CPT 95004 pays $3.67 in a non-facility setting and $3.67 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $3.09 in Arkansas to $4.26 in District of Columbia, a 38% spread.
National non-facility rate
$3.67
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 38% 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 | $4.26 | $4.26 | |
| New York | $4.16 | $4.16 | |
| New Jersey | $4.10 | $4.10 | |
| California | $4.08 | $4.08 | |
| Washington | $4.03 | $4.03 | |
| Florida | $4.00 | $4.00 | |
| Massachusetts | $4.00 | $4.00 | |
| Connecticut | $3.98 | $3.98 | |
| Hawaii | $3.95 | $3.95 | |
| Alaska | $3.89 | $3.89 | |
| Illinois | $3.88 | $3.88 | |
| Maryland | $3.83 | $3.83 | |
| Colorado | $3.80 | $3.80 | |
| New Hampshire | $3.76 | $3.76 | |
| Oregon | $3.75 | $3.75 | |
| Rhode Island | $3.74 | $3.74 | |
| Puerto Rico | $3.70 | $3.70 | |
| Virgin Islands | $3.70 | $3.70 | |
| Montana | $3.67 | $3.67 | |
| Pennsylvania | $3.64 | $3.64 | |
| Michigan | $3.63 | $3.63 | |
| Nevada | $3.62 | $3.62 | |
| Delaware | $3.61 | $3.61 | |
| Texas | $3.61 | $3.61 | |
| Georgia | $3.60 | $3.60 | |
| Wyoming | $3.59 | $3.59 | |
| Arizona | $3.53 | $3.53 | |
| Minnesota | $3.53 | $3.53 | |
| Virginia | $3.52 | $3.52 | |
| New Mexico | $3.49 | $3.49 | |
| North Dakota | $3.48 | $3.48 | |
| Vermont | $3.48 | $3.48 | |
| Utah | $3.46 | $3.46 | |
| South Dakota | $3.45 | $3.45 | |
| Louisiana | $3.43 | $3.43 | |
| Maine | $3.42 | $3.42 | |
| Missouri | $3.42 | $3.42 | |
| Ohio | $3.42 | $3.42 | |
| West Virginia | $3.42 | $3.42 | |
| South Carolina | $3.40 | $3.40 | |
| North Carolina | $3.35 | $3.35 | |
| Wisconsin | $3.32 | $3.32 | |
| Kentucky | $3.31 | $3.31 | |
| Indiana | $3.28 | $3.28 | |
| Oklahoma | $3.28 | $3.28 | |
| Idaho | $3.26 | $3.26 | |
| Tennessee | $3.25 | $3.25 | |
| Nebraska | $3.23 | $3.23 | |
| Iowa | $3.22 | $3.22 | |
| Kansas | $3.22 | $3.22 | |
| Mississippi | $3.17 | $3.17 | |
| Alabama | $3.15 | $3.15 | |
| Arkansas | $3.09 | $3.09 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates