CPT 95851

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CPT 95851 pays $26.05 in a non-facility setting and $6.68 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $23.02 in Arkansas to $30.01 in District of Columbia, a 30% spread.

National non-facility rate

$26.05

Office and other outpatient settings

Facility rate
$6.68

Hospital and ASC settings

Highest state
$30.01

District of Columbia

Lowest state
$23.02

Arkansas · 30% 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 $26.05
CPT 95851 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $26.05, national facility $6.68.
StateRate compared visuallyNon-facilityFacility
District of Columbia
$30.01$7.18
Alaska
$29.90$9.27
California
$29.83$6.90
Washington
$29.00$6.92
New Jersey
$28.92$7.11
New York
$28.78$7.17
Hawaii
$28.70$6.68
Massachusetts
$28.67$6.90
Connecticut
$27.80$6.93
Colorado
$27.35$6.74
Oregon
$27.09$6.68
Maryland
$27.01$6.82
New Hampshire
$26.85$6.68
Rhode Island
$26.79$6.78
Florida
$26.44$7.00
Minnesota
$26.41$6.47
Puerto Rico
$26.27$6.69
Virgin Islands
$26.27$6.69
Montana
$26.05$6.68
Nevada
$26.02$6.63
Wyoming
$25.97$6.59
North Dakota
$25.85$6.48
South Dakota
$25.83$6.46
Delaware
$25.80$6.66
Texas
$25.74$6.67
Pennsylvania
$25.71$6.73
Illinois
$25.69$6.97
Vermont
$25.68$6.51
Virginia
$25.61$6.56
Arizona
$25.37$6.60
Georgia
$25.19$6.71
Maine
$25.02$6.51
Wisconsin
$24.97$6.41
Michigan
$24.95$6.76
Utah
$24.80$6.59
North Carolina
$24.57$6.49
South Carolina
$24.45$6.55
New Mexico
$24.43$6.66
Indiana
$24.39$6.44
Missouri
$24.37$6.59
Louisiana
$24.30$6.61
Nebraska
$24.28$6.40
Ohio
$24.28$6.60
Idaho
$24.25$6.42
Iowa
$24.12$6.39
Tennessee
$24.04$6.43
Kansas
$23.93$6.42
Oklahoma
$23.80$6.50
Kentucky
$23.76$6.54
West Virginia
$23.53$6.69
Alabama
$23.36$6.41
Mississippi
$23.13$6.45
Arkansas
$23.02$6.38

Billed by 1 specialties

Commercial rates for 95851

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

See negotiated rates