CPT 96904 pays $66.13 in a non-facility setting and $66.13 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $56.69 in Arkansas to $78.04 in California, a 38% spread.
National non-facility rate
$66.13
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 | $78.04 | $78.04 | |
| District of Columbia | $77.88 | $77.88 | |
| Washington | $75.28 | $75.28 | |
| Hawaii | $75.01 | $75.01 | |
| New Jersey | $74.45 | $74.45 | |
| Massachusetts | $74.21 | $74.21 | |
| New York | $73.86 | $73.86 | |
| Connecticut | $71.27 | $71.27 | |
| Colorado | $70.27 | $70.27 | |
| Alaska | $70.26 | $70.26 | |
| Oregon | $69.56 | $69.56 | |
| Maryland | $68.96 | $68.96 | |
| New Hampshire | $68.79 | $68.79 | |
| Rhode Island | $68.27 | $68.27 | |
| Minnesota | $67.81 | $67.81 | |
| Puerto Rico | $66.85 | $66.85 | |
| Virgin Islands | $66.85 | $66.85 | |
| Florida | $66.67 | $66.67 | |
| Nevada | $66.14 | $66.14 | |
| Montana | $66.13 | $66.13 | |
| Wyoming | $66.05 | $66.05 | |
| North Dakota | $65.94 | $65.94 | |
| South Dakota | $65.91 | $65.91 | |
| Delaware | $65.31 | $65.31 | |
| Vermont | $65.31 | $65.31 | |
| Texas | $65.09 | $65.09 | |
| Virginia | $64.92 | $64.92 | |
| Pennsylvania | $64.81 | $64.81 | |
| Illinois | $64.22 | $64.22 | |
| Arizona | $64.05 | $64.05 | |
| Georgia | $63.17 | $63.17 | |
| Wisconsin | $63.14 | $63.14 | |
| Maine | $63.08 | $63.08 | |
| Michigan | $62.26 | $62.26 | |
| Utah | $62.15 | $62.15 | |
| North Carolina | $61.60 | $61.60 | |
| Indiana | $61.16 | $61.16 | |
| South Carolina | $61.08 | $61.08 | |
| Nebraska | $60.86 | $60.86 | |
| New Mexico | $60.74 | $60.74 | |
| Missouri | $60.71 | $60.71 | |
| Idaho | $60.69 | $60.69 | |
| Louisiana | $60.42 | $60.42 | |
| Ohio | $60.41 | $60.41 | |
| Iowa | $60.34 | $60.34 | |
| Tennessee | $59.99 | $59.99 | |
| Kansas | $59.65 | $59.65 | |
| Oklahoma | $59.02 | $59.02 | |
| Kentucky | $58.80 | $58.80 | |
| Alabama | $57.76 | $57.76 | |
| West Virginia | $57.66 | $57.66 | |
| Mississippi | $56.90 | $56.90 | |
| Arkansas | $56.69 | $56.69 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates