CPT 99252

Ip/Obs Consltj New/Est Pt Sf Mdm 35 Minutes

CPT 99252 pays $70.14 in a non-facility setting and $70.14 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $66.40 in Arkansas to $95.12 in Alaska, a 43% spread.

National non-facility rate

$70.14

Office and other outpatient settings

Facility rate
$70.14

Hospital and ASC settings

Highest state
$95.12

Alaska

Lowest state
$66.40

Arkansas · 43% 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 $70.14
CPT 99252 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $70.14, national facility $70.14.
StateRate compared visuallyNon-facilityFacility
Alaska
$95.12$95.12
District of Columbia
$76.24$76.24
New York
$75.49$75.49
New Jersey
$75.13$75.13
California
$73.90$73.90
Washington
$73.59$73.59
Massachusetts
$73.30$73.30
Connecticut
$73.04$73.04
Florida
$72.73$72.73
Illinois
$72.17$72.17
Maryland
$71.74$71.74
Hawaii
$71.40$71.40
Rhode Island
$71.38$71.38
Colorado
$71.27$71.27
Oregon
$70.73$70.73
New Hampshire
$70.52$70.52
Pennsylvania
$70.42$70.42
Puerto Rico
$70.29$70.29
Virgin Islands
$70.29$70.29
Michigan
$70.17$70.17
Montana
$70.14$70.14
Texas
$69.96$69.96
Georgia
$69.94$69.94
Delaware
$69.91$69.91
Nevada
$69.71$69.71
Wyoming
$69.45$69.45
New Mexico
$69.24$69.24
Arizona
$69.22$69.22
Virginia
$69.06$69.06
West Virginia
$69.02$69.02
Utah
$68.83$68.83
Louisiana
$68.76$68.76
Minnesota
$68.76$68.76
Missouri
$68.67$68.67
Ohio
$68.65$68.65
Vermont
$68.65$68.65
North Dakota
$68.55$68.55
South Carolina
$68.42$68.42
Maine
$68.37$68.37
South Dakota
$68.37$68.37
North Carolina
$68.01$68.01
Kentucky
$67.99$67.99
Oklahoma
$67.69$67.69
Wisconsin
$67.56$67.56
Indiana
$67.50$67.50
Idaho
$67.34$67.34
Tennessee
$67.32$67.32
Kansas
$67.15$67.15
Nebraska
$67.14$67.14
Iowa
$67.05$67.05
Mississippi
$67.03$67.03
Alabama
$66.81$66.81
Arkansas
$66.40$66.40

Commercial rates for 99252

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

See negotiated rates