CPT 78016 pays $251.51 in a non-facility setting and $251.51 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $219.01 in Arkansas to $292.81 in District of Columbia, a 34% spread.
National non-facility rate
$251.51
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 34% 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 | $292.81 | $292.81 | |
| California | $292.17 | $292.17 | |
| Washington | $283.00 | $283.00 | |
| New Jersey | $281.11 | $281.11 | |
| Hawaii | $281.00 | $281.00 | |
| Massachusetts | $279.38 | $279.38 | |
| New York | $279.33 | $279.33 | |
| Alaska | $278.28 | $278.28 | |
| Connecticut | $269.66 | $269.66 | |
| Colorado | $265.55 | $265.55 | |
| Oregon | $262.98 | $262.98 | |
| Maryland | $261.49 | $261.49 | |
| New Hampshire | $260.34 | $260.34 | |
| Rhode Island | $259.10 | $259.10 | |
| Minnesota | $256.31 | $256.31 | |
| Florida | $254.46 | $254.46 | |
| Puerto Rico | $253.92 | $253.92 | |
| Virgin Islands | $253.92 | $253.92 | |
| Montana | $251.50 | $251.50 | |
| Nevada | $251.34 | $251.34 | |
| Wyoming | $250.90 | $250.90 | |
| North Dakota | $250.12 | $250.12 | |
| South Dakota | $249.96 | $249.96 | |
| Delaware | $248.74 | $248.74 | |
| Vermont | $248.13 | $248.13 | |
| Texas | $248.04 | $248.04 | |
| Pennsylvania | $247.35 | $247.35 | |
| Virginia | $247.04 | $247.04 | |
| Illinois | $246.22 | $246.22 | |
| Arizona | $244.28 | $244.28 | |
| Georgia | $241.78 | $241.78 | |
| Maine | $240.74 | $240.74 | |
| Wisconsin | $240.55 | $240.55 | |
| Michigan | $238.89 | $238.89 | |
| Utah | $237.92 | $237.92 | |
| North Carolina | $235.76 | $235.76 | |
| South Carolina | $234.25 | $234.25 | |
| Indiana | $234.07 | $234.07 | |
| New Mexico | $233.52 | $233.52 | |
| Missouri | $233.16 | $233.16 | |
| Nebraska | $232.93 | $232.93 | |
| Idaho | $232.48 | $232.48 | |
| Louisiana | $232.27 | $232.27 | |
| Ohio | $232.17 | $232.17 | |
| Iowa | $231.19 | $231.19 | |
| Tennessee | $230.18 | $230.18 | |
| Kansas | $228.99 | $228.99 | |
| Oklahoma | $227.19 | $227.19 | |
| Kentucky | $226.62 | $226.62 | |
| West Virginia | $223.38 | $223.38 | |
| Alabama | $222.69 | $222.69 | |
| Mississippi | $219.98 | $219.98 | |
| Arkansas | $219.01 | $219.01 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates