69
NEBRASKA (NE)	$73.98	$37.91
NEW HAMPSHIRE (NH)	$80.85	$40.17
NORTHERN NJ (NJ)	$88.86	$43.53
REST OF NEW JERSEY (NJ)	$84.98	$42.30
NEW MEXICO (NM)	$75.61	$39.77
NEVADA** (NV)	$78.82	$39.70
MANHATTAN (NY)	$90.19	$44.78
NYC SUBURBS/LONG ISLAND (NY)	$92.13	$45.67
POUGHKPSIE/N NYC SUBURBS (NY)	$85.53	$42.74
QUEENS (NY)	$90.83	$44.63
REST OF NEW YORK (NY)	$76.04	$38.92
OHIO (OH)	$74.97	$39.29
OKLAHOMA (OK)	$73.46	$38.56
PORTLAND (OR)	$84.39	$40.97
REST OF OREGON (OR)	$78.27	$39.35
METROPOLITAN PHILADELPHIA (PA)	$82.11	$41.43
REST OF PENNSYLVANIA (PA)	$75.06	$39.19
PUERTO RICO (PR)	$79.66	$40.15
RHODE ISLAND (RI)	$81.05	$40.68
SOUTH CAROLINA (SC)	$75.13	$39.02
SOUTH DAKOTA** (SD)	$77.61	$38.53
TENNESSEE (TN)	$73.67	$38.15
BRAZORIA (TX)	$78.44	$39.71
DALLAS (TX)	$78.89	$39.97
GALVESTON (TX)	$78.65	$39.84
HOUSTON (TX)	$79.93	$41.12
BEAUMONT (TX)	$74.64	$39.07
FORT WORTH (TX)	$78.44	$39.90
AUSTIN (TX)	$81.76	$40.41
REST OF TEXAS (TX)	$76.46	$39.38
UTAH (UT)	$76.02	$39.28
VIRGINIA (VA)	$77.65	$39.23
VIRGIN ISLANDS (VI)	$79.66	$40.15
VERMONT (VT)	$77.52	$38.83
SEATTLE (KING CNTY) (WA)	$91.15	$43.20
REST OF WASHINGTON (WA)	$81.54	$40.39
WISCONSIN (WI)	$75.51	$38.07
WEST VIRGINIA (WV)	$73.82	$39.86
WYOMING** (WY)	$78.55	$39.47

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 15 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 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. The geographically adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility rates differ mainly in the practice-expense component, since overhead costs assumed for an independent office differ from those in a hospital or ambulatory surgical center where the facility absorbs some costs. Because GPCIs vary by locality and the conversion factor is updated annually, the same code can price differently from year to year and place to place.

RVUs — work 0.85, practice expense 1.45 (non-facility) / 0.28 (facility), malpractice 0.07 — × 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 beneficiary's deductible is met; the patient or secondary insurer is generally responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates can shift amounts even if RVUs stay the same.
Always confirm the specific allowed amount and coverage rules with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount for this code?

The practice-expense RVU is lower in the facility setting because the facility (such as a hospital) bears some of the overhead costs, while in a non-facility setting like an office, the billing provider absorbs those costs.

Why might the amount I was paid differ from the fee schedule amount shown here?

Actual payment can vary due to the beneficiary's deductible status, applied modifiers, multiple-procedure payment reductions, sequestration, and locality-specific GPCI adjustments.

Does this fee schedule amount apply to all Medicare plans?

This reflects Original Medicare Part B's Physician Fee Schedule. Medicare Advantage plans may use different negotiated rates or payment methodologies.

How often does this amount change?

The conversion factor and RVUs are typically updated annually, and GPCIs are reviewed periodically, so the allowed amount for this code can change from year to 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.