CPT 99157 pays $54.11 in a non-facility setting and $54.11 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $50.55 in Wisconsin to $73.38 in Alaska, a 45% spread.
National non-facility rate
$54.11
Office and other outpatient settings
Hospital and ASC settings
Alaska
Wisconsin · 45% 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 |
|---|---|---|---|
| Alaska | $73.38 | $73.38 | |
| New York | $58.66 | $58.66 | |
| Florida | $58.56 | $58.56 | |
| District of Columbia | $58.26 | $58.26 | |
| Illinois | $58.26 | $58.26 | |
| New Jersey | $57.61 | $57.61 | |
| Connecticut | $56.52 | $56.52 | |
| Michigan | $55.55 | $55.55 | |
| Massachusetts | $55.52 | $55.52 | |
| Washington | $55.51 | $55.51 | |
| Maryland | $55.34 | $55.34 | |
| West Virginia | $55.12 | $55.12 | |
| California | $54.87 | $54.87 | |
| Georgia | $54.74 | $54.74 | |
| Pennsylvania | $54.65 | $54.65 | |
| Rhode Island | $54.65 | $54.65 | |
| New Mexico | $54.41 | $54.41 | |
| Puerto Rico | $54.12 | $54.12 | |
| Virgin Islands | $54.12 | $54.12 | |
| Montana | $54.10 | $54.10 | |
| Colorado | $54.08 | $54.08 | |
| Texas | $53.89 | $53.89 | |
| New Hampshire | $53.84 | $53.84 | |
| Delaware | $53.75 | $53.75 | |
| Louisiana | $53.66 | $53.66 | |
| Oregon | $53.56 | $53.56 | |
| Ohio | $53.48 | $53.48 | |
| Missouri | $53.40 | $53.40 | |
| Nevada | $53.34 | $53.34 | |
| Arizona | $53.20 | $53.20 | |
| Hawaii | $53.19 | $53.19 | |
| Utah | $53.17 | $53.17 | |
| Wyoming | $52.89 | $52.89 | |
| Kentucky | $52.86 | $52.86 | |
| South Carolina | $52.82 | $52.82 | |
| Virginia | $52.60 | $52.60 | |
| Oklahoma | $52.24 | $52.24 | |
| Maine | $52.02 | $52.02 | |
| North Carolina | $51.91 | $51.91 | |
| Mississippi | $51.82 | $51.82 | |
| Vermont | $51.72 | $51.72 | |
| North Dakota | $51.33 | $51.33 | |
| Tennessee | $51.25 | $51.25 | |
| Indiana | $51.15 | $51.15 | |
| Alabama | $51.12 | $51.12 | |
| Kansas | $51.05 | $51.05 | |
| Minnesota | $51.04 | $51.04 | |
| Idaho | $51.03 | $51.03 | |
| South Dakota | $51.00 | $51.00 | |
| Arkansas | $50.76 | $50.76 | |
| Iowa | $50.64 | $50.64 | |
| Nebraska | $50.61 | $50.61 | |
| Wisconsin | $50.55 | $50.55 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates