CPT 96401 pays $71.81 in a non-facility setting and $71.81 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $62.22 in Arkansas to $83.64 in District of Columbia, a 34% spread.
National non-facility rate
$71.81
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 | $83.64 | $83.64 | |
| California | $83.08 | $83.08 | |
| Washington | $80.64 | $80.64 | |
| New Jersey | $80.28 | $80.28 | |
| New York | $79.96 | $79.96 | |
| Hawaii | $79.94 | $79.94 | |
| Massachusetts | $79.64 | $79.64 | |
| Alaska | $78.84 | $78.84 | |
| Connecticut | $77.12 | $77.12 | |
| Colorado | $75.67 | $75.67 | |
| Oregon | $74.89 | $74.89 | |
| Maryland | $74.70 | $74.70 | |
| New Hampshire | $74.25 | $74.25 | |
| Rhode Island | $73.90 | $73.90 | |
| Florida | $73.29 | $73.29 | |
| Minnesota | $72.71 | $72.71 | |
| Puerto Rico | $72.49 | $72.49 | |
| Virgin Islands | $72.49 | $72.49 | |
| Montana | $71.81 | $71.81 | |
| Nevada | $71.65 | $71.65 | |
| Wyoming | $71.46 | $71.46 | |
| North Dakota | $71.02 | $71.02 | |
| Delaware | $70.95 | $70.95 | |
| South Dakota | $70.92 | $70.92 | |
| Illinois | $70.91 | $70.91 | |
| Texas | $70.77 | $70.77 | |
| Pennsylvania | $70.67 | $70.67 | |
| Vermont | $70.52 | $70.52 | |
| Virginia | $70.34 | $70.34 | |
| Arizona | $69.65 | $69.65 | |
| Georgia | $69.17 | $69.17 | |
| Maine | $68.49 | $68.49 | |
| Michigan | $68.49 | $68.49 | |
| Wisconsin | $68.22 | $68.22 | |
| Utah | $67.87 | $67.87 | |
| North Carolina | $67.08 | $67.08 | |
| New Mexico | $66.81 | $66.81 | |
| South Carolina | $66.79 | $66.79 | |
| Missouri | $66.57 | $66.57 | |
| Indiana | $66.49 | $66.49 | |
| Louisiana | $66.35 | $66.35 | |
| Ohio | $66.30 | $66.30 | |
| Nebraska | $66.09 | $66.09 | |
| Idaho | $66.03 | $66.03 | |
| Iowa | $65.61 | $65.61 | |
| Tennessee | $65.42 | $65.42 | |
| Kansas | $65.06 | $65.06 | |
| Oklahoma | $64.72 | $64.72 | |
| Kentucky | $64.65 | $64.65 | |
| West Virginia | $64.07 | $64.07 | |
| Alabama | $63.30 | $63.30 | |
| Mississippi | $62.64 | $62.64 | |
| Arkansas | $62.22 | $62.22 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates