CPT 96405 pays $84.50 in a non-facility setting and $23.71 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $74.69 in Arkansas to $97.33 in District of Columbia, a 30% spread.
National non-facility rate
$84.50
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 30% 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 | $97.33 | $25.72 | |
| Alaska | $97.04 | $32.30 | |
| California | $96.79 | $24.86 | |
| Washington | $94.10 | $24.80 | |
| New Jersey | $93.81 | $25.37 | |
| New York | $93.33 | $25.52 | |
| Hawaii | $93.14 | $24.02 | |
| Massachusetts | $93.01 | $24.71 | |
| Connecticut | $90.15 | $24.68 | |
| Colorado | $88.73 | $24.05 | |
| Oregon | $87.90 | $23.86 | |
| Maryland | $87.62 | $24.25 | |
| New Hampshire | $87.09 | $23.81 | |
| Rhode Island | $86.91 | $24.11 | |
| Minnesota | $85.72 | $23.16 | |
| Florida | $85.67 | $24.68 | |
| Puerto Rico | $85.22 | $23.76 | |
| Virgin Islands | $85.22 | $23.76 | |
| Montana | $84.50 | $23.71 | |
| Nevada | $84.40 | $23.55 | |
| Wyoming | $84.24 | $23.45 | |
| North Dakota | $83.91 | $23.12 | |
| South Dakota | $83.84 | $23.05 | |
| Delaware | $83.70 | $23.64 | |
| Texas | $83.50 | $23.66 | |
| Pennsylvania | $83.37 | $23.83 | |
| Vermont | $83.35 | $23.17 | |
| Illinois | $83.25 | $24.51 | |
| Virginia | $83.09 | $23.33 | |
| Arizona | $82.31 | $23.40 | |
| Georgia | $81.69 | $23.69 | |
| Maine | $81.19 | $23.10 | |
| Wisconsin | $81.03 | $22.80 | |
| Michigan | $80.88 | $23.80 | |
| Utah | $80.43 | $23.29 | |
| North Carolina | $79.71 | $22.99 | |
| South Carolina | $79.33 | $23.16 | |
| New Mexico | $79.22 | $23.47 | |
| Indiana | $79.16 | $22.81 | |
| Missouri | $79.04 | $23.26 | |
| Louisiana | $78.80 | $23.30 | |
| Nebraska | $78.79 | $22.68 | |
| Ohio | $78.76 | $23.26 | |
| Idaho | $78.69 | $22.76 | |
| Iowa | $78.28 | $22.66 | |
| Tennessee | $78.02 | $22.76 | |
| Kansas | $77.66 | $22.70 | |
| Oklahoma | $77.20 | $22.92 | |
| Kentucky | $77.08 | $23.04 | |
| West Virginia | $76.27 | $23.45 | |
| Alabama | $75.80 | $22.61 | |
| Mississippi | $75.05 | $22.71 | |
| Arkansas | $74.69 | $22.48 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates