CPT 99234

Hospital Ip/Obs Care Same Date Sf/Low Mdm 45 Min

CPT 99234 pays $88.18 in a non-facility setting and $88.18 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $83.10 in Arkansas to $119.88 in Alaska, a 44% spread.

National non-facility rate

$88.18

Office and other outpatient settings

Facility rate
$88.18

Hospital and ASC settings

Highest state
$119.88

Alaska

Lowest state
$83.10

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 $88.18
CPT 99234 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $88.18, national facility $88.18.
StateRate compared visuallyNon-facilityFacility
Alaska
$119.88$119.88
New York
$95.28$95.28
District of Columbia
$95.20$95.20
New Jersey
$94.05$94.05
Florida
$93.92$93.92
Illinois
$93.37$93.37
Connecticut
$91.96$91.96
Washington
$91.17$91.17
Massachusetts
$91.04$91.04
California
$90.64$90.64
Maryland
$90.17$90.17
Michigan
$89.69$89.69
Rhode Island
$89.31$89.31
Pennsylvania
$88.88$88.88
West Virginia
$88.76$88.76
Georgia
$88.75$88.75
Colorado
$88.65$88.65
Puerto Rico
$88.26$88.26
Virgin Islands
$88.26$88.26
Montana
$88.17$88.17
New Mexico
$88.11$88.11
New Hampshire
$88.06$88.06
Texas
$87.88$87.88
Oregon
$87.87$87.87
Hawaii
$87.75$87.75
Delaware
$87.72$87.72
Nevada
$87.19$87.19
Louisiana
$87.12$87.12
Ohio
$86.89$86.89
Arizona
$86.84$86.84
Missouri
$86.82$86.82
Utah
$86.64$86.64
Wyoming
$86.62$86.62
Virginia
$86.15$86.15
South Carolina
$86.11$86.11
Kentucky
$85.96$85.96
Maine
$85.25$85.25
Oklahoma
$85.19$85.19
Vermont
$85.05$85.05
North Carolina
$84.98$84.98
North Dakota
$84.61$84.61
Mississippi
$84.47$84.47
Minnesota
$84.39$84.39
South Dakota
$84.19$84.19
Tennessee
$84.00$84.00
Indiana
$83.97$83.97
Idaho
$83.78$83.78
Kansas
$83.72$83.72
Alabama
$83.65$83.65
Wisconsin
$83.37$83.37
Nebraska
$83.26$83.26
Iowa
$83.25$83.25
Arkansas
$83.10$83.10

Billed by 2 specialties

Commercial rates for 99234

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

See negotiated rates