CPT 97130

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CPT 97130 pays $21.04 in a non-facility setting and $18.37 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $20.34 in Arkansas to $29.38 in Alaska, a 44% spread.

National non-facility rate

$21.04

Office and other outpatient settings

Facility rate
$18.37

Hospital and ASC settings

Highest state
$29.38

Alaska

Lowest state
$20.34

Arkansas · 44% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $21.04
CPT 97130 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $21.04, national facility $18.37.
StateRate compared visuallyNon-facilityFacility
Alaska
$29.38$26.54
District of Columbia
$22.80$19.65
California
$22.54$19.37
New Jersey
$22.50$19.49
New York
$22.38$19.40
Washington
$22.25$19.20
Massachusetts
$22.12$19.12
Connecticut
$21.75$18.87
Hawaii
$21.73$18.69
Colorado
$21.56$18.71
Rhode Island
$21.51$18.75
Maryland
$21.46$18.68
Oregon
$21.44$18.62
New Hampshire
$21.25$18.47
Minnesota
$21.19$18.44
Puerto Rico
$21.10$18.40
Virgin Islands
$21.10$18.40
Pennsylvania
$21.08$18.47
Delaware
$21.06$18.42
Florida
$21.06$18.38
Nevada
$21.05$18.37
Texas
$21.05$18.42
Montana
$21.04$18.37
North Dakota
$21.04$18.37
South Dakota
$21.04$18.37
Wyoming
$21.04$18.37
Vermont
$20.99$18.35
Virginia
$20.96$18.33
Illinois
$20.93$18.35
Arizona
$20.89$18.30
Georgia
$20.84$18.29
Wisconsin
$20.83$18.27
Maine
$20.82$18.27
Michigan
$20.74$18.23
Utah
$20.74$18.23
North Carolina
$20.71$18.21
Indiana
$20.68$18.20
Nebraska
$20.66$18.19
South Carolina
$20.66$18.19
Idaho
$20.64$18.18
Missouri
$20.63$18.18
New Mexico
$20.63$18.18
Iowa
$20.62$18.17
Louisiana
$20.61$18.17
Ohio
$20.61$18.17
Tennessee
$20.59$18.16
Kansas
$20.56$18.15
Oklahoma
$20.51$18.12
Kentucky
$20.49$18.11
Alabama
$20.42$18.08
West Virginia
$20.39$18.06
Mississippi
$20.35$18.05
Arkansas
$20.34$18.04

Billed by 1 specialties

Commercial rates for 97130

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates