Medicare Reimbursement for CPT 22015

This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this procedure code, both nationally and adjusted for your local area. Because this is a CPT code, the official AMA procedure descriptor is not reproduced here, but the pricing logic applies the same way regardless of code type. Amounts are shown for non-facility and facility settings, which can differ depending on where the service is performed.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$921.86	$921.86
ALASKA* (AK)	$1098.64	$1098.64
ALABAMA (AL)	$820.71	$820.71
ARKANSAS (AR)	$808.31	$808.31
ARIZONA (AZ)	$892.38	$892.38
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1051.11	$1051.11
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1066.36	$1066.36
OXNARD-THOUSAND OAKS-VENTURA (CA)	$958.68	$958.68
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$969.38	$969.38
NAPA (CA)	$1012.15	$1012.15
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1055.22	$1055.22
VALLEJO (CA)	$1006.22	$1006.22
BAKERSFIELD (CA)	$919.79	$919.79
CHICO (CA)	$910.15	$910.15
FRESNO (CA)	$910.15	$910.15
HANFORD-CORCORAN (CA)	$910.15	$910.15
MADERA (CA)	$910.15	$910.15
MERCED (CA)	$910.15	$910.15
MODESTO (CA)	$910.15	$910.15
REDDING (CA)	$910.15	$910.15
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$948.89	$948.89
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$944.06	$944.06
SALINAS (CA)	$940.44	$940.44
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1083.17	$1083.17
SANTA CRUZ-WATSONVILLE (CA)	$958.14	$958.14
SANTA ROSA-PETALUMA (CA)	$966.90	$966.90
STOCKTON (CA)	$910.15	$910.15
VISALIA (CA)	$910.15	$910.15
YUBA CITY (CA)	$910.15	$910.15
EL CENTRO (CA)	$910.75	$910.75
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$955.17	$955.17
SAN LUIS OBISPO-PASO ROBLES (CA)	$926.89	$926.89
SANTA MARIA-SANTA BARBARA (CA)	$941.93	$941.93
REST OF CALIFORNIA (CA)	$910.15	$910.15
COLORADO (CO)	$925.25	$925.25
CONNECTICUT (CT)	$985.47	$985.47
DC + MD/VA SUBURBS (DC)	$1027.07	$1027.07
DELAWARE (DE)	$907.04	$907.04
FORT LAUDERDALE (FL)	$1024.62	$1024.62
MIAMI (FL)	$1122.71	$1122.71
REST OF FLORIDA (FL)	$965.55	$965.55
ATLANTA (GA)	$953.63	$953.63
REST OF GEORGIA (GA)	$903.02	$903.02
HAWAII, GUAM (HI)	$924.32	$924.32
IOWA (IA)	$815.85	$815.85
IDAHO (ID)	$826.99	$826.99
EAST ST. LOUIS (IL)	$1013.31	$1013.31
SUBURBAN CHICAGO (IL)	$1028.60	$1028.60
CHICAGO (IL)	$1083.27	$1083.27
REST OF ILLINOIS (IL)	$956.06	$956.06
INDIANA (IN)	$831.29	$831.29
KANSAS (KS)	$824.51	$824.51
KENTUCKY (KY)	$868.36	$868.36
NEW ORLEANS (LA)	$915.33	$915.33
REST OF LOUISIANA (LA)	$872.00	$872.00
METROPOLITAN BOSTON (MA)	$1000.99	$1000.99
REST OF MASSACHUSETTS (MA)	$924.54	$924.54
BALTIMORE/SURR. CNTYS (MD)	$985.53	$985.53
REST OF MARYLAND (MD)	$920.74	$920.74
SOUTHERN MAINE (ME)	$873.74	$873.74
REST OF MAINE (ME)	$845.00	$845.00
DETROIT (MI)	$991.18	$991.18
REST OF MICHIGAN (MI)	$903.58	$903.58
MINNESOTA (MN)	$848.04	$848.04
METROPOLITAN ST. LOUIS (MO)	$903.41	$903.41
METROPOLITAN KANSAS CITY (MO)	$895.33	$895.33
REST OF MISSOURI (MO)	$864.98	$864.98
MISSISSIPPI (MS)	$836.17	$836.17
MONTANA** (MT)	$921.62	$921.62
NORTH CAROLINA (NC)	$852.12	$852.12
NORTH DAKOTA** (ND)	$850.04	$850.04
NEBRASKA (NE)	$816.67	$816.67
NEW HAMPSHIRE (NH)	$922.72	$922.72
NORTHERN NJ (NJ)	$1018.32	$1018.32
REST OF NEW JERSEY (NJ)	$985.88	$985.88
NEW MEXICO (NM)	$913.84	$913.84
NEVADA** (NV)	$902.06	$902.06
MANHATTAN (NY)	$1082.15	$1082.15
NYC SUBURBS/LONG ISLAND (NY)	$1125.43	$1125.43
POUGHKPSIE/N NYC SUBURBS (NY)	$1002.77	$1002.77
QUEENS (NY)	$1072.52	$1072.52
REST OF NEW YORK (NY)	$866.48	$866.48
OHIO (OH)	$888.95	$888.95
OKLAHOMA (OK)	$853.23	$853.23
PORTLAND (OR)	$940.72	$940.72
REST OF OREGON (OR)	$884.40	$884.40
METROPOLITAN PHILADELPHIA (PA)	$968.58	$968.58
REST OF PENNSYLVANIA (PA)	$883.28	$883.28
PUERTO RICO (PR)	$924.34	$924.34
RHODE ISLAND (RI)	$929.48	$929.48
SOUTH CAROLINA (SC)	$874.13	$874.13
SOUTH DAKOTA** (SD)	$841.58	$841.58
TENNESSEE (TN)	$830.44	$830.44
BRAZORIA (TX)	$895.05	$895.05
DALLAS (TX)	$906.84	$906.84
GALVESTON (TX)	$901.63	$901.63
HOUSTON (TX)	$967.89	$967.89
BEAUMONT (TX)	$878.23	$878.23
FORT WORTH (TX)	$904.52	$904.52
AUSTIN (TX)	$931.49	$931.49
REST OF TEXAS (TX)	$890.27	$890.27
UTAH (UT)	$886.16	$886.16
VIRGINIA (VA)	$879.70	$879.70
VIRGIN ISLANDS (VI)	$924.34	$924.34
VERMONT (VT)	$858.24	$858.24
SEATTLE (KING CNTY) (WA)	$1008.72	$1008.72
REST OF WASHINGTON (WA)	$918.96	$918.96
WISCONSIN (WI)	$821.84	$821.84
WEST VIRGINIA (WV)	$922.96	$922.96
WYOMING** (WY)	$890.43	$890.43

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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

Medicare pricing starts with three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice risk. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed, accounting for regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice expense RVUs often differ between non-facility (e.g., physician office) and facility (e.g., hospital) settings, which is why the two amounts can vary — though for some codes, as with this one, they may be the same.

RVUs — work 12.32, practice expense 11.66 (non-facility) / 11.66 (facility), malpractice 3.62 — × 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 insurer is responsible for the remainder.
Actual payment can vary due to modifiers, place-of-service rules, sequestration reductions, and annual budget-neutrality adjustments.
Localities use different GPICs, so the same code can price differently across regions.
Always verify the final allowed amount and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why are the non-facility and facility amounts sometimes the same?

When the practice expense RVU is identical for both settings, the calculated allowed amount will also be the same, even though Medicare still tracks them as separate rates.

Does this amount reflect what the patient will actually owe?

No. This figure is the Medicare-allowed amount before cost-sharing. Patients typically owe 20% coinsurance after the deductible, subject to secondary coverage.

Why might my MAC's actual payment differ from this estimate?

Local coverage determinations, claim-specific modifiers, sequestration, and mid-year adjustments to the conversion factor or RVUs can all cause the final payment to differ from the estimate shown here.

Is this the same amount for every state?

No. The GPICs applied to the RVUs vary by locality, so the final allowed amount can differ across different parts of the country even for the same code.

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.