CPT 96921 pays $147.97 in a non-facility setting and $46.76 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $130.79 in Arkansas to $170.57 in District of Columbia, a 30% spread.
National non-facility rate
$147.97
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 | $170.57 | $51.35 | |
| California | $169.89 | $50.14 | |
| Alaska | $169.68 | $61.90 | |
| Washington | $165.02 | $49.65 | |
| New Jersey | $164.36 | $50.41 | |
| Hawaii | $163.47 | $48.40 | |
| New York | $163.39 | $50.49 | |
| Massachusetts | $163.07 | $49.37 | |
| Connecticut | $157.86 | $48.86 | |
| Colorado | $155.53 | $47.85 | |
| Oregon | $154.10 | $47.48 | |
| Maryland | $153.43 | $47.93 | |
| New Hampshire | $152.61 | $47.25 | |
| Rhode Island | $152.25 | $47.70 | |
| Minnesota | $150.43 | $46.29 | |
| Florida | $149.62 | $48.08 | |
| Puerto Rico | $149.24 | $46.92 | |
| Virgin Islands | $149.24 | $46.92 | |
| Montana | $147.96 | $46.76 | |
| Nevada | $147.86 | $46.55 | |
| Wyoming | $147.62 | $46.41 | |
| North Dakota | $147.17 | $45.97 | |
| South Dakota | $147.08 | $45.87 | |
| Delaware | $146.57 | $46.58 | |
| Texas | $146.22 | $46.58 | |
| Vermont | $146.13 | $45.94 | |
| Pennsylvania | $145.92 | $46.79 | |
| Virginia | $145.58 | $46.10 | |
| Illinois | $145.33 | $47.54 | |
| Arizona | $144.14 | $46.07 | |
| Georgia | $142.88 | $46.33 | |
| Maine | $142.25 | $45.55 | |
| Wisconsin | $142.12 | $45.16 | |
| Michigan | $141.36 | $46.33 | |
| Utah | $140.80 | $45.66 | |
| North Carolina | $139.63 | $45.20 | |
| South Carolina | $138.86 | $45.34 | |
| Indiana | $138.72 | $44.90 | |
| New Mexico | $138.50 | $45.70 | |
| Missouri | $138.29 | $45.42 | |
| Nebraska | $138.11 | $44.70 | |
| Idaho | $137.88 | $44.77 | |
| Louisiana | $137.83 | $45.43 | |
| Ohio | $137.78 | $45.38 | |
| Iowa | $137.20 | $44.59 | |
| Tennessee | $136.68 | $44.68 | |
| Kansas | $136.05 | $44.56 | |
| Oklahoma | $135.12 | $44.75 | |
| Kentucky | $134.84 | $44.87 | |
| West Virginia | $133.18 | $45.24 | |
| Alabama | $132.73 | $44.18 | |
| Mississippi | $131.32 | $44.18 | |
| Arkansas | $130.79 | $43.85 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates