CPT 11055 pays $70.14 in a non-facility setting and $13.69 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $61.51 in Arkansas to $81.15 in District of Columbia, a 32% spread.
National non-facility rate
$70.14
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 32% spread
53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.
| State | Rate compared visually | Non-facility | Facility |
|---|---|---|---|
| District of Columbia | $81.15 | $14.66 | |
| California | $80.68 | $13.89 | |
| Alaska | $79.13 | $19.01 | |
| Washington | $78.38 | $14.03 | |
| New Jersey | $78.09 | $14.53 | |
| New York | $77.72 | $14.75 | |
| Hawaii | $77.64 | $13.46 | |
| Massachusetts | $77.44 | $14.03 | |
| Connecticut | $75.03 | $14.23 | |
| Colorado | $73.76 | $13.70 | |
| Oregon | $73.05 | $13.58 | |
| Maryland | $72.82 | $13.98 | |
| New Hampshire | $72.39 | $13.62 | |
| Rhode Island | $72.16 | $13.85 | |
| Florida | $71.28 | $14.65 | |
| Minnesota | $71.11 | $13.03 | |
| Puerto Rico | $70.76 | $13.69 | |
| Virgin Islands | $70.76 | $13.69 | |
| Montana | $70.14 | $13.69 | |
| Nevada | $70.03 | $13.53 | |
| Wyoming | $69.88 | $13.43 | |
| North Dakota | $69.55 | $13.10 | |
| South Dakota | $69.48 | $13.03 | |
| Delaware | $69.40 | $13.63 | |
| Texas | $69.24 | $13.66 | |
| Illinois | $69.14 | $14.60 | |
| Pennsylvania | $69.13 | $13.84 | |
| Vermont | $69.07 | $13.19 | |
| Virginia | $68.86 | $13.38 | |
| Arizona | $68.21 | $13.51 | |
| Georgia | $67.70 | $13.85 | |
| Maine | $67.20 | $13.26 | |
| Michigan | $67.03 | $14.02 | |
| Wisconsin | $67.02 | $12.94 | |
| Utah | $66.57 | $13.51 | |
| North Carolina | $65.91 | $13.24 | |
| South Carolina | $65.60 | $13.44 | |
| New Mexico | $65.55 | $13.78 | |
| Indiana | $65.41 | $13.08 | |
| Missouri | $65.37 | $13.57 | |
| Louisiana | $65.16 | $13.63 | |
| Ohio | $65.12 | $13.59 | |
| Nebraska | $65.07 | $12.97 | |
| Idaho | $64.99 | $13.06 | |
| Iowa | $64.63 | $12.98 | |
| Tennessee | $64.42 | $13.11 | |
| Kansas | $64.10 | $13.07 | |
| Oklahoma | $63.74 | $13.33 | |
| Kentucky | $63.64 | $13.46 | |
| West Virginia | $63.00 | $13.95 | |
| Alabama | $62.48 | $13.09 | |
| Mississippi | $61.85 | $13.25 | |
| Arkansas | $61.51 | $13.02 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates