Medicare Reimbursement for CPT 23415

This page covers CPT code 23415, a physician procedure code reported under Medicare Part B. It shows the Medicare Physician Fee Schedule (PFS) allowed amount nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$658.33	$658.33
ALASKA* (AK)	$800.13	$800.13
ALABAMA (AL)	$594.52	$594.52
ARKANSAS (AR)	$586.64	$586.64
ARIZONA (AZ)	$640.26	$640.26
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$772.69	$772.69
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$784.94	$784.94
OXNARD-THOUSAND OAKS-VENTURA (CA)	$697.31	$697.31
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$704.05	$704.05
NAPA (CA)	$740.97	$740.97
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$774.79	$774.79
VALLEJO (CA)	$737.95	$737.95
BAKERSFIELD (CA)	$668.29	$668.29
CHICO (CA)	$663.18	$663.18
FRESNO (CA)	$663.18	$663.18
HANFORD-CORCORAN (CA)	$663.18	$663.18
MADERA (CA)	$663.18	$663.18
MERCED (CA)	$663.18	$663.18
MODESTO (CA)	$663.18	$663.18
REDDING (CA)	$663.18	$663.18
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$683.07	$683.07
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$688.72	$688.72
SALINAS (CA)	$686.03	$686.03
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$793.53	$793.53
SANTA CRUZ-WATSONVILLE (CA)	$699.60	$699.60
SANTA ROSA-PETALUMA (CA)	$706.15	$706.15
STOCKTON (CA)	$663.18	$663.18
VISALIA (CA)	$663.18	$663.18
YUBA CITY (CA)	$663.18	$663.18
EL CENTRO (CA)	$663.49	$663.49
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$697.05	$697.05
SAN LUIS OBISPO-PASO ROBLES (CA)	$675.91	$675.91
SANTA MARIA-SANTA BARBARA (CA)	$687.20	$687.20
REST OF CALIFORNIA (CA)	$663.18	$663.18
COLORADO (CO)	$667.35	$667.35
CONNECTICUT (CT)	$700.11	$700.11
DC + MD/VA SUBURBS (DC)	$734.22	$734.22
DELAWARE (DE)	$650.04	$650.04
FORT LAUDERDALE (FL)	$712.11	$712.11
MIAMI (FL)	$764.94	$764.94
REST OF FLORIDA (FL)	$676.39	$676.39
ATLANTA (GA)	$676.39	$676.39
REST OF GEORGIA (GA)	$638.24	$638.24
HAWAII, GUAM (HI)	$672.86	$672.86
IOWA (IA)	$595.92	$595.92
IDAHO (ID)	$602.09	$602.09
EAST ST. LOUIS (IL)	$697.31	$697.31
SUBURBAN CHICAGO (IL)	$716.13	$716.13
CHICAGO (IL)	$741.94	$741.94
REST OF ILLINOIS (IL)	$667.37	$667.37
INDIANA (IN)	$604.97	$604.97
KANSAS (KS)	$599.27	$599.27
KENTUCKY (KY)	$620.23	$620.23
NEW ORLEANS (LA)	$649.28	$649.28
REST OF LOUISIANA (LA)	$621.70	$621.70
METROPOLITAN BOSTON (MA)	$721.27	$721.27
REST OF MASSACHUSETTS (MA)	$666.28	$666.28
BALTIMORE/SURR. CNTYS (MD)	$699.39	$699.39
REST OF MARYLAND (MD)	$659.82	$659.82
SOUTHERN MAINE (ME)	$632.87	$632.87
REST OF MAINE (ME)	$611.30	$611.30
DETROIT (MI)	$690.36	$690.36
REST OF MICHIGAN (MI)	$640.56	$640.56
MINNESOTA (MN)	$623.41	$623.41
METROPOLITAN ST. LOUIS (MO)	$644.25	$644.25
METROPOLITAN KANSAS CITY (MO)	$638.86	$638.86
REST OF MISSOURI (MO)	$615.89	$615.89
MISSISSIPPI (MS)	$601.07	$601.07
MONTANA** (MT)	$658.21	$658.21
NORTH CAROLINA (NC)	$616.20	$616.20
NORTH DAKOTA** (ND)	$621.63	$621.63
NEBRASKA (NE)	$597.11	$597.11
NEW HAMPSHIRE (NH)	$662.74	$662.74
NORTHERN NJ (NJ)	$728.82	$728.82
REST OF NEW JERSEY (NJ)	$703.58	$703.58
NEW MEXICO (NM)	$646.19	$646.19
NEVADA** (NV)	$648.31	$648.31
MANHATTAN (NY)	$761.72	$761.72
NYC SUBURBS/LONG ISLAND (NY)	$786.46	$786.46
POUGHKPSIE/N NYC SUBURBS (NY)	$712.95	$712.95
QUEENS (NY)	$758.74	$758.74
REST OF NEW YORK (NY)	$625.18	$625.18
OHIO (OH)	$633.08	$633.08
OKLAHOMA (OK)	$612.89	$612.89
PORTLAND (OR)	$680.17	$680.17
REST OF OREGON (OR)	$638.80	$638.80
METROPOLITAN PHILADELPHIA (PA)	$687.80	$687.80
REST OF PENNSYLVANIA (PA)	$630.67	$630.67
PUERTO RICO (PR)	$660.66	$660.66
RHODE ISLAND (RI)	$667.14	$667.14
SOUTH CAROLINA (SC)	$626.57	$626.57
SOUTH DAKOTA** (SD)	$617.30	$617.30
TENNESSEE (TN)	$602.79	$602.79
BRAZORIA (TX)	$644.48	$644.48
DALLAS (TX)	$651.08	$651.08
GALVESTON (TX)	$648.04	$648.04
HOUSTON (TX)	$681.90	$681.90
BEAUMONT (TX)	$627.31	$627.31
FORT WORTH (TX)	$648.92	$648.92
AUSTIN (TX)	$669.05	$669.05
REST OF TEXAS (TX)	$637.25	$637.25
UTAH (UT)	$634.27	$634.27
VIRGINIA (VA)	$635.13	$635.13
VIRGIN ISLANDS (VI)	$660.66	$660.66
VERMONT (VT)	$624.85	$624.85
SEATTLE (KING CNTY) (WA)	$729.23	$729.23
REST OF WASHINGTON (WA)	$663.16	$663.16
WISCONSIN (WI)	$603.14	$603.14
WEST VIRGINIA (WV)	$646.20	$646.20
WYOMING** (WY)	$642.27	$642.27

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. 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 — assigned to this procedure code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility rates can differ because practice-expense RVUs are typically higher in non-facility settings, where the practice bears more of the overhead costs; for this code those settings share the same practice-expense value shown here.

RVUs — work 9, practice expense 8.86 (non-facility) / 8.86 (facility), malpractice 1.85 — × 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 patient meets their Part B deductible; the patient or secondary payer is responsible for the remainder.
Actual payment can vary with modifiers, place of service, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments.
GPCI values and the conversion factor can change year to year, altering the final amount.
Always verify the exact allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why does the allowed amount differ by locality?

Each locality has its own GPCI values for work, practice expense, and malpractice, which adjust the national RVUs to reflect local cost-of-living and practice cost differences.

Why are non-facility and facility amounts sometimes different?

Practice-expense RVUs are usually higher in non-facility settings because the billing practice covers overhead costs that a facility would otherwise absorb when the service is performed there.

Does this amount reflect what the patient will owe?

No. This is the Medicare-allowed amount before cost-sharing; after the deductible is met, Medicare generally pays 80%, leaving the patient or secondary insurance responsible for the remaining 20%.

Can modifiers change this amount?

Yes. Modifiers (e.g., for bilateral procedures, reduced services, or assistant surgeons) can increase or decrease the final payment relative to the base PFS amount shown here.

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.