CPT 65420

Excision/Transposition Pterygium W/O Graft

CPT 65420 pays $540.43 in a non-facility setting and $334.68 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $480.22 in Arkansas to $631.30 in Alaska, a 31% spread.

National non-facility rate

$540.43

Office and other outpatient settings

Facility rate
$334.68

Hospital and ASC settings

Highest state
$631.30

Alaska

Lowest state
$480.22

Arkansas · 31% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $540.43
CPT 65420 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $540.43, national facility $334.68.
StateRate compared visuallyNon-facilityFacility
Alaska
$631.30$412.17
District of Columbia
$618.26$375.89
California
$611.05$367.59
New Jersey
$597.44$365.76
Washington
$596.58$362.03
New York
$596.07$366.54
Massachusetts
$590.41$359.25
Hawaii
$588.49$354.56
Connecticut
$575.50$353.91
Colorado
$564.32$345.41
Maryland
$559.62$345.12
Oregon
$559.02$342.27
New Hampshire
$554.82$340.64
Rhode Island
$554.62$342.09
Florida
$552.78$346.35
Puerto Rico
$544.51$336.49
Virgin Islands
$544.51$336.49
Minnesota
$543.41$331.70
Montana
$540.40$334.65
Nevada
$538.86$332.91
Illinois
$538.52$339.71
Wyoming
$537.39$331.64
Delaware
$535.31$332.03
Pennsylvania
$534.58$333.05
Texas
$534.38$331.82
North Dakota
$533.48$327.73
South Dakota
$532.66$326.91
Vermont
$530.78$327.09
Virginia
$530.41$328.16
Arizona
$526.75$327.38
Georgia
$525.14$328.86
Michigan
$521.60$328.40
Maine
$518.85$322.25
Wisconsin
$516.09$318.98
Utah
$516.03$322.62
New Mexico
$510.67$322.00
North Carolina
$510.29$318.33
South Carolina
$509.28$319.16
Missouri
$508.40$319.59
Louisiana
$507.33$319.48
Ohio
$506.87$319.02
Indiana
$506.18$315.45
Nebraska
$503.37$313.47
Idaho
$503.32$314.03
Iowa
$500.50$312.24
Tennessee
$499.82$312.79
Kansas
$497.50$311.50
Kentucky
$496.50$313.59
Oklahoma
$496.43$312.70
West Virginia
$494.80$316.00
Alabama
$487.01$306.97
Mississippi
$483.61$306.46
Arkansas
$480.22$303.48

Billed by 1 specialties

Commercial rates for 65420

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates