CPT 78469 pays $203.75 in a non-facility setting and $203.75 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $178.34 in Arkansas to $236.11 in District of Columbia, a 32% spread.
National non-facility rate
$203.75
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 32% 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 | $236.11 | $236.11 | |
| California | $234.94 | $234.94 | |
| Alaska | $228.69 | $228.69 | |
| Washington | $228.07 | $228.07 | |
| New Jersey | $227.06 | $227.06 | |
| Hawaii | $226.05 | $226.05 | |
| New York | $225.90 | $225.90 | |
| Massachusetts | $225.30 | $225.30 | |
| Connecticut | $218.08 | $218.08 | |
| Colorado | $214.47 | $214.47 | |
| Oregon | $212.40 | $212.40 | |
| Maryland | $211.61 | $211.61 | |
| New Hampshire | $210.42 | $210.42 | |
| Rhode Island | $209.67 | $209.67 | |
| Florida | $206.85 | $206.85 | |
| Minnesota | $206.82 | $206.82 | |
| Puerto Rico | $205.59 | $205.59 | |
| Virgin Islands | $205.59 | $205.59 | |
| Montana | $203.74 | $203.74 | |
| Nevada | $203.47 | $203.47 | |
| Wyoming | $203.05 | $203.05 | |
| North Dakota | $202.16 | $202.16 | |
| South Dakota | $201.97 | $201.97 | |
| Delaware | $201.57 | $201.57 | |
| Texas | $201.07 | $201.07 | |
| Vermont | $200.72 | $200.72 | |
| Pennsylvania | $200.69 | $200.69 | |
| Illinois | $200.51 | $200.51 | |
| Virginia | $200.05 | $200.05 | |
| Arizona | $198.06 | $198.06 | |
| Georgia | $196.45 | $196.45 | |
| Maine | $195.14 | $195.14 | |
| Wisconsin | $194.71 | $194.71 | |
| Michigan | $194.40 | $194.40 | |
| Utah | $193.21 | $193.21 | |
| North Carolina | $191.32 | $191.32 | |
| South Carolina | $190.35 | $190.35 | |
| New Mexico | $190.09 | $190.09 | |
| Indiana | $189.89 | $189.89 | |
| Missouri | $189.62 | $189.62 | |
| Louisiana | $188.99 | $188.99 | |
| Nebraska | $188.92 | $188.92 | |
| Ohio | $188.89 | $188.89 | |
| Idaho | $188.66 | $188.66 | |
| Iowa | $187.60 | $187.60 | |
| Tennessee | $186.95 | $186.95 | |
| Kansas | $186.00 | $186.00 | |
| Oklahoma | $184.85 | $184.85 | |
| Kentucky | $184.54 | $184.54 | |
| West Virginia | $182.49 | $182.49 | |
| Alabama | $181.21 | $181.21 | |
| Mississippi | $179.28 | $179.28 | |
| Arkansas | $178.34 | $178.34 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates