CPT 42821 pays $272.22 in a non-facility setting and $272.22 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $246.84 in Arkansas to $341.19 in Alaska, a 38% spread.
National non-facility rate
$272.22
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 | $341.19 | $341.19 | |
| District of Columbia | $301.75 | $301.75 | |
| New York | $298.98 | $298.98 | |
| New Jersey | $295.05 | $295.05 | |
| Florida | $291.87 | $291.87 | |
| California | $288.12 | $288.12 | |
| Connecticut | $287.80 | $287.80 | |
| Washington | $287.77 | $287.77 | |
| Illinois | $287.57 | $287.57 | |
| Massachusetts | $286.65 | $286.65 | |
| Maryland | $280.31 | $280.31 | |
| Hawaii | $278.69 | $278.69 | |
| Colorado | $276.49 | $276.49 | |
| Rhode Island | $276.34 | $276.34 | |
| New Hampshire | $274.18 | $274.18 | |
| Michigan | $273.82 | $273.82 | |
| Oregon | $273.60 | $273.60 | |
| Puerto Rico | $273.12 | $273.12 | |
| Virgin Islands | $273.12 | $273.12 | |
| Pennsylvania | $272.65 | $272.65 | |
| Montana | $272.18 | $272.18 | |
| Georgia | $271.38 | $271.38 | |
| Texas | $269.85 | $269.85 | |
| Delaware | $269.55 | $269.55 | |
| Nevada | $268.92 | $268.92 | |
| New Mexico | $267.19 | $267.19 | |
| Wyoming | $266.92 | $266.92 | |
| West Virginia | $266.60 | $266.60 | |
| Arizona | $265.88 | $265.88 | |
| Virginia | $264.36 | $264.36 | |
| Louisiana | $263.61 | $263.61 | |
| Utah | $263.55 | $263.55 | |
| Missouri | $262.85 | $262.85 | |
| Ohio | $262.82 | $262.82 | |
| Minnesota | $261.06 | $261.06 | |
| Vermont | $261.05 | $261.05 | |
| South Carolina | $260.81 | $260.81 | |
| North Dakota | $260.11 | $260.11 | |
| Maine | $259.72 | $259.72 | |
| South Dakota | $258.69 | $258.69 | |
| Kentucky | $258.29 | $258.29 | |
| North Carolina | $257.50 | $257.50 | |
| Oklahoma | $255.92 | $255.92 | |
| Indiana | $253.72 | $253.72 | |
| Wisconsin | $253.50 | $253.50 | |
| Tennessee | $252.78 | $252.78 | |
| Idaho | $252.69 | $252.69 | |
| Mississippi | $251.63 | $251.63 | |
| Kansas | $251.56 | $251.56 | |
| Nebraska | $251.08 | $251.08 | |
| Iowa | $250.59 | $250.59 | |
| Alabama | $249.64 | $249.64 | |
| Arkansas | $246.84 | $246.84 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates