CPT 12004 pays $161.99 in a non-facility setting and $72.15 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $141.95 in Arkansas to $187.20 in Alaska, a 32% spread.
National non-facility rate
$161.99
Office and other outpatient settings
Hospital and ASC settings
Alaska
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 |
|---|---|---|---|
| Alaska | $187.20 | $91.51 | |
| District of Columbia | $184.31 | $78.47 | |
| New York | $180.22 | $79.99 | |
| New Jersey | $178.44 | $77.27 | |
| California | $177.72 | $71.41 | |
| Washington | $175.73 | $73.30 | |
| Massachusetts | $174.47 | $73.53 | |
| Connecticut | $173.27 | $76.50 | |
| Florida | $172.78 | $82.63 | |
| Hawaii | $171.63 | $69.47 | |
| Illinois | $168.68 | $81.87 | |
| Maryland | $167.89 | $74.22 | |
| Colorado | $166.81 | $71.21 | |
| Rhode Island | $165.13 | $72.32 | |
| Oregon | $164.90 | $70.24 | |
| New Hampshire | $164.89 | $71.36 | |
| Puerto Rico | $162.98 | $72.14 | |
| Virgin Islands | $162.98 | $72.14 | |
| Montana | $161.97 | $72.12 | |
| Pennsylvania | $161.04 | $73.03 | |
| Nevada | $160.26 | $70.32 | |
| Michigan | $160.13 | $75.76 | |
| Delaware | $159.86 | $71.09 | |
| Texas | $159.85 | $71.40 | |
| Georgia | $159.44 | $73.72 | |
| Wyoming | $159.13 | $69.28 | |
| Minnesota | $157.26 | $64.80 | |
| Arizona | $157.18 | $70.11 | |
| Virginia | $156.98 | $68.66 | |
| New Mexico | $155.56 | $73.17 | |
| Vermont | $155.51 | $66.56 | |
| North Dakota | $155.45 | $65.60 | |
| South Dakota | $154.68 | $64.83 | |
| Utah | $154.62 | $70.16 | |
| Louisiana | $153.45 | $71.41 | |
| Maine | $153.24 | $67.39 | |
| Missouri | $153.24 | $70.79 | |
| West Virginia | $153.09 | $75.02 | |
| Ohio | $153.02 | $70.98 | |
| South Carolina | $152.42 | $69.40 | |
| North Carolina | $151.03 | $67.20 | |
| Wisconsin | $149.99 | $63.92 | |
| Kentucky | $149.49 | $69.61 | |
| Indiana | $148.72 | $65.43 | |
| Oklahoma | $148.39 | $68.15 | |
| Idaho | $147.85 | $65.19 | |
| Tennessee | $147.41 | $65.74 | |
| Nebraska | $147.11 | $64.18 | |
| Kansas | $146.52 | $65.30 | |
| Iowa | $146.49 | $64.28 | |
| Mississippi | $144.63 | $67.27 | |
| Alabama | $144.18 | $65.57 | |
| Arkansas | $141.95 | $64.78 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates