CPT 92004

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CPT 92004 pays $149.64 in a non-facility setting and $77.82 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $136.65 in Arkansas to $185.12 in Alaska, a 35% spread.

National non-facility rate

$149.64

Office and other outpatient settings

Facility rate
$77.82

Hospital and ASC settings

Highest state
$185.12

Alaska

Lowest state
$136.65

Arkansas · 35% 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 $149.64
CPT 92004 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $149.64, national facility $77.82.
StateRate compared visuallyNon-facilityFacility
Alaska
$185.12$108.64
District of Columbia
$168.65$84.05
California
$167.24$82.27
New Jersey
$163.90$83.04
Washington
$163.52$81.65
New York
$163.11$83.00
Massachusetts
$161.97$81.29
Hawaii
$161.06$79.41
Connecticut
$157.87$80.53
Colorado
$155.67$79.27
Oregon
$154.43$78.78
Maryland
$154.25$79.39
Rhode Island
$153.53$79.35
New Hampshire
$153.06$78.30
Minnesota
$151.23$77.34
Florida
$151.19$79.14
Puerto Rico
$150.58$77.98
Virgin Islands
$150.58$77.98
Montana
$149.63$77.82
Nevada
$149.50$77.62
Wyoming
$149.29$77.48
North Dakota
$148.84$77.03
Delaware
$148.75$77.80
South Dakota
$148.75$76.94
Texas
$148.52$77.82
Pennsylvania
$148.48$78.14
Illinois
$148.11$78.72
Vermont
$148.10$77.01
Virginia
$147.76$77.16
Arizona
$146.73$77.15
Georgia
$145.96$77.46
Maine
$145.24$76.63
Wisconsin
$145.04$76.24
Michigan
$144.84$77.41
Utah
$144.25$76.75
North Carolina
$143.29$76.29
South Carolina
$142.78$76.43
New Mexico
$142.64$76.79
Indiana
$142.56$75.99
Missouri
$142.41$76.51
Louisiana
$142.09$76.52
Nebraska
$142.07$75.78
Ohio
$142.03$76.47
Idaho
$141.93$75.86
Iowa
$141.39$75.68
Tennessee
$141.05$75.78
Kansas
$140.57$75.65
Oklahoma
$139.97$75.85
Kentucky
$139.81$75.97
West Virginia
$138.75$76.34
Alabama
$138.12$75.28
Mississippi
$137.12$75.29
Arkansas
$136.65$74.96

Billed by 2 specialties

Commercial rates for 92004

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

See negotiated rates