CPT 96920 pays $137.95 in a non-facility setting and $41.08 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $121.85 in Arkansas to $159.06 in District of Columbia, a 31% spread.
National non-facility rate
$137.95
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 31% 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 | $159.06 | $44.95 | |
| California | $158.38 | $43.77 | |
| Alaska | $157.99 | $54.84 | |
| Washington | $153.85 | $43.43 | |
| New Jersey | $153.25 | $44.19 | |
| Hawaii | $152.39 | $42.26 | |
| New York | $152.37 | $44.31 | |
| Massachusetts | $152.04 | $43.21 | |
| Connecticut | $147.20 | $42.88 | |
| Colorado | $144.99 | $41.93 | |
| Oregon | $143.65 | $41.61 | |
| Maryland | $143.06 | $42.08 | |
| New Hampshire | $142.27 | $41.44 | |
| Rhode Island | $141.93 | $41.87 | |
| Minnesota | $140.18 | $40.51 | |
| Florida | $139.58 | $42.39 | |
| Puerto Rico | $139.13 | $41.20 | |
| Virgin Islands | $139.13 | $41.20 | |
| Montana | $137.94 | $41.08 | |
| Nevada | $137.83 | $40.87 | |
| Wyoming | $137.60 | $40.74 | |
| North Dakota | $137.15 | $40.29 | |
| South Dakota | $137.06 | $40.20 | |
| Delaware | $136.63 | $40.93 | |
| Texas | $136.30 | $40.94 | |
| Vermont | $136.19 | $40.30 | |
| Pennsylvania | $136.04 | $41.16 | |
| Virginia | $135.69 | $40.47 | |
| Illinois | $135.56 | $41.97 | |
| Arizona | $134.36 | $40.50 | |
| Georgia | $133.21 | $40.80 | |
| Maine | $132.57 | $40.02 | |
| Wisconsin | $132.42 | $39.63 | |
| Michigan | $131.81 | $40.85 | |
| Utah | $131.24 | $40.19 | |
| North Carolina | $130.12 | $39.75 | |
| South Carolina | $129.42 | $39.92 | |
| Indiana | $129.26 | $39.47 | |
| New Mexico | $129.12 | $40.30 | |
| Missouri | $128.90 | $40.02 | |
| Nebraska | $128.68 | $39.27 | |
| Idaho | $128.48 | $39.36 | |
| Louisiana | $128.48 | $40.04 | |
| Ohio | $128.43 | $39.99 | |
| Iowa | $127.83 | $39.20 | |
| Tennessee | $127.36 | $39.31 | |
| Kansas | $126.77 | $39.20 | |
| Oklahoma | $125.93 | $39.43 | |
| Kentucky | $125.67 | $39.56 | |
| West Virginia | $124.17 | $40.00 | |
| Alabama | $123.67 | $38.92 | |
| Mississippi | $122.37 | $38.97 | |
| Arkansas | $121.85 | $38.65 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates