CPT 78013 pays $166.00 in a non-facility setting and $166.00 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $143.72 in Arkansas to $193.95 in District of Columbia, a 35% spread.
National non-facility rate
$166.00
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 35% 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 |
|---|---|---|---|
| District of Columbia | $193.95 | $193.95 | |
| California | $193.58 | $193.58 | |
| Washington | $187.35 | $187.35 | |
| Hawaii | $186.17 | $186.17 | |
| New Jersey | $185.95 | $185.95 | |
| Massachusetts | $184.89 | $184.89 | |
| New York | $184.78 | $184.78 | |
| Alaska | $181.16 | $181.16 | |
| Connecticut | $178.32 | $178.32 | |
| Colorado | $175.53 | $175.53 | |
| Oregon | $173.79 | $173.79 | |
| Maryland | $172.76 | $172.76 | |
| New Hampshire | $172.04 | $172.04 | |
| Rhode Island | $171.08 | $171.08 | |
| Minnesota | $169.24 | $169.24 | |
| Florida | $168.09 | $168.09 | |
| Puerto Rico | $167.65 | $167.65 | |
| Virgin Islands | $167.65 | $167.65 | |
| Montana | $166.00 | $166.00 | |
| Nevada | $165.88 | $165.88 | |
| Wyoming | $165.57 | $165.57 | |
| North Dakota | $165.01 | $165.01 | |
| South Dakota | $164.89 | $164.89 | |
| Delaware | $164.07 | $164.07 | |
| Vermont | $163.65 | $163.65 | |
| Texas | $163.59 | $163.59 | |
| Pennsylvania | $163.10 | $163.10 | |
| Virginia | $162.92 | $162.92 | |
| Illinois | $162.43 | $162.43 | |
| Arizona | $161.04 | $161.04 | |
| Georgia | $159.34 | $159.34 | |
| Maine | $158.60 | $158.60 | |
| Wisconsin | $158.45 | $158.45 | |
| Michigan | $157.39 | $157.39 | |
| Utah | $156.69 | $156.69 | |
| North Carolina | $155.19 | $155.19 | |
| South Carolina | $154.18 | $154.18 | |
| Indiana | $154.03 | $154.03 | |
| New Mexico | $153.70 | $153.70 | |
| Missouri | $153.44 | $153.44 | |
| Nebraska | $153.24 | $153.24 | |
| Idaho | $152.94 | $152.94 | |
| Louisiana | $152.83 | $152.83 | |
| Ohio | $152.77 | $152.77 | |
| Iowa | $152.05 | $152.05 | |
| Tennessee | $151.37 | $151.37 | |
| Kansas | $150.55 | $150.55 | |
| Oklahoma | $149.33 | $149.33 | |
| Kentucky | $148.95 | $148.95 | |
| West Virginia | $146.77 | $146.77 | |
| Alabama | $146.24 | $146.24 | |
| Mississippi | $144.40 | $144.40 | |
| Arkansas | $143.72 | $143.72 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates