CPT 99153 pays $12.36 in a non-facility setting and $12.36 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $10.39 in Arkansas to $14.51 in District of Columbia, a 40% spread.
National non-facility rate
$12.36
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 40% 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 | $14.51 | $14.51 | |
| California | $14.20 | $14.20 | |
| New York | $13.95 | $13.95 | |
| New Jersey | $13.89 | $13.89 | |
| Washington | $13.85 | $13.85 | |
| Massachusetts | $13.70 | $13.70 | |
| Hawaii | $13.68 | $13.68 | |
| Connecticut | $13.40 | $13.40 | |
| Florida | $13.03 | $13.03 | |
| Colorado | $12.96 | $12.96 | |
| Maryland | $12.91 | $12.91 | |
| Alaska | $12.82 | $12.82 | |
| Oregon | $12.80 | $12.80 | |
| New Hampshire | $12.75 | $12.75 | |
| Rhode Island | $12.67 | $12.67 | |
| Illinois | $12.57 | $12.57 | |
| Puerto Rico | $12.48 | $12.48 | |
| Virgin Islands | $12.48 | $12.48 | |
| Montana | $12.36 | $12.36 | |
| Nevada | $12.26 | $12.26 | |
| Minnesota | $12.23 | $12.23 | |
| Wyoming | $12.18 | $12.18 | |
| Pennsylvania | $12.16 | $12.16 | |
| Delaware | $12.15 | $12.15 | |
| Texas | $12.13 | $12.13 | |
| North Dakota | $11.96 | $11.96 | |
| Virginia | $11.96 | $11.96 | |
| Georgia | $11.95 | $11.95 | |
| Michigan | $11.92 | $11.92 | |
| South Dakota | $11.91 | $11.91 | |
| Vermont | $11.91 | $11.91 | |
| Arizona | $11.90 | $11.90 | |
| Maine | $11.59 | $11.59 | |
| Utah | $11.59 | $11.59 | |
| New Mexico | $11.52 | $11.52 | |
| Wisconsin | $11.41 | $11.41 | |
| Missouri | $11.39 | $11.39 | |
| Louisiana | $11.37 | $11.37 | |
| South Carolina | $11.37 | $11.37 | |
| Ohio | $11.35 | $11.35 | |
| North Carolina | $11.33 | $11.33 | |
| Indiana | $11.16 | $11.16 | |
| West Virginia | $11.11 | $11.11 | |
| Idaho | $11.07 | $11.07 | |
| Nebraska | $11.04 | $11.04 | |
| Kentucky | $11.00 | $11.00 | |
| Tennessee | $10.99 | $10.99 | |
| Iowa | $10.96 | $10.96 | |
| Oklahoma | $10.96 | $10.96 | |
| Kansas | $10.90 | $10.90 | |
| Alabama | $10.61 | $10.61 | |
| Mississippi | $10.56 | $10.56 | |
| Arkansas | $10.39 | $10.39 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates