CPT 43242 pays $229.80 in a non-facility setting and $229.80 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $213.48 in Arkansas to $303.30 in Alaska, a 42% spread.
National non-facility rate
$229.80
Office and other outpatient settings
Hospital and ASC settings
Alaska
Arkansas · 42% 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 | $303.30 | $303.30 | |
| District of Columbia | $250.55 | $250.55 | |
| New York | $249.85 | $249.85 | |
| New Jersey | $246.57 | $246.57 | |
| Florida | $245.49 | $245.49 | |
| Illinois | $243.24 | $243.24 | |
| Connecticut | $240.89 | $240.89 | |
| Washington | $239.52 | $239.52 | |
| Massachusetts | $238.97 | $238.97 | |
| California | $238.72 | $238.72 | |
| Maryland | $235.60 | $235.60 | |
| Rhode Island | $232.92 | $232.92 | |
| Michigan | $232.84 | $232.84 | |
| Colorado | $231.87 | $231.87 | |
| Pennsylvania | $231.09 | $231.09 | |
| Hawaii | $231.05 | $231.05 | |
| Georgia | $230.51 | $230.51 | |
| Puerto Rico | $230.21 | $230.21 | |
| Virgin Islands | $230.21 | $230.21 | |
| New Hampshire | $230.19 | $230.19 | |
| Montana | $229.77 | $229.77 | |
| Oregon | $229.69 | $229.69 | |
| West Virginia | $229.06 | $229.06 | |
| Texas | $228.56 | $228.56 | |
| Delaware | $228.20 | $228.20 | |
| New Mexico | $228.15 | $228.15 | |
| Nevada | $227.12 | $227.12 | |
| Arizona | $225.60 | $225.60 | |
| Wyoming | $225.54 | $225.54 | |
| Louisiana | $225.39 | $225.39 | |
| Ohio | $224.76 | $224.76 | |
| Missouri | $224.65 | $224.65 | |
| Utah | $224.56 | $224.56 | |
| Virginia | $223.98 | $223.98 | |
| South Carolina | $222.82 | $222.82 | |
| Kentucky | $221.81 | $221.81 | |
| Vermont | $221.12 | $221.12 | |
| Maine | $221.04 | $221.04 | |
| North Dakota | $220.08 | $220.08 | |
| Minnesota | $220.00 | $220.00 | |
| North Carolina | $219.91 | $219.91 | |
| Oklahoma | $219.79 | $219.79 | |
| South Dakota | $218.93 | $218.93 | |
| Mississippi | $217.26 | $217.26 | |
| Indiana | $217.05 | $217.05 | |
| Tennessee | $216.81 | $216.81 | |
| Idaho | $216.42 | $216.42 | |
| Wisconsin | $215.98 | $215.98 | |
| Kansas | $215.97 | $215.97 | |
| Alabama | $215.26 | $215.26 | |
| Nebraska | $215.04 | $215.04 | |
| Iowa | $214.88 | $214.88 | |
| Arkansas | $213.48 | $213.48 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates