CPT 96409 pays $104.54 in a non-facility setting and $104.54 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $90.24 in Arkansas to $122.03 in District of Columbia, a 35% spread.
National non-facility rate
$104.54
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 35% 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 | $122.03 | $122.03 | |
| California | $121.24 | $121.24 | |
| Washington | $117.61 | $117.61 | |
| New Jersey | $117.03 | $117.03 | |
| Hawaii | $116.65 | $116.65 | |
| New York | $116.57 | $116.57 | |
| Massachusetts | $116.13 | $116.13 | |
| Alaska | $113.80 | $113.80 | |
| Connecticut | $112.40 | $112.40 | |
| Colorado | $110.25 | $110.25 | |
| Oregon | $109.11 | $109.11 | |
| Maryland | $108.82 | $108.82 | |
| New Hampshire | $108.17 | $108.17 | |
| Rhode Island | $107.60 | $107.60 | |
| Florida | $106.76 | $106.76 | |
| Minnesota | $105.88 | $105.88 | |
| Puerto Rico | $105.55 | $105.55 | |
| Virgin Islands | $105.55 | $105.55 | |
| Montana | $104.54 | $104.54 | |
| Nevada | $104.30 | $104.30 | |
| Wyoming | $104.02 | $104.02 | |
| North Dakota | $103.35 | $103.35 | |
| Delaware | $103.25 | $103.25 | |
| Illinois | $103.21 | $103.21 | |
| South Dakota | $103.21 | $103.21 | |
| Texas | $102.98 | $102.98 | |
| Pennsylvania | $102.82 | $102.82 | |
| Vermont | $102.61 | $102.61 | |
| Virginia | $102.35 | $102.35 | |
| Arizona | $101.33 | $101.33 | |
| Georgia | $100.60 | $100.60 | |
| Michigan | $99.60 | $99.60 | |
| Maine | $99.59 | $99.59 | |
| Wisconsin | $99.19 | $99.19 | |
| Utah | $98.67 | $98.67 | |
| North Carolina | $97.49 | $97.49 | |
| New Mexico | $97.10 | $97.10 | |
| South Carolina | $97.06 | $97.06 | |
| Missouri | $96.73 | $96.73 | |
| Indiana | $96.61 | $96.61 | |
| Louisiana | $96.42 | $96.42 | |
| Ohio | $96.34 | $96.34 | |
| Nebraska | $96.02 | $96.02 | |
| Idaho | $95.93 | $95.93 | |
| Iowa | $95.30 | $95.30 | |
| Tennessee | $95.02 | $95.02 | |
| Kansas | $94.48 | $94.48 | |
| Oklahoma | $93.98 | $93.98 | |
| Kentucky | $93.88 | $93.88 | |
| West Virginia | $93.03 | $93.03 | |
| Alabama | $91.86 | $91.86 | |
| Mississippi | $90.88 | $90.88 | |
| Arkansas | $90.24 | $90.24 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates