CPT 99416 pays $12.69 in a non-facility setting and $12.69 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $10.79 in Arkansas to $14.93 in District of Columbia, a 38% spread.
National non-facility rate
$12.69
Office and other outpatient settings
Hospital and ASC settings
District of Columbia
Arkansas · 38% 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 |
|---|---|---|---|
| District of Columbia | $14.93 | $14.93 | |
| California | $14.80 | $14.80 | |
| Washington | $14.35 | $14.35 | |
| New Jersey | $14.28 | $14.28 | |
| Hawaii | $14.24 | $14.24 | |
| New York | $14.24 | $14.24 | |
| Massachusetts | $14.17 | $14.17 | |
| Connecticut | $13.71 | $13.71 | |
| Colorado | $13.41 | $13.41 | |
| Alaska | $13.35 | $13.35 | |
| Oregon | $13.26 | $13.26 | |
| Maryland | $13.24 | $13.24 | |
| New Hampshire | $13.16 | $13.16 | |
| Rhode Island | $13.06 | $13.06 | |
| Florida | $13.05 | $13.05 | |
| Minnesota | $12.82 | $12.82 | |
| Puerto Rico | $12.82 | $12.82 | |
| Virgin Islands | $12.82 | $12.82 | |
| Montana | $12.69 | $12.69 | |
| Nevada | $12.65 | $12.65 | |
| Wyoming | $12.61 | $12.61 | |
| Illinois | $12.58 | $12.58 | |
| Delaware | $12.51 | $12.51 | |
| North Dakota | $12.49 | $12.49 | |
| Texas | $12.48 | $12.48 | |
| South Dakota | $12.47 | $12.47 | |
| Pennsylvania | $12.46 | $12.46 | |
| Vermont | $12.40 | $12.40 | |
| Virginia | $12.38 | $12.38 | |
| Arizona | $12.26 | $12.26 | |
| Georgia | $12.19 | $12.19 | |
| Michigan | $12.07 | $12.07 | |
| Maine | $12.02 | $12.02 | |
| Wisconsin | $11.94 | $11.94 | |
| Utah | $11.92 | $11.92 | |
| North Carolina | $11.74 | $11.74 | |
| New Mexico | $11.73 | $11.73 | |
| South Carolina | $11.70 | $11.70 | |
| Missouri | $11.67 | $11.67 | |
| Louisiana | $11.63 | $11.63 | |
| Indiana | $11.62 | $11.62 | |
| Ohio | $11.62 | $11.62 | |
| Idaho | $11.53 | $11.53 | |
| Nebraska | $11.53 | $11.53 | |
| Iowa | $11.44 | $11.44 | |
| Tennessee | $11.41 | $11.41 | |
| Kansas | $11.34 | $11.34 | |
| Oklahoma | $11.30 | $11.30 | |
| Kentucky | $11.29 | $11.29 | |
| West Virginia | $11.22 | $11.22 | |
| Alabama | $11.00 | $11.00 | |
| Mississippi | $10.89 | $10.89 | |
| Arkansas | $10.79 | $10.79 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates