CPT 99174

Instrument Based Ocular Scr Bi W/Rmt Anal & Rpt

CPT 99174 pays $6.68 in a non-facility setting and $6.68 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $5.62 in Arkansas to $7.85 in District of Columbia, a 40% spread.

National non-facility rate

$6.68

Office and other outpatient settings

Facility rate
$6.68

Hospital and ASC settings

Highest state
$7.85

District of Columbia

Lowest state
$5.62

Arkansas · 40% 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 $6.68
CPT 99174 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $6.68, national facility $6.68.
StateRate compared visuallyNon-facilityFacility
District of Columbia
$7.85$7.85
California
$7.69$7.69
New York
$7.53$7.53
New Jersey
$7.51$7.51
Washington
$7.50$7.50
Hawaii
$7.41$7.41
Massachusetts
$7.41$7.41
Connecticut
$7.24$7.24
Florida
$7.02$7.02
Colorado
$7.01$7.01
Maryland
$6.98$6.98
Alaska
$6.94$6.94
Oregon
$6.93$6.93
New Hampshire
$6.90$6.90
Rhode Island
$6.85$6.85
Illinois
$6.77$6.77
Puerto Rico
$6.74$6.74
Virgin Islands
$6.74$6.74
Montana
$6.68$6.68
Minnesota
$6.63$6.63
Nevada
$6.63$6.63
Wyoming
$6.59$6.59
Delaware
$6.57$6.57
Pennsylvania
$6.57$6.57
Texas
$6.56$6.56
North Dakota
$6.48$6.48
Virginia
$6.47$6.47
South Dakota
$6.46$6.46
Georgia
$6.45$6.45
Vermont
$6.45$6.45
Arizona
$6.44$6.44
Michigan
$6.43$6.43
Maine
$6.27$6.27
Utah
$6.27$6.27
New Mexico
$6.22$6.22
Wisconsin
$6.18$6.18
Missouri
$6.15$6.15
South Carolina
$6.15$6.15
Louisiana
$6.14$6.14
North Carolina
$6.13$6.13
Ohio
$6.13$6.13
Indiana
$6.05$6.05
Idaho
$6.00$6.00
West Virginia
$5.99$5.99
Nebraska
$5.98$5.98
Kentucky
$5.95$5.95
Tennessee
$5.95$5.95
Iowa
$5.94$5.94
Oklahoma
$5.93$5.93
Kansas
$5.91$5.91
Alabama
$5.74$5.74
Mississippi
$5.71$5.71
Arkansas
$5.62$5.62

Billed by 2 specialties

Commercial rates for 99174

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

See negotiated rates