CPT 42831 pays $212.76 in a non-facility setting and $212.76 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $191.07 in Arkansas to $259.54 in Alaska, a 36% spread.
National non-facility rate
$212.76
Office and other outpatient settings
Hospital and ASC settings
Alaska
Arkansas · 36% 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 | $259.54 | $259.54 | |
| District of Columbia | $238.42 | $238.42 | |
| New York | $234.38 | $234.38 | |
| New Jersey | $232.17 | $232.17 | |
| California | $229.70 | $229.70 | |
| Washington | $227.93 | $227.93 | |
| Massachusetts | $226.60 | $226.60 | |
| Florida | $225.77 | $225.77 | |
| Connecticut | $225.71 | $225.71 | |
| Hawaii | $221.92 | $221.92 | |
| Illinois | $221.61 | $221.61 | |
| Maryland | $219.57 | $219.57 | |
| Colorado | $217.84 | $217.84 | |
| Rhode Island | $216.62 | $216.62 | |
| Oregon | $215.57 | $215.57 | |
| New Hampshire | $215.52 | $215.52 | |
| Puerto Rico | $213.75 | $213.75 | |
| Virgin Islands | $213.75 | $213.75 | |
| Montana | $212.74 | $212.74 | |
| Pennsylvania | $212.30 | $212.30 | |
| Michigan | $211.63 | $211.63 | |
| Nevada | $210.64 | $210.64 | |
| Texas | $210.64 | $210.64 | |
| Delaware | $210.58 | $210.58 | |
| Georgia | $210.56 | $210.56 | |
| Wyoming | $209.29 | $209.29 | |
| Arizona | $207.50 | $207.50 | |
| Virginia | $207.00 | $207.00 | |
| Minnesota | $206.49 | $206.49 | |
| New Mexico | $206.49 | $206.49 | |
| Vermont | $205.08 | $205.08 | |
| Utah | $204.93 | $204.93 | |
| North Dakota | $204.83 | $204.83 | |
| West Virginia | $204.39 | $204.39 | |
| Louisiana | $204.01 | $204.01 | |
| South Dakota | $203.89 | $203.89 | |
| Missouri | $203.67 | $203.67 | |
| Ohio | $203.48 | $203.48 | |
| Maine | $202.97 | $202.97 | |
| South Carolina | $202.56 | $202.56 | |
| North Carolina | $200.71 | $200.71 | |
| Kentucky | $199.65 | $199.65 | |
| Wisconsin | $198.99 | $198.99 | |
| Oklahoma | $198.24 | $198.24 | |
| Indiana | $198.02 | $198.02 | |
| Idaho | $197.09 | $197.09 | |
| Tennessee | $196.76 | $196.76 | |
| Nebraska | $196.15 | $196.15 | |
| Kansas | $195.78 | $195.78 | |
| Iowa | $195.54 | $195.54 | |
| Mississippi | $194.28 | $194.28 | |
| Alabama | $193.48 | $193.48 | |
| Arkansas | $191.07 | $191.07 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates