CPT 42820 pays $260.86 in a non-facility setting and $260.86 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $236.66 in Arkansas to $327.40 in Alaska, a 38% spread.
National non-facility rate
$260.86
Office and other outpatient settings
Hospital and ASC settings
Alaska
Arkansas · 38% 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 | $327.40 | $327.40 | |
| District of Columbia | $288.99 | $288.99 | |
| New York | $286.46 | $286.46 | |
| New Jersey | $282.65 | $282.65 | |
| Florida | $279.86 | $279.86 | |
| California | $275.80 | $275.80 | |
| Illinois | $275.79 | $275.79 | |
| Connecticut | $275.74 | $275.74 | |
| Washington | $275.57 | $275.57 | |
| Massachusetts | $274.52 | $274.52 | |
| Maryland | $268.59 | $268.59 | |
| Hawaii | $266.80 | $266.80 | |
| Colorado | $264.84 | $264.84 | |
| Rhode Island | $264.77 | $264.77 | |
| New Hampshire | $262.66 | $262.66 | |
| Michigan | $262.55 | $262.55 | |
| Oregon | $262.07 | $262.07 | |
| Puerto Rico | $261.71 | $261.71 | |
| Virgin Islands | $261.71 | $261.71 | |
| Pennsylvania | $261.33 | $261.33 | |
| Montana | $260.82 | $260.82 | |
| Georgia | $260.16 | $260.16 | |
| Texas | $258.60 | $258.60 | |
| Delaware | $258.31 | $258.31 | |
| Nevada | $257.67 | $257.67 | |
| New Mexico | $256.20 | $256.20 | |
| West Virginia | $255.75 | $255.75 | |
| Wyoming | $255.74 | $255.74 | |
| Arizona | $254.80 | $254.80 | |
| Virginia | $253.30 | $253.30 | |
| Louisiana | $252.75 | $252.75 | |
| Utah | $252.62 | $252.62 | |
| Missouri | $252.00 | $252.00 | |
| Ohio | $251.98 | $251.98 | |
| Vermont | $250.09 | $250.09 | |
| South Carolina | $250.01 | $250.01 | |
| Minnesota | $250.00 | $250.00 | |
| North Dakota | $249.16 | $249.16 | |
| Maine | $248.88 | $248.88 | |
| South Dakota | $247.78 | $247.78 | |
| Kentucky | $247.66 | $247.66 | |
| North Carolina | $246.79 | $246.79 | |
| Oklahoma | $245.35 | $245.35 | |
| Indiana | $243.15 | $243.15 | |
| Wisconsin | $242.86 | $242.86 | |
| Tennessee | $242.28 | $242.28 | |
| Idaho | $242.17 | $242.17 | |
| Mississippi | $241.28 | $241.28 | |
| Kansas | $241.11 | $241.11 | |
| Nebraska | $240.61 | $240.61 | |
| Iowa | $240.15 | $240.15 | |
| Alabama | $239.32 | $239.32 | |
| Arkansas | $236.66 | $236.66 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates