CPT 95816 pays $413.50 in a non-facility setting and $413.50 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $359.00 in Arkansas to $482.54 in District of Columbia, a 34% spread.
National non-facility rate
$413.50
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 | $482.54 | $482.54 | |
| California | $481.98 | $481.98 | |
| Washington | $466.42 | $466.42 | |
| Hawaii | $463.48 | $463.48 | |
| New Jersey | $462.85 | $462.85 | |
| Massachusetts | $460.30 | $460.30 | |
| New York | $459.73 | $459.73 | |
| Alaska | $453.92 | $453.92 | |
| Connecticut | $443.79 | $443.79 | |
| Colorado | $437.20 | $437.20 | |
| Oregon | $432.93 | $432.93 | |
| Maryland | $430.16 | $430.16 | |
| New Hampshire | $428.46 | $428.46 | |
| Rhode Island | $426.19 | $426.19 | |
| Minnesota | $422.03 | $422.03 | |
| Florida | $417.92 | $417.92 | |
| Puerto Rico | $417.58 | $417.58 | |
| Virgin Islands | $417.58 | $417.58 | |
| Montana | $413.50 | $413.50 | |
| Nevada | $413.32 | $413.32 | |
| Wyoming | $412.63 | $412.63 | |
| North Dakota | $411.52 | $411.52 | |
| South Dakota | $411.29 | $411.29 | |
| Delaware | $408.84 | $408.84 | |
| Vermont | $408.10 | $408.10 | |
| Texas | $407.64 | $407.64 | |
| Pennsylvania | $406.36 | $406.36 | |
| Virginia | $406.14 | $406.14 | |
| Illinois | $404.01 | $404.01 | |
| Arizona | $401.39 | $401.39 | |
| Georgia | $396.96 | $396.96 | |
| Maine | $395.56 | $395.56 | |
| Wisconsin | $395.44 | $395.44 | |
| Michigan | $391.98 | $391.98 | |
| Utah | $390.66 | $390.66 | |
| North Carolina | $387.17 | $387.17 | |
| South Carolina | $384.50 | $384.50 | |
| Indiana | $384.40 | $384.40 | |
| New Mexico | $383.04 | $383.04 | |
| Missouri | $382.57 | $382.57 | |
| Nebraska | $382.54 | $382.54 | |
| Idaho | $381.74 | $381.74 | |
| Louisiana | $381.03 | $381.03 | |
| Ohio | $380.90 | $380.90 | |
| Iowa | $379.61 | $379.61 | |
| Tennessee | $377.82 | $377.82 | |
| Kansas | $375.84 | $375.84 | |
| Oklahoma | $372.62 | $372.62 | |
| Kentucky | $371.58 | $371.58 | |
| West Virginia | $365.81 | $365.81 | |
| Alabama | $365.17 | $365.17 | |
| Mississippi | $360.49 | $360.49 | |
| Arkansas | $359.00 | $359.00 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates