CPT 96116 pays $94.19 in a non-facility setting and $72.15 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $88.98 in Arkansas to $126.31 in Alaska, a 42% spread.
National non-facility rate
$94.19
Office and other outpatient settings
Hospital and ASC settings
Alaska
Arkansas · 42% 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 |
|---|---|---|---|
| Alaska | $126.31 | $102.83 | |
| District of Columbia | $103.12 | $77.15 | |
| New Jersey | $101.34 | $76.52 | |
| New York | $101.33 | $76.74 | |
| California | $101.01 | $74.92 | |
| Washington | $99.93 | $74.80 | |
| Massachusetts | $99.36 | $74.59 | |
| Connecticut | $98.17 | $74.43 | |
| Hawaii | $97.47 | $72.40 | |
| Maryland | $96.43 | $73.45 | |
| Colorado | $96.42 | $72.97 | |
| Florida | $96.19 | $74.07 | |
| Rhode Island | $96.15 | $73.37 | |
| Oregon | $95.74 | $72.52 | |
| Illinois | $95.22 | $73.92 | |
| New Hampshire | $95.17 | $72.22 | |
| Puerto Rico | $94.49 | $72.20 | |
| Virgin Islands | $94.49 | $72.20 | |
| Pennsylvania | $94.27 | $72.68 | |
| Montana | $94.19 | $72.14 | |
| Delaware | $93.94 | $72.16 | |
| Texas | $93.92 | $72.22 | |
| Nevada | $93.89 | $71.82 | |
| Wyoming | $93.67 | $71.62 | |
| Minnesota | $93.65 | $70.97 | |
| Georgia | $93.29 | $72.26 | |
| Michigan | $93.17 | $72.47 | |
| Virginia | $93.09 | $71.42 | |
| North Dakota | $93.00 | $70.96 | |
| Arizona | $92.97 | $71.61 | |
| Vermont | $92.90 | $71.08 | |
| South Dakota | $92.86 | $70.82 | |
| Utah | $92.18 | $71.46 | |
| Maine | $92.10 | $71.04 | |
| New Mexico | $92.10 | $71.88 | |
| Missouri | $91.68 | $71.45 | |
| Louisiana | $91.67 | $71.54 | |
| South Carolina | $91.61 | $71.24 | |
| Ohio | $91.59 | $71.46 | |
| Wisconsin | $91.54 | $70.42 | |
| North Carolina | $91.45 | $70.89 | |
| West Virginia | $91.12 | $71.96 | |
| Indiana | $90.97 | $70.53 | |
| Idaho | $90.73 | $70.45 | |
| Kentucky | $90.68 | $71.09 | |
| Nebraska | $90.63 | $70.28 | |
| Oklahoma | $90.53 | $70.84 | |
| Tennessee | $90.53 | $70.49 | |
| Iowa | $90.43 | $70.26 | |
| Kansas | $90.31 | $70.38 | |
| Alabama | $89.56 | $70.27 | |
| Mississippi | $89.49 | $70.51 | |
| Arkansas | $88.98 | $70.04 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates