CPT 91038 pays $445.90 in a non-facility setting and $445.90 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $387.29 in Arkansas to $520.54 in District of Columbia, a 34% spread.
National non-facility rate
$445.90
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 | $520.54 | $520.54 | |
| California | $520.50 | $520.50 | |
| Washington | $503.40 | $503.40 | |
| Hawaii | $500.47 | $500.47 | |
| New Jersey | $499.23 | $499.23 | |
| Massachusetts | $496.73 | $496.73 | |
| New York | $495.59 | $495.59 | |
| Alaska | $489.49 | $489.49 | |
| Connecticut | $478.50 | $478.50 | |
| Colorado | $471.77 | $471.77 | |
| Oregon | $467.20 | $467.20 | |
| Maryland | $463.86 | $463.86 | |
| New Hampshire | $462.23 | $462.23 | |
| Rhode Island | $459.73 | $459.73 | |
| Minnesota | $455.81 | $455.81 | |
| Puerto Rico | $450.33 | $450.33 | |
| Virgin Islands | $450.33 | $450.33 | |
| Florida | $449.79 | $449.79 | |
| Montana | $445.90 | $445.90 | |
| Nevada | $445.86 | $445.86 | |
| Wyoming | $445.21 | $445.21 | |
| North Dakota | $444.31 | $444.31 | |
| South Dakota | $444.13 | $444.13 | |
| Delaware | $440.94 | $440.94 | |
| Vermont | $440.52 | $440.52 | |
| Texas | $439.61 | $439.61 | |
| Virginia | $438.21 | $438.21 | |
| Pennsylvania | $438.08 | $438.08 | |
| Illinois | $434.75 | $434.75 | |
| Arizona | $432.92 | $432.92 | |
| Georgia | $427.78 | $427.78 | |
| Wisconsin | $426.98 | $426.98 | |
| Maine | $426.82 | $426.82 | |
| Michigan | $422.20 | $422.20 | |
| Utah | $421.24 | $421.24 | |
| North Carolina | $417.70 | $417.70 | |
| Indiana | $414.85 | $414.85 | |
| South Carolina | $414.61 | $414.61 | |
| Nebraska | $412.94 | $412.94 | |
| New Mexico | $412.70 | $412.70 | |
| Missouri | $412.39 | $412.39 | |
| Idaho | $411.97 | $411.97 | |
| Louisiana | $410.66 | $410.66 | |
| Ohio | $410.56 | $410.56 | |
| Iowa | $409.74 | $409.74 | |
| Tennessee | $407.67 | $407.67 | |
| Kansas | $405.55 | $405.55 | |
| Oklahoma | $401.81 | $401.81 | |
| Kentucky | $400.55 | $400.55 | |
| Alabama | $393.93 | $393.93 | |
| West Virginia | $393.80 | $393.80 | |
| Mississippi | $388.70 | $388.70 | |
| Arkansas | $387.29 | $387.29 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates