CPT 96416 pays $133.27 in a non-facility setting and $133.27 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $114.66 in Arkansas to $155.97 in District of Columbia, a 36% spread.
National non-facility rate
$133.27
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 36% 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 | $155.97 | $155.97 | |
| California | $155.16 | $155.16 | |
| Washington | $150.35 | $150.35 | |
| New Jersey | $149.44 | $149.44 | |
| Hawaii | $149.26 | $149.26 | |
| New York | $148.77 | $148.77 | |
| Massachusetts | $148.41 | $148.41 | |
| Alaska | $143.78 | $143.78 | |
| Connecticut | $143.44 | $143.44 | |
| Colorado | $140.77 | $140.77 | |
| Oregon | $139.31 | $139.31 | |
| Maryland | $138.81 | $138.81 | |
| New Hampshire | $138.06 | $138.06 | |
| Rhode Island | $137.24 | $137.24 | |
| Florida | $135.90 | $135.90 | |
| Minnesota | $135.22 | $135.22 | |
| Puerto Rico | $134.60 | $134.60 | |
| Virgin Islands | $134.60 | $134.60 | |
| Montana | $133.26 | $133.26 | |
| Nevada | $133.00 | $133.00 | |
| Wyoming | $132.66 | $132.66 | |
| North Dakota | $131.88 | $131.88 | |
| South Dakota | $131.72 | $131.72 | |
| Delaware | $131.58 | $131.58 | |
| Illinois | $131.24 | $131.24 | |
| Texas | $131.22 | $131.22 | |
| Pennsylvania | $130.95 | $130.95 | |
| Vermont | $130.88 | $130.88 | |
| Virginia | $130.48 | $130.48 | |
| Arizona | $129.09 | $129.09 | |
| Georgia | $128.04 | $128.04 | |
| Maine | $126.88 | $126.88 | |
| Michigan | $126.66 | $126.66 | |
| Wisconsin | $126.45 | $126.45 | |
| Utah | $125.60 | $125.60 | |
| North Carolina | $124.12 | $124.12 | |
| South Carolina | $123.50 | $123.50 | |
| New Mexico | $123.45 | $123.45 | |
| Missouri | $123.03 | $123.03 | |
| Indiana | $123.02 | $123.02 | |
| Louisiana | $122.60 | $122.60 | |
| Ohio | $122.51 | $122.51 | |
| Nebraska | $122.27 | $122.27 | |
| Idaho | $122.12 | $122.12 | |
| Iowa | $121.33 | $121.33 | |
| Tennessee | $120.91 | $120.91 | |
| Kansas | $120.21 | $120.21 | |
| Oklahoma | $119.49 | $119.49 | |
| Kentucky | $119.32 | $119.32 | |
| West Virginia | $118.04 | $118.04 | |
| Alabama | $116.77 | $116.77 | |
| Mississippi | $115.43 | $115.43 | |
| Arkansas | $114.66 | $114.66 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates