CPT 99253

Ip/Obs Consltj New/Est Pt Low Mdm 45 Minutes

CPT 99253 pays $98.87 in a non-facility setting and $98.87 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $92.97 in Arkansas to $132.29 in Alaska, a 42% spread.

National non-facility rate

$98.87

Office and other outpatient settings

Facility rate
$98.87

Hospital and ASC settings

Highest state
$132.29

Alaska

Lowest state
$92.97

Arkansas · 42% 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 $98.87
CPT 99253 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $98.87, national facility $98.87.
StateRate compared visuallyNon-facilityFacility
Alaska
$132.29$132.29
District of Columbia
$107.92$107.92
New York
$106.72$106.72
New Jersey
$106.17$106.17
California
$104.57$104.57
Washington
$104.05$104.05
Massachusetts
$103.61$103.61
Connecticut
$103.20$103.20
Florida
$102.75$102.75
Illinois
$101.80$101.80
Maryland
$101.24$101.24
Hawaii
$101.02$101.02
Rhode Island
$100.63$100.63
Colorado
$100.59$100.59
Oregon
$99.79$99.79
New Hampshire
$99.52$99.52
Pennsylvania
$99.17$99.17
Puerto Rico
$99.12$99.12
Virgin Islands
$99.12$99.12
Montana
$98.86$98.86
Michigan
$98.79$98.79
Texas
$98.51$98.51
Delaware
$98.46$98.46
Georgia
$98.46$98.46
Nevada
$98.23$98.23
Wyoming
$97.82$97.82
Arizona
$97.42$97.42
New Mexico
$97.34$97.34
Virginia
$97.21$97.21
West Virginia
$96.92$96.92
Minnesota
$96.86$96.86
Utah
$96.77$96.77
Louisiana
$96.61$96.61
Vermont
$96.61$96.61
Missouri
$96.49$96.49
North Dakota
$96.49$96.49
Ohio
$96.46$96.46
South Dakota
$96.21$96.21
South Carolina
$96.13$96.13
Maine
$96.12$96.12
North Carolina
$95.54$95.54
Kentucky
$95.41$95.41
Oklahoma
$94.97$94.97
Wisconsin
$94.91$94.91
Indiana
$94.76$94.76
Idaho
$94.51$94.51
Tennessee
$94.46$94.46
Nebraska
$94.21$94.21
Kansas
$94.19$94.19
Iowa
$94.06$94.06
Mississippi
$93.92$93.92
Alabama
$93.62$93.62
Arkansas
$92.97$92.97

Commercial rates for 99253

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

See negotiated rates