CPT 96138 pays $37.74 in a non-facility setting and $37.74 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $32.31 in Arkansas to $44.45 in California, a 38% spread.
National non-facility rate
$37.74
Office and other outpatient settings
Hospital and ASC settings
California
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 |
|---|---|---|---|
| California | $44.45 | $44.45 | |
| District of Columbia | $44.44 | $44.44 | |
| Washington | $42.91 | $42.91 | |
| Hawaii | $42.73 | $42.73 | |
| New Jersey | $42.48 | $42.48 | |
| Massachusetts | $42.31 | $42.31 | |
| New York | $42.19 | $42.19 | |
| Connecticut | $40.69 | $40.69 | |
| Colorado | $40.06 | $40.06 | |
| Alaska | $40.02 | $40.02 | |
| Oregon | $39.65 | $39.65 | |
| Maryland | $39.36 | $39.36 | |
| New Hampshire | $39.24 | $39.24 | |
| Rhode Island | $38.94 | $38.94 | |
| Minnesota | $38.59 | $38.59 | |
| Florida | $38.18 | $38.18 | |
| Puerto Rico | $38.15 | $38.15 | |
| Virgin Islands | $38.15 | $38.15 | |
| Montana | $37.74 | $37.74 | |
| Nevada | $37.72 | $37.72 | |
| Wyoming | $37.66 | $37.66 | |
| North Dakota | $37.54 | $37.54 | |
| South Dakota | $37.52 | $37.52 | |
| Delaware | $37.26 | $37.26 | |
| Vermont | $37.20 | $37.20 | |
| Texas | $37.14 | $37.14 | |
| Virginia | $37.01 | $37.01 | |
| Pennsylvania | $37.00 | $37.00 | |
| Illinois | $36.78 | $36.78 | |
| Arizona | $36.54 | $36.54 | |
| Georgia | $36.09 | $36.09 | |
| Maine | $35.95 | $35.95 | |
| Wisconsin | $35.94 | $35.94 | |
| Michigan | $35.60 | $35.60 | |
| Utah | $35.46 | $35.46 | |
| North Carolina | $35.12 | $35.12 | |
| South Carolina | $34.85 | $34.85 | |
| Indiana | $34.84 | $34.84 | |
| New Mexico | $34.71 | $34.71 | |
| Missouri | $34.66 | $34.66 | |
| Nebraska | $34.65 | $34.65 | |
| Idaho | $34.57 | $34.57 | |
| Louisiana | $34.50 | $34.50 | |
| Ohio | $34.49 | $34.49 | |
| Iowa | $34.36 | $34.36 | |
| Tennessee | $34.18 | $34.18 | |
| Kansas | $33.99 | $33.99 | |
| Oklahoma | $33.67 | $33.67 | |
| Kentucky | $33.56 | $33.56 | |
| West Virginia | $32.99 | $32.99 | |
| Alabama | $32.92 | $32.92 | |
| Mississippi | $32.46 | $32.46 | |
| Arkansas | $32.31 | $32.31 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates